Associated Press - Tuesday, Nov. 28, 2000
Geir Moulson, Associated Press Writer

However, they warned, the worst is still to come for the continent, with even that progress fragile and the economic effects only beginning to bite.

The United Nations' annual AIDS Epidemic Update said the number of new HIV infections in sub-Saharan Africa declined this year to 3.8 million from 4 million. That will leave 25.3 million people on the worst-affected continent infected with the disease - an increase of nearly a million.

"The decrease is just a very slight decrease - there are regional variations," said Peter Ghys, chief epidemiologist of UNAIDS, the U.N. program leading the fight the epidemic. "The need for prevention programs is as great as ever. The numbers are still huge."

The number of people living with the virus worldwide is expected to rise to 36.1 million by year's end - with 5.3 million of those people newly infected.

The 27-page report said part of the turnaround was due to campaigns in countries such as Uganda that have urged caution and persuaded teen-agers to delay having sex by up to three years.

But, it said, "the epidemic in many countries has gone on for so long that it has already affected many people in the sexually active population, leaving a smaller group of people still to acquire the infection."

UNAIDS said progress will depend partly on how the epidemic develops in Nigeria, Africa's most populous nation, which so far has fared relatively well.

Even if infections slow, the full effect of the AIDS epidemic is only now making itself felt on African economies.

Three million people worldwide, up from 2.6 million last year, are expected to die of AIDS this year. Of them, 2.4 million are in Africa.

With deaths mounting, "we're only at the beginning of the impact," said Peter Piot, executive director of UNAIDS. "It's measurable now in terms of gross domestic product. It kills the people who are supposed to develop countries."

Swaziland estimates it will have to train twice as many teachers as usual over the next 17 years just to keep services at their 1997 levels, the report said. Together with sickness and death benefits for teachers, the country estimates the extra costs will add up to $233 million.

As more people develop full-blown AIDS and die, the disease could slash 17 percent from South Africa's gross domestic product and wipe $22 billion off the national economy over the next decade, the report said.

In neighboring Botswana, which has the world's highest rate of HIV infection, it is estimated that a shrinking economy and tax base will remove 20 percent from the government budget by 2010, while spending on health and social support is forced up. The country already is importing white-collar workers.

UNAIDS urged the rest of the world to finance a full-scale assault on AIDS in Africa. It said an annual $3 billion investment could make a massive difference to prevention and basic care on the continent.

That figure compares with an estimated $52 billion spent in the United States on coping with obesity and Africa's $198 billion in foreign debt. But in Washington, the World Bank said that not enough governments are taking advantage of loans available for AIDS prevention and treatment, though it has offered "unlimited resources" to any nation with a "well-designed national HIV/AIDS program."

While infections dropped in Africa, they surged in Eastern Europe and the former Soviet Union, where the number of people living with the virus is expected to increase this year by close to two-thirds, to 700,000 from 420,000.

In Russia, the figure more than doubled. Drug addicts who share needles accounted for most of the cases.

"We believe that there is still potential for a lot of growth," Ghys said.

"Also, there is potential for the spread of HIV from the group of injecting drug users to the general population through heterosexual relations" - something that already is happening in Ukraine, Ghys added. The report was released ahead of Friday's World AIDS Day, this year themed "Men Make a Difference."
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