United Press International - Wednesday, June 28, 2000
John Zarocostas

The longer we wait, the higher will be the bill, Piot said.

In Botswana, the most infected country in the world, over 35 percent of the population or 1 in 3 adults has HIV, the virus that causes AIDS, said Piot, in launching the latest report on the global HIV/Aids epidemic.

In neighboring South Africa, he said 4.2 million people are living with HIV/Aids and warned "it all happened in front of our eyes and we had the means to prevent it,".

Asked by reporters to explain the sharp increase, from the low infection levels of the early 1990s, Piot said the legacy of apartheid and the fact that governments have not intervened early enough to stop the spread, played a role.

But he added there are many elements we don't know.

He said that as a result of the spread of the epidemic many African countries are facing "a development crisis unprecedented in modern times."

Already, it has left over 30 million child orphans, and is taking its toll on agriculture, business, and critical segments of the population such as teachers.

Piot said the fight against AIDS must be made the heart of development aid and warned poor countries would not be able to achieve sustainable development without a cut in AIDS.

Piot told reporters that for Africa alone, in which there are now 16 countries with more than one tenth of the adult population (aged 15-49) is infected, there is an urgent need to mobilize resources to reduce the spread and the impact of the pandemic.

Dr. Bernhard Schwartlnder, head of UNAIDS' epidemiology evaluation team, said at the end of 1999, 34.3 million people were living with HIV/AIDS, and that the disease had already claimed 18.8 million people, including 3.8 million of them children.

The report concludes that of the 34.3 million "barring a miracle, most will die over the next decade or so."

Schwartlander said in 1999 alone, 5.4 million people were newly infected with AIDS and that 2.8 million died last year alone, which ranks AIDS as the fourth major cause of death behind cardiovascular, and respiratory infections.

Piot said that Africa remained the worst affected with 4 million new infections just last year alone.

In comparison, the number of new infections in the United States has remained stable over the last decade at around 40,000 per year, the experts said.

In 1999 Sub-Saharan Africa, which the report said had 24.5 million people living with HIV/AIDS, accounted for 2.2 million deaths, or more then three quarters of the global total.

But on a brighter note, Piot said that there are also some successes in the areas of prevention.

He said that in wealthy countries such as Western Europe where care and drug therapy for infected people has increased, the mortality rate due to AIDS has collapsed quite dramatically in the last four years.

Uganda, which has launched a widespread prevention campaign, has managed to reduce the share of the population infected from 14 percent a few years ago to less then 8 percent today, Piot said.

Piot noted that Zambia, which has also launched an awareness campaign, has also seen a decline in the number of young people with new infections.

The campaign in Thailand is also reducing the numbers, while the level of condom use by sex workers in Cambodia, the most affected country in Asia, has also increase to 75 percent, Piot said.

In Brazil use of a condom has become the norm for intercourse, he said.

The U.N. AIDS chief said that the Southern African experience is a warning for other regions such as Asia, Eastern Europe and the Caribbean (in particular Haiti) where the epidemic has not yet become a major problem.
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