South African Press Association (Johannesburg) - July 5, 2002

In an interview in Barcelona he said, "This is the first time there has been a comprehensive plan for African development, and yet, although HIV, with armed conflict, is one of the most significant challenges in Africa, there is not a significant approach to dealing with HIV/Aids in that development plan.

"Aids is a global political issue and accountability is shifting to top political leaders.

Aids should be a bigger part of Nepad. In Eastern Europe it should be an issue for (Russian Federation president Vladimir) Putin and not just a deputy Minister of Health. It should be top of the political agenda."

But it is not merely countries of high infection that are showing political inertia in coming to terms with an epidemic that is claiming 14000 new infections a day. At the recent G8 summit in Canada, African appeals for agricultural subsidies to be removed, allowing produce from developing nations onto world markets, were flatly rejected.

This is despite the head of the World Trade Organisation noting that such a move would improve profitability in world trade.

And the 2002 report from UNAids released this week notes that: "Greater access to high income countries markets, debt relief and more development aid will go a long way toward enabling countries to reduce poverty. High-income countries spent more than US300-billion (about R3018-billion) in 2001 on agricultural subsidies roughly equivalent to the combined gross domestic product of all of sub-Saharan Africa.

Piot observed that the G8 communique confined Aids to a single paragraph, it said something to the effect that without combating Aids, African development would be a pipe dream "but then we saw no action, no commitment from the G8 to increase resources".

But too, UNAids is coming under fire following the release of its 2002 Report On the Global Aids Epidemic, which it says is proving "far worse than predicted", this after only two years ago suggesting Aids was starting to plateau in southern Africa.

Instead the United Nations seems to have fallen victim to its own PR-speak and a groundless optimism that HIV would find "a natural limit beyond which it would not grow", as its 2002 report puts it.

Instead infections are leaping ahead: in Botswana infection rates in pregnant women stood at 38,5 percent in 1997, by 2001, despite Botswana introducing one of the most progressive prevention and treatment programmes in African in recent years, infections had risen to 44,9 percent, and as high as 55,6 percent in women aged 25 to 29. Similarly in Zimbabwe, infections rose from 26 percent in 1997 to 35 percent in 2000.

In the report Piot, observes, "We now know that the epidemic is still in its early stages and that effective responses are possible but only when they are politically backed and full-scale HIV, if left to run its natural course will cause devastation on an unprecedented scale."

China this week denied UNAids reports that it is facing "catastrophe".

UNAids says: "It is estimated that around 850000 Chinese were living with HIV/AIDS in 2001 with reported HIV infections having risen more than 67 percent in the first six months of 2001."

However, China gives no evidence that UNAids is wrong.

UNAids says the "estimated number of people now living with HIV/Aids in the Russian Federation is thought to be around four times higher than reported figures" of 173000 in 2001.

However, not all research reports are balanced, UNAids, notes, as a further example, that research in South Africa suggests that 55 percent of girls claim they use condoms while having sex, but it fails to urge caution when viewing that claim, because government figures show that the highest rate of HIV infection is in girls aged 13 to 19, and the age of sexual commencement in South Africa is, on average, 12.

Science magazine in its pre-conference edition hailed the Durban 2002 International Aids conference as being a wake up call for the world.

But it says: "Despite campaigns launched after Durban that have slashed drug prices and raised billions of dollars for Aids treatment and prevention in developing countries only a tiny fraction of the worlds poor receive medication to protect them from HIV."

Indeed UNAids says that less than 30000 people receive anti-retrovirals in all of Africa, of which around 25000 are medical aid recipients in South Africa. This is despite the fact that the price of anti-retroviral medication has dropped from around US10000 (about R100600) per year two years ago, to as low as US350 (about R3500) per person per year now in some areas of the world, most particularly the developing world.

Piot says, "In the last two years the speeches and words have come right, the United Nations General Assembly (UNGASS) for the first time saw political endorsement from all member states with many important decisions including the recognition that treatment, care and support were integral."

UNAids is about to send out a questionnaire to all UN General Assembly Special Session (UNGass) signatory governments to map how much progress is being made toward 2003 and 2005 commitments.

By 2003, as an example, signatory nations have pledged to "have in place strategies, policies and programmes that identify and begin to address those factors that make individuals particularly vulnerable to HIV infection, including under-development, economic insecurity, poverty, lack of empowerment of women, lack of education, social exclusion, illiteracy, discrimination, lack of information and/or commodities for self protection, all types of sexual exploitation of women, girls and boys, including for commercial reasons".

An ancillary set of surveys and studies by UNAids missions in various countries will assess the veracity of government responses to the questionnaires. However, despite the UNAids report saying that political commitment was increasing the US10-billion (about R100,6-billion) needed each year to fight HIV/Aids mooted by UN secretary general Kofi Annan last year, only US2,8-billion (about R281,6-billion) of that amount has been met.

While carpets are still being laid, offices constructed, and computers installed at Barcelonas Fira conference centre, hope is already slim that powerful new commitments will come to fight an epidemic that is sweeping across the world.
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