Inter Press Service - July 29, 2008
Nergui Manalsuren

Peter Piot, the head of UNAIDS, said Tuesday that in overall terms, there has been enormous progress with real results.

The 2008 "Report on the Global AIDS Epidemic" estimates 33 million people were living with HIV worldwide in 2007, including 2.7 million new infections, down from 3.0 million, and 2.0 million deaths that are down from 2.2 million in 2005.

However, the total number of HIV-infected children is up from 1.6 million in 2001 to 2.0 million in 2007 -- and 90 percent live in sub-Saharan Africa.

Sub-Saharan Africa remains on the top of the list, with two-thirds, or 67 percent, of all people living with HIV worldwide.

Globally, the most affected people are injected drug users, sex workers, and men who have sex with men, while the percentage of the rest of adults living with HIV has stabilised, according to the report.

An increase in HIV infections is also reported among married couples. "We see it in Thailand, Cambodia, also in some places in Africa," Piot told IPS.

"These men were infected through commercial sex, or injecting drug use in some other places, and now they are infecting their regular partners, their wives. This is how it goes in the communities that are the next wave of the epidemic," he added.

The report highlighted the vulnerability of young people, with 45 percent of all new adult infections that occurred in 2007 among the 15 to 24 age group.

Thoraya Ahmed Obaid, the executive director of UNFPA, the U.N. Population Fund, said that there will not be significant progress in reversing the epidemic without sustained success in reducing new HIV infections, particularly among young people, pointing out that half of all people on Earth are under the age of 25.

"There has been progress in the most affected countries in young people delaying their first sexual encounter, reducing multiple concurrent partners and in using condoms," however, "many young people continue to lack accurate and comprehensive information to protect themselves from infection," Obaid said Tuesday.

Seven of the world's most affected countries have reported positive changes in sexual behaviour among young people, who increased their use of condoms and abstained from sex longer: Burkina Faso, Cameroon, Ethiopia, Ghana, Malawi, Uganda, and Zambia.

In terms of prevention, the report shows that from 2005 to 2007, the percentage of HIV-positive pregnant women receiving antiretroviral drugs to prevent mother-to-child transmission (PMCT) increased from 14 percent to 33 percent.

Argentina, the Bahamas, Barbados, Belarus, Botswana, Cuba, Georgia, Moldova, the Russian Federation, and Thailand have achieved close to universal access, with more than 75 percent coverage of PMTCT, noted report.

"We have achieved more in the fight against AIDS in the last two years than in the preceding 20 years," said Piot.

However, he expressed concern over the rise of new HIV infections in China, Indonesia, Kenya, Mozambique, Papua New Guinea, the Russian Federation, Ukraine, and Vietnam, as well as in developed countries such as Germany, Britain and Australia.

In Russia, methadone to treat heroin addiction is illegal, even though the country is home to 69 percent of HIV-infected people in the Eastern European and Central Asian regions.

Methadone is the most proven strategy to prevent infection among drug users, Joe Amon, director of the HIV/AIDS programme at Human Rights Watch, told IPS.

"Russian health authorities view that it is not sufficiently shown that methadone is an effective medicine, despite the fact that the WHO [World Health Organisation] includes methadone on its list of essential medicines, and the medical and public health communities published repeated studies which have shown its effectiveness," Amon said.

Asked by IPS what he thinks of Piot's assertion that this year's report was "undoubtedly the most positive", Amon replied that "It's hard to suggest that it's been the most positive report so far. The picture can't be seen as positive with over two million new infections this year -- [it's just] comparing a bad situation with a worse situation."

"I think it's important that the report shows that the epidemic globally is stabilising, but what's critical to understand is that there's not a single global epidemic," he added. "There is an epidemic in different countries, regions in the world, and what we need to focus on is the countries where there hasn't been success, where the epidemic is getting worse."

In Amon's view there's still a long way to go. "I don't think we'll have a positive report until we see progress in all countries with epidemic," he said.

He urged the U.N. to do more in holding governments accountable for commitments they make, and to look closely at their ability of what they can deliver.

"We know how it works, we've got countries that have been successful, and we've got research which demonstrates comprehensive evidence-based, human rights-based strategies that work. HIV treatment reaching a large number of people in countries helps to reduce both stigma and also reduce infectiousness, and by achieving universal access we can turn the epidemic around," Amon told IPS.

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