Press Release WHO/66
23 November 1999
AIDS NOT LOSING MOMENTUM -
HIV HAS INFECTED 50 MILLION,
KILLED 16 MILLION,
SINCE EPIDEMIC BEGAN
In Africa HIV-positive women now outnumber infected men by 2 million.
Countries of former Soviet Union see infection rates double in just two years.
Strong prevention efforts, care programmes, find success in certain regions.
LONDON, 23 November � Since the beginning of the AIDS epidemic, 50 million
individuals worldwide have been infected with HIV, of whom more than 33
million are still alive and over 16 million have died, according to a report
issued today by the World Health Organization (WHO) and the Joint United
Nations Programme on HIV/AIDS (UNAIDS). The report, entitled AIDS Epidemic
Update - December 1999, was released in advance of World AIDS Day,
commemorated each year on 1 December. It shows that AIDS deaths reached a
record 2.6 million this year and that new HIV infections continued unabated,
with an estimated 5.6 million adults and children worldwide becoming infected
in 1999.
"With an epidemic of this scale, every new infection adds to the ripple
effect, impacting families, communities, households and increasingly,
businesses and economies. AIDS has emerged as the single greatest threat to
development in many countries of the world," said Peter Piot, Executive
Director of UNAIDS.
"We have to ensure that health systems are capable of handling the increasing
numbers of HIV-positive people who develop AIDS. De-stigmatization, access to
health care and low-cost measures such as the treatment of opportunistic
infections become important. WHO is working with Ministries of Health across
the world to ensure that adequate facilities and resources are made available
to the millions of people likely to develop AIDS in the coming years," said
Gro Harlem Brundtland, Director-General of WHO.
AIDS develops in an HIV-positive person after years of infection, as HIV
steadily weakens the body's immune system and increases its vulnerability to
pneumonia, tuberculosis, diarrhoea, tumours and other illnesses. With the
number of people infected with HIV continuing to rise, the number of people
falling sick and dying of AIDS will multiply.
HIV-positive women now outnumber HIV-positive men in Africa
In sub-Saharan Africa � still the global epicentre of the epidemic � new
evidence shows clearly for the first time that women infected with HIV
outnumber men. "Ten years ago, it was hard to make people listen when we were
saying AIDS wasn't just a man's disease," said Dr Piot. "Today, we see the
evidence of the terrible burden women now carry in Africa's epidemic."
Fifty-five percent of infected adults in sub-Saharan Africa are women, which
means more than six HIV-positive women for every five HIV-positive men.
UNAIDS and WHO estimate that 12.2 million African women and 10.1 million
African men aged 15-49 are living with HIV at the end of 1999.
Studies in several countries have found that African girls aged 15-19 are
five to six times more likely to be HIV-positive than boys the same age. Ease
of male-to-female sexual transmission, and sex with older, infected men
appear to be contributing factors to girls' greater vulnerability to HIV.
According to the United Nations Development Programme (UNDP), a number of
African nations suffered downward changes this year in the Human Development
Index, a ranking based on levels of health, wealth and education. Almost all
of the major changes in rank could be attributed to declining life expectancy
as a result of AIDS.
Life expectancy at birth in southern Africa, which climbed from 44 in the
early 1950s to 59 in the early 1990s, is expected to drop back to 45 sometime
between 2005 and 2010.
UNDP estimates that fewer than 50% of South Africans currently alive can
expect to reach the age of 60, compared with an average of 70% for all
developing countries and 90% for industrialized countries.
According to a survey of commercial farms in Kenya, illness and death have
already replaced old-age retirement as the leading reason why employees leave
service.
Yet there are reasons for optimism even in this most devastated region: a
number of African countries have demonstrated a much stronger commitment to
fighting AIDS than ever before. "I believe we are now at a turning point in
the 20-year history of the AIDS epidemic in Africa. Everywhere I go, I hear
the top African leaders speaking out about AIDS as the major threat to the
continent's development", said Dr Piot. "This gives me grounds for hope that
in the coming years, we will see stronger, more effective responses to AIDS
in many more sub-Saharan African nations � responses to complement the strong
programmes that already exist."
Injecting drug use in former USSR fuels world's steepest HIV increases
The report further reveals that the world's steepest HIV curve in 1999 was
recorded in the newly independent states of the former Soviet Union, where
the proportion of the population living with HIV doubled between 1997 and
1999. In the larger region comprising these nations and the remainder of
Central and Eastern Europe, the number of HIV-infected rose by more than a
third in 1999 alone, to reach an estimated 360 000.
In the Russian Federation, nearly half of all reported cases of HIV infection
since the start of the epidemic were recorded in the first nine months of
1999 alone.
In Moscow, three times as many cases were reported in the first nine months
of 1999 as in all previous years combined. Towns around Moscow had even
sharper rises in HIV, with over five times as many infections reported in the
first nine months of 1999 as in all previous years combined.
Preliminary studies suggest that injecting drug use is becoming increasingly
common among unemployed young people in many of the industrial cities of the
Russian Federation and Ukraine. HIV is not limited to Russia's major
metropolitan regions; in the Siberian city of Irkutsk, nearly 1300 infections
have been reported, most of them in 1999.
Injecting drug use appears to be well established even among Russian
schoolchildren. An outreach programme for drug injectors in St Petersburg
reported that the caseload for clients under age 14 increased 20-fold between
1997 and the first quarter of 1999.
Strong prevention efforts, care programmes, find success in certain regions
In the report, UNAIDS and WHO also point to some countries and regions which
are managing to keep down the number of new infections or improve the
well-being of those already infected. For example, evidence continues to
mount that the strong prevention programmes of Thailand and the Philippines
have had sustained success in reducing HIV risk and lowering or stabilizing
HIV rates.
In India, major efforts to improve the tracking of the epidemic more than
tripled the number of HIV surveillance sites in 1998. Estimates now place
total HIV infections in the country at around 4 million�more than in any
other country, but fewer than projected on the basis of earlier surveillance
estimates. Consequently, the regional estimate of HIV infections in Asia has
been revised downward by 800 000.
The AIDS Society in the Indian state of Tamil Nadu has enlisted the support
of an advertising agency to encourage safer sexual behaviour, airing
television advertisements during major sporting events. Casual sex among
factory workers in the state reportedly fell by half between 1996 and 1998,
while condom use with casual partners rose from 17% to 50%.
Some Latin American countries have joined the ranks of those providing
antiretroviral drugs to people infected with HIV. Brazil, for example, spent
an estimated US $300 million to treat some 75 000 people in 1999. Brazilian
health officials said the considerable expense was offset in part by savings
in hospitalization and medical care; the country averted an estimated US $136
million in such costs between 1997 and 1998.
"Providing care to growing numbers of HIV-positive people when health systems
are already overburdened is no straightforward task. But these examples show
how countries around the world can make a difference in fighting the epidemic
through both prevention and care. WHO has shown how relatively inexpensive
modifications and additions to health-care systems can bring major benefits
to people with HIV. Everyone, and every country, can learn and benefit from
these examples," said Dr Brundtland.
No room for complacency
Releasing the report, UNAIDS Executive Director Peter Piot also urged
industrialized nations to put more emphasis on HIV prevention efforts. "There
is no room for complacency in any discussion of this epidemic. The threat of
HIV has not diminished in any country. We have even seen evidence from North
America and Western Europe suggesting that availability of life-prolonging
therapies may be contributing to an erosion of safer sexual behaviour. This
is tragic," Dr Piot said.
"While antiretrovirals have brought hope to many people with HIV who are
fortunate enough to have access to them, they are not a panacea, and they are
not available in most of the world", Dr Piot said. "The key to fighting AIDS
is preventing new infections. For this more resources are needed � to
implement the prevention strategies we have today, and to develop new and
better tools, such as microbicides and a vaccine."
Dr Brundtland added, "While prevention is the most promising strategy for
managing the AIDS epidemic in the long term, we cannot lose sight of the fact
that millions of people are infected today. For them, we must do a much
better job of increasing access to health care and support, including
inexpensive antibiotics that can add many months to the lives of people
already sick with AIDS, to palliative therapies that can help increase
comfort and reduce suffering, and to psychological and social support for
patients and their families. WHO and UNAIDS will continue to engage the
pharmaceutical industry to make new HIV-related drugs available at affordable
prices for those in need."
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Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41
22) 791 48 58. E-Mail: [EMAIL PROTECTED]
All WHO Press Releases, Fact Sheets and Features as well as other information
on this subject can be obtained on Internet on the WHO home page
http://www.who.int
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