Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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The San Francisco Examiner; April 21, 1998
Lisa M. Krieger, Examiner Medical Writer
"We know what works. We've shown it's effective. What we need now is the money to implement them," said Martha Bulter deLister, director of the Dominican Republic AIDS organization Fundacion Genesis.
"We can't wait for a vaccine," she said.
If affluent governments, corporations and individuals dug deeper and spent 10 to 15 times more on global prevention programs, the number of new HIV infections could be reduced by as much as half, according to United Nations calculations presented at the three-day meeting.
Hard-hit regions
HIV infection is rampaging through Africa, the Caribbean, Latin America and Southeast Asia, but many countries are unable to afford something as simple as a blood test to keep their blood supply clean.
Nor can they afford testing and counseling of HIV-infected people to warn against transmitting the infection to others. And sexually transmitted diseases, known to boost the risk of HIV infection, go untreated.
Furthermore, mothers pass on the virus to their infants because they lack access to the brief AZT drug regimen that could interrupt deadly viral transmission.
While much of the globe is riveted by fancy three- and four-drug anti-viral regimens, costing $25,000 to $37,000 per person a year, an estimated 16,000 men, women and children in developing countries are newly infected each day.
Conference co-chair Margaret Chesney of the UCSF Center for AIDS Prevention Studies, working with AIDS specialists from 38 different nations, sought practical and affordable solutions to the growing epidemic.
They estimated that it costs:
*50 cents to test blood for the AIDS virus.
*Several dollars to cure a sexually transmitted disease.
*$50 to give an infected mother a short course of AZT to prevent transmission of the virus to her baby.
Worldwide, about $1.5 billion has been spent each year on comic books, radio spots and condom rallies in developing nations. But such prevention efforts have proved to be mere speed bumps, not roadblocks, in the path of HIV.
Supplies are limited
Blood testing is the official "standard of care" in most nations, but that is no assurance that it actually happens. Some nations, such as Uganda and Kenya, have a supply of blood-testing kits - but then use them up, and run out. In other nations, the kits are available in the capital, but not rural regions.
Pharmaceutical companies should help serve the communities that volunteer for drug and vaccine testing, the experts urged.
And multinational corporations that do business in poor nations should consider contributing to the anti-HIV effort. Without effective AIDS prevention, the countries' "work force would be wiped out . . . their talent would be wiped out," said Thomas J. Coates, director of the UCSF AIDS Research Institute and workshop co-chair.
The disparity between rich and poor nations has increased dramatically over the course of the epidemic. In 1980, about twice as many adults were infected in sub-Saharan Africa as in North America. Today, 14 times as many are infected there.
The cumulative number of HIV infections among adults around the world has more than doubled from about 10 million in 1990 to almost 25.5 million by mid-1996. HIV has disproportionately devastated the developing world. In 1996, 93 percent of HIV-infected people were in the the developing world.
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