Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
Newsday - June 28, 2000
Laurie Garrett, Staff Writer
In grim country-by-country detail, the report shows that the epidemic in many nations-particularly in southern Africa-has reached such extreme devastation that it is unlikely their economies, industries or public infrastructures would be able to recover for generations to come-even if the spread of HIV ceased today.
"Subsaharan Africa remains the hardest hit," UN AIDS executive director Dr. Peter Piot said in a Geneva press conference. "We have now 16 countries [in that region] in which more than one out of 10 adults is infected with HIV. And in seven countries, at least one out of five is living with HIV."
Hardest hit is Botswana, where 35 percent of adults ages 15 to 49 are now infected. There, and in the six other hardest-hit African nations, UN AIDS predicts that two-thirds of all children now age 15 will eventually die of AIDS. In the other 10 African nations where more than 10 percent of adults are infected, the forecast is that half of all teenagers now age 15 will eventually die of AIDS.
The report went on to say that in virtually any country where 15 percent or more of the adult population is infected, even an aggressive HIV-prevention campaign won't preserve the lives of today's children-"at least 35 percent of boys now aged 15 will died of AIDS," it said.
"I believe we're only at the beginning of the actual impact on society of AIDS," Piot said. "AIDS is really now a development crisis."
Throughout Africa, Asia and, to a lesser degree, Latin America and the former Soviet Union, HIV is spreading at rates that defy even worst-case computer projections a decade ago, Piot said. And UN AIDS experts are hard-pressed to tell whether the epidemic's toll will keep rising, eventually claiming more than half of some nations' populations.
To put the "catastrophe," as UN AIDS calls it, in perspective: HIV has a prevalence rate in the United States of 0.6 percent of the population, and the highest prevalence in any European society is 0.7 percent, in Portugal. In contrast, in Botswana the adult female prevalence of HIV is 36 percent. In South Africa and Zimbabwe it's 26 to 27 percent. The highest prevalence in Asia is 3.1 percent among adult females in Thailand.
In the United States, Europe and Asia the repercussions of the pandemic are manageable, perhaps even minimal, for society as a whole. But that's not the case in subsaharan Africa, UN AIDS says, where the epidemic is causing severe and irreversible damage to businesses, educational systems, family structures, agricultural production and government function.
"Consider the example of education," Piot said. "The epidemic is killing off teachers well before they reach retirement age."
In 1998, Zambia lost almost as many teachers to AIDS as it trained that year. The nation has been unable to train new teachers fast enough to replace those who are ailing or dead. Across Africa, school systems are operating on less revenue, as AIDS-beleaguered families are unable to pay their children's fees. And there are now 30 million youngsters who have lost one or both parents to AIDS; they have no money for school fees.
The report was timed for release to influence the bi-annual world AIDS Conference, which convenes July 9 in Durban, South Africa. Piot said few significant scientific advances have been made in the war on HIV since the last gathering in Geneva in July, 1998.
"But there have been political advances," Piot said, noting heightened levels of resolve within the United Nations, at the White House, within the G-8 Summit, and among African heads of state.
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