USIS Washington File - November 21, 2005
Judy Aita, Washington File United Nations Correspondent

"The fundamental message of the report is that we must scale up prevention and scale it up immediately," said Dr. Jim Kim, director of the World Health Organization's (WHO) department of HIV/AIDS. "Prevention efforts have indeed worked -- but we have known that for quite some time. We've known that for every form of transmission of the virus, we have effective ways of preventing transmission."

"We can prevent mother-to-child transmission in almost 100 percent of the cases now. In the U.S. and other developed countries mother-to-child transmission has been cut almost to zero," Kim said at a press conference at U.N. headquarters. "We have the means to do that in developing countries as well. We have all the drugs and the protocols are easily carried out in any developing country. We just haven't done it."

Kim briefed on AIDS Epidemic Update 2005, the annual report on the state of the epidemic released by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the WHO. (See related article.)

ACCESS TO TREATMENT IMPROVES

Access to treatment has improved markedly, however, he said. More than 1 million people are on treatment. While the WHO/UNAIDS goal to get 3 million into treatment programs by the end of 2005 will not be reached, "dramatic movement in over 50 countries to scale up access to treatment" has been achieved, Kim said at one of 19 news conferences worldwide where the results were unveiled.

"Because there are over [1] million people who are now on treatment, we estimate that we averted between 250,000 and 350,000 deaths" in 2005, Kim said.

Dr. Desmond John, director of the New York office of UNAIDS, said that prevention strategies must be pursued in sustained and intensive ways to be effective.

"We've seen sustained application of these programs in Uganda and Tanzania reduce HIV among young people. Efforts in Western Europe and North American have reduced HIV prevalence among men who have sex with men. In Thailand and Cambodia [preventive measures] among sex workers have had a similar impact," John said.

In the growing epicenter of the epidemic in India, prevention efforts between 2001 and 2004 have resulted in a rise in condom use to 85 percent and HIV prevalence among sex workers has dropped from 7 percent to 4 percent, he said.

Treatment and prevention go hand-in-hand, and that synergy must be intensified to make a difference, the experts said.

But the reality is that fewer than one in five people who could benefit from HIV prevention services actually have access, John said, and dangerous behavior continues. Drug use and unprotected sex is fueling significance epidemics in Latin America, Eastern Europe and Asia, but prevention efforts are failing to address that gap, he said.

"Universal access to prevention, treatment, care, and support has to be our ultimate goal," John said. "We have to reach out and get the services to all who need it."

PEOPLE LIVING WITH HIV/AIDS SURPASSES 40 MILLION

In 2005 the number of people living with HIV/AIDS surpassed 40 million, up from 37.5 million. More than 3.1 million died, including an estimated 570,000 children, according to the 2005 UNAIDS/WHO report. Over the past two years the steepest increases in HIV infections have been in Eastern Europe and Central Asia with a 30 percent increase, but sub-Saharan Africa remains the hardest hit area with 65 percent of all new infections worldwide.

The updated figures also show that Asia has a worsening trend with several countries, including Pakistan and Indonesia, on the brink of rapidly expanding epidemics.

Since 1981, more than 25 million people have died from AIDS making it one of history's most destructive epidemics, Kim said.

Nevertheless, there are some bright spots in the report, Kim said. In the past three years Kenya, Zimbabwe, Uganda and some countries in the Caribbean have shown real declines in HIV rates. In Burkina Faso, he added, HIV rates among pregnant women under 25 dropped from 4 percent in 2001 to less than 2 percent in 2003.

In Haiti, he said, the epidemic "could be turning the corner." HIV prevalence among pregnant women in urban areas has dropped from 9 percent in 1993 to 3.7 percent in 2004 due to behavior change -- reduction in the number of partners and more abstinence. (See related article.)

"We know behavior change has had significant impact on [the] epidemic" in Haiti, Kim said.

Stemming the spread of HIV/AID worldwide is a priority for the United States. U.S. support for AIDS treatment programs has served 235,000 people around the world in fewer than 18 months, keeping the President's Emergency Plan for AIDS Relief well on target to provide virus-inhibiting drugs to 2 million people over the next several years. (See related article.)

The U.N. report, available on the UNAIDS Web site in English, French, German, Russian and Spanish, was released in advance of World AIDS Day, December 1. For additional information, see HIV/AIDS.

051121
US051103