AEGiS-WSJ: 20 Years of AIDS: The Problem: AIDS Ravages the Poorest Countries

20 Years of AIDS: The Problem: AIDS Ravages the Poorest Countries

Wall Street Journal - May 30, 2001
Paul Cheung

The table below lists the 1999 GDP per capita* vs. HIV adult prevalence rate for these 45 countries:

Group A			Group B			Group C
HIV adult rate more than 5% GDP per capita less than $5,000			HIV adult rate less than 5% GDP per capita less than $5,000			HIV adult rate less than 1% GDP per capita more than $5,000
1. Botswana	35.80%	$3,775.70	14. Ghana	3.60%	$413.83	30. Argentina	0.69%	$7,741.01
2. Zimbabwe	25.06	471.08	15. Dominican Rep.	2.80	2,070.07	31. U.S.	0.61	32,894.01
3. Zambia	19.95	318.78	16. Thailand	2.15	2,064.36	32. Spain	0.58	15,121.06
4. South Africa	19.94	3,114.20	17. Senegal	1.77	511.79	33. Switzerland	0.46	36,231.78
5. Namibia	19.54	1,807.12	18. Ukraine	0.96	773.83	34. France	0.44	24,433.86
6. Malawi	15.96	167.79	19. India	0.70	448.41	35. Italy	0.35	20,313.12
7. Kenya	13.95	361.72	20. Brazil	0.57	4,474.12	36. Canada	0.30	20,822.26
8. Mozambique	13.22	229.99	21. Costa Rica	0.54	4,220.53	37. Denmark	0.17	32,722.49
9. Rwanda	11.21	235.42	22. Venezuela	0.49	4,311.89	38. Greece	0.16	11,870.18
10. Ethiopia	10.63	102.56	23. Chile	0.19	4,492.58	39. Australia	0.15	21,301.89
11. Uganda	8.30	298.49	24. Russian Fed.	0.18	2,745.84	40. U.K.	0.11	24,231.40
12. Tanzania	8.09	266.09	25. China	0.07	789.30	41. Germany	0.10	25,724.00
13. Haiti	5.17	551.34	26. Indonesia	0.05	688.39	42. Israel	0.08	16,517.61
*GDP per capita in current dollars			27. Bangladesh	0.02	360.00	43. Sweden	0.08	26,947.19
			28. Romania	0.02	1,515.16	44. Hong Kong	0.06	23,649.77
			29. Yemen	0.01	400.35	45. Japan	0.02	34,344.00

Population vs. HIV Population

Many African and some Asian countries have a greater proportion of the world’s AIDS victims relative to their overall share of the world population.

	Botswana	South Africa	Thailand	India	Brazil	U.S.
Est. 2000 Population	1.6 million	42.8 million	60.7 million	1.02 billion	170.1 million	281.6 million
Percentage of world's total population	0.03%	0.70%	1.00%	16.80%	2.80%	4.70%
’97 Per capita health spending	$131	$268	$143	$23	$19	$4,004
’99 People living with HIV/AIDS	290,000	4.2 million	755,000	3.7 million	540,000	850,000
Percentage of world’s total people (adults and children) living with HIV/AIDS	0.90%	12.40%	2.20%	10.90%	1.60%	2.50%
Sources: World Bank, World Development Indicators; UNAIDS report; WHO Health Report 2000; IMS Health; FDA; Pharmaceutical Research and Manufacturers of America

Obed Ndwandwe, who is living with AIDS, undresses at his house in Hiabisa, South Africa

A Thai nurse talks to an orphaned AIDS patient in Bangkok

Doctors examine an AIDS patient in New York

The Hope: More Drugs and Vaccines

Because the AIDS virus quickly mutates and develops resistance to existing drugs, new classes of drugs are needed. Since the 1980s, a plethora of drugs has been released to manage and suppress the virus:

Year	Treatment Method	FDA Approved Drugs (Generic name/Brand name)
1980’s	The first antiretroviral drug was introduced in 1987.	zidovudine/Retrovir (AZT)
1990’s	With the advent of protease inhibitors, an arsenal of drugs hit the market. Researchers find that combining three drugs is effective in suppressing the virus	didanosine/Videx; zalcitabine/Hivid; stavudine/zerit; lamivudine/Epivir; saquinavir/Invirase; ritonavir/Norvir; indinavir/Crixivan; nevirapine/ Viramune; nelfinavir/Viracept; delavirdine/Rescriptor; lamivudine and zidovudine/ Combivir; saquinavir/Fortovase; efavirenz/Sustiva, abacavir/Ziagen; amprenavir/Agenerase
2000	Combination drug therapies integrate different drugs into one pill, making them easier to take.	lopinavir and ritonavir/Kaletra; abacavir, zidovudine and lamivudine/Trizivir.
Looking Ahead	Currently, there are 103 medicines under development.	In testing or awaiting approval are 30 antivirals, 13 vaccines, 12 immunomodulators, and other treatments for AIDS-related cancers and infections.

The People: Searching for a Solution

The fight against AIDS is being waged on many fronts: among them are scientists searching for a cure, activists pushing for social and political changes, and international health and funding organizations scrambling to find the resources to treat the millions who are afflicted. Here are three who are at the forefront:


James Love: Mr. Love’s efforts to get lower-priced versions of AIDS drugs to sub-Saharan Africa eventually prompted Indian generic drug company, Cipla, to offer the drugs far below the prices of branded versions. Cipla’s move spurred a price war among big drug companies to export the drugs cheaply. Mr. Love directs an activist group focusing on health care.	Debrework Zewdie: Currently the principal spokeswoman for the World Bank's global action against HIV/AIDS, Ms. Zewdie develops, implements and evaluates World Bank HIV/AIDS projects. She is also the head of the AIDS Campaign Team for Africa, a unit designed to mainstream HIV/AIDS into World Bank operations in Africa.	Emilio Emini: Mr. Emini led Merck’s research group that discovered and developed the company’s protease inhibitor drug. He currently heads Merck’s efforts to find an AIDS vaccine, which have so far shown positive results in lab monkeys.

Sources: World Bank, World Development Indicators; UNAIDS report; WHO Health Report 2000; IMS Health; FDA; Pharmaceutical Research and Manufacturers of America;

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