United Press International - Tuesday, 10 July 2001
Michael Smith, UPI Science News

"This pandemic is not stabilizing," said Italian researcher Stefano Vella, president of the International AIDS Society. "It's just beginning, it's just a baby -- that's what people don't understand."

There are about 36 million people infected with HIV today and about 6 million new infections are expected this year, about 16,000 a day, Vella said. Most of those infected are in Africa, where in some countries as many as one adult in four has the illness.

Vella told the International AIDS Society's Conference on HIV Pathogenesis and Treatment in Buenos Aires that experts fear similar epidemics are in the early stages in India, China, the former Soviet Union and Latin America. If the world does not begin to take more effective action in those regions than it has done in Africa, he said, "there are hundreds of millions who will die."

Vella said the eventual numbers depend on what the world does to stop the spread of disease in the wake of the recent United Nations special meeting on acquired immune deficiency syndrome.

"It's not unreasonable at all" to project 200 million cases unless effective action is taken, he added.

Vella said he is both optimistic and pessimistic about the U.N.'s commitment to halt the disease.

"It's an opportunity to change the trend," he said. "(But) it needs an incredible effort from the North to address a catastrophe in the South -- and that has never happened before."

Vella cited the example of Botswana, a southern African nation of about 1.5 million where between 35 percent and 40 percent of adults are infected, depending on locality.

"If we had the same prevalence in the North as they have in Botswana," he said, "then in Italy, we would have 12 million" HIV infections. At that rate, the United States would have 40 million. Such a large number of HIV-infected people would overwhelm even modern health care systems, he said.

Epidemiologist Helene Gayle, director of HIV/STD/TB Prevention at the Centers for Disease Control and Prevention in Atlanta said, "The figures ... are not unreasonable when you consider that the epidemic is just beginning in India, China, the former republics of the Soviet Union and in populous African nations such as Nigeria and Ethiopia."

She said she hopes the U.N. commitment will turn things around but in China, for instance, unsafe sexual behavior is coupled to a contaminated blood supply "and that equals transmission."

"It is really anybody's guess as to how many people will be infected by this epidemic," Gayle said.

AIDS researcher Julio Montaner, a director of the Canadian HIV Trials Network, said Vella's prediction is entirely likely.

"If we don't do anything, India alone will double the HIV load to the world in 2020," he said.

Aside from humanitarian considerations, Montaner said the effect of such unchecked epidemics would be economic catastrophe around the world.

For instance, hard-hit Botswana is falling into economic chaos because of the loss of productive workers.

"If Botswana falls apart and then India falls apart and then China falls apart," Montaner said. "Then everything falls apart."

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