Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
Associated Press - Tuesday November 24, 1998
"The big rise that we had over the last year was based on some shocking findings, especially in sub-Saharan Africa, where we reached levels that we never thought could be reached," said Bernhard Schwartlaender, chief epidemiologist at the Joint United Nations Program on HIV/AIDS.
In the early 1990s, U.N. experts assumed that infection rates and patterns were the same for all countries in a region.
For Africa they took the best data, from Uganda, and projected the numbers for the whole region. But while infection rates were leveling off in Uganda, they continued to rise elsewhere, especially populous countries like Nigeria and South Africa.
By last year, more data became available.
"If you had talked to any of us a couple of years back and told us there would be levels of HIV infection of 25, 30, 40 percent in some countries, nobody would have believed that," Schwartlaender said.
The U.N. agency abandoned the regional approach and started working with each country, with more accurate figures and better knowledge of the varying patterns of infection and survival.
A year ago, the agency re-calculated the figures it released for 1996 and realized the figures for Africa were incorrect. The real number of people living with AIDS in sub-Saharan Africa was closer to 18.6 million - not 14 million previously estimated.
The agency concedes that for many countries, it can still only make estimates. "We are most comfortable with the accuracy of that number, " Schwartlaender said, though he added that researchers may be off by 20 percent to 25 percent in each direction.
The numbers need to be accurate so health workers can focus their efforts where they are most needed.
Determining the number of people who have died from AIDS is also a problem. Many death certificates list only the immediate cause of death, such as pneumonia, and don't mention AIDS. In some cultures, the stigma attached to AIDS is great and families try hard not to have the cause of death known.
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