United Press International - November 25, 2003
Ed Susman, UPI Science News

The grim statistics:

-- About 40-million people are living with the disease or infection with human immunodeficiency virus, the organism that causes AIDS.

-- An estimated 5-million more were infected with HIV in 2003 -- a 4-percent increase over 2002.

-- About 3-million died from the disease in 2003 -- an 11-percent increase over the previous year.

"The epidemic continues to deepen and spread," said Dr. Peter Piot, executive director of the Joint United Nations Programme in HIV/AIDS, known as UNAIDS, based in Geneva, Switzerland.

"In southern Africa," he said, "one in five adults -- 20 percent of this population group -- is infected with HIV." In two small countries in southern Africa -- Botswana and Swaziland -- about 39 percent of the adult population is infected, he said, an indication of how pervasive the disease is in that part of the world.

Piot said the figures cited in the new report -- despite the increases -- actually are conservative estimates, the accuracy of which has been improved by extending disease-monitoring sites into the rural areas of some of the African nations. In fact, the dismal figures for Africa, where 2.2 million new HIV infections were transmitted in 2003, are more accurate than for some areas of Asia and Eastern Europe.

Piot noted the epidemic is rapidly expanding in Eastern Europe, in Southeast Asia, and in India -- a nation that may have as many as 5-million people living with HIV, second only to the number of people infected in South Africa.

"One of my biggest concerns is what is going on in India," Piot said at a news briefing from London announcing the release of the latest report by UNAIDS, "AIDS Epidemic Update 2003." Using that nation's total population "as a denominator for the epidemic is meaningless," he said, noting 5 million is a small figure when compared with the 1-billion people living in India, but in certain districts of the Asian sub-continent, HIV incidence rates exceed 5 percent of population.

In Thailand, where governmental policy and educational influence have helped reverse a rocketing epidemic among commercial sex workers, the disease is found increasingly among young people and injecting drug users not involved in the sex trade.

Successful examples of fighting the spread of the disease remain few -- the shining example being Uganda, the east African nation that registered its 12th consecutive year of declining HIV rates. However, Piot said he has been dismayed by the reaction in Russian to combating the epidemic. "I don't see the political will there at all," he said, adding that the Russian government is devoting little money and only a low-level administrator to tackle the growing rate of infections.

"This new report is not surprising, but it is disturbing," said Dr. Paul Zeitz, executive director of the Global AIDS Alliance in Washington. "It is disturbing because we know how to prevent AIDS and how to treat it."

Zeitz told United Press International that funds to attack the disease are still needed and noted all nine Democratic presidential candidates support a $30-billion effort to fight the worldwide epidemic by 2008.

"We are still waiting for a UNAIDS report that shows the incidences of this disease are going down," he said. "The death rates are not going to go sown unless we are able to meet it with an effective response."

Piot noted the $4.7 billion spent worldwide in 2003 to fight HIV/AIDS "represents about half of what we need to mount an effective response."

Ed Susman covers AIDS and medical issues for UPI Science News. E-mail sciencemail@upi.com

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