Associated Press - Saturday, December 1, 2001

"IT'S HARD, but I have to do what I have to do," she said.

Since the first report of a new deadly disease in a U.S. government bulletin on June 5, 1981, AIDS has seeped into countries around the world, transforming and scarring societies in its path.

As activists around the globe mark World AIDS Day on Saturday, the AIDS virus has infected an estimated 60 million people, killing 22 million of them. About 13 million children have been orphaned by the disease.

In the United States and Western Europe, the disease, once a death sentence, has been transformed into a chronic, survivable illness by expensive anti-AIDS medication. However, the treatment appears to have damaged prevention efforts, and new infections have begun to grow again in the developed world.

"We never really turned back the epidemic," said Neff Walker, an epidemiologist at UNAIDS, which helps coordinate the world fight against the disease. "It just keeps going on."

Walker and other experts fighting AIDS worry about the spread of the disease through the huge population of China and the rapidly rising infections in Southeast Asia and Eastern Europe, which have the world's fastest rising rates of new infections.

WORST YET TO COME?

"Everyone feels like the worst is still to come," Walker said.

In the Ukraine, an estimated 240,000 people had the AIDS virus in 1999. Up to 80 percent of those were drug users who were infected by sharing unclean needles.

"Unfortunately, the situation continues to worsen," said Nina Horehliad of the Ukraine's Center on AIDS.

In sub-Saharan Africa, which is home to about 70 percent of the world's AIDS infections, hospitals are filled with dying AIDS patients, cemeteries are packed with bodies of people in their 20s and 30s, grandparents are forced to raise their orphaned grandchildren.

Businesses are hiring extra workers to replace those too sick to show up and those attending the endless parade of funerals.

In most countries on the poorest continent, there is no hope for those infected getting the expensive medication needed to fight the disease.

"I don't think we know what we are dealing with because the knife is coming down, and it's a silent one," said Jenny Marcus, coordinator of Community AIDS Response, a support group for people living with AIDS. "People are just quietly disappearing."

In South Africa, where 4.7 million people are infected, 420,000 children have been orphaned by AIDS and thousands of them are living in households headed by children, according to a report released in June.

Technically, Maggie is not one of them. Her brother Frederick is 18. But he is still in school and most of the domestic duties and the responsibility of raising her 11-year-old sister, Tsakane, and 10-year-old brother, Nhlanhla, fall to Maggie.

The four are raising themselves in a tiny windowless shack made of wood, tarp and cardboard in the poor township of Vosloorus outside Johannesburg. The boys sleep in one bed in a tiny, dark room with a dirt floor, the girls in another.

When they feel like it, they go to school. Often they don't.

Their father disappeared so many years ago, the children no longer remember why he left. They survive now on what little money their uncle, struggling to feed his own family, can spare.

Some weeks he gives them 50 rand ($5) to buy corn meal and sugar. Other weeks they get half that much. Local charities occasionally bring food and tattered clothing.

While Frederick dreams of borrowing a refrigerator so he can buy meat and resell it for a profit to support the family, Maggie has the burden of comforting the younger ones and helping them come to terms with their new life, even as she works to come to terms with it herself.

When they ask for new school bags, she lies and says she will buy them. When an ice cream truck drives by and the children beg for money, she has to tell them no.

"But I want ice cream, too," she said sadly.

The social devastation caused by AIDS and the government's slow efforts to battle the disease are disheartening to many AIDS workers.

"We need a mighty miracle," Marcus said.

Scientists are hoping to develop an AIDS vaccine to create a firewall of immunity around the world's infected populations.

However, even with recent encouraging developments, it could still be years before a vaccine could be widely distributed.

In that time, tens of millions of people will die and tens of millions more will be infected.

SIGNS OF HOPE

But there are other signs of hope.

New infections among young people are decreasing in Uganda, Zambia, Tanzania, South Africa, Cambodia and the Bahamas, UNAIDS says.

In Botswana, where an estimated 35 percent of adults are infected -- the highest rate in the world -- the government has announced plans to provide AIDS medication to every infected person who needs it.

A grant of $100 million from Bill Gates' philanthropic foundation and the pharmaceutical company Merck and Co. also has rejuvenated struggling private organizations working to fight the disease and the stigma it carries.

"The perspectives are different from what we saw two, three or five years ago," said the Rev. Edward Baralemwa, national coordinator for the Botswana Christian AIDS Intervention Program.

"When you have political will -- excellent political will -- and then you have the private sector backing you up and the faith-based communities with you, then you are in the process of destigmatizing AIDS. I am very optimistic."

In Vosloorus, Maggie Ubisi, too, has hope.

"The day will come when we will be able to buy ice cream like other kids," she said.

011201
AP011202

Copyright © 2001 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, Pacific Life Foundation, and donations from users like you.

Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2001. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .