Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
Wall Street Journal - July 7, 2004
Gautam Naik, gautam.naik@wsj.com
LONDON - Five million people last year were infected with HIV, the virus that causes AIDS -- the largest number in any single year since the epidemic began two decades ago, according to new data published by UNAIDS, an AIDS program sponsored by the United Nations and other groups.
Despite a huge global push to fight HIV in developing countries, the AIDS virus continues to infect a growing number of people and claim millions of lives each year, according to the report, released ahead of a major AIDS conference starting this weekend in Bangkok, Thailand. UNAIDS estimates that three million people world-wide died in 2003 because of AIDS, and about 38 million are living with HIV, up from 35 million in 2001.
Four years ago, a heady optimism had built up among public-health workers as Western nations pledged money, health groups launched dozens of HIV treatment-and-prevention programs and pharmaceuticals companies began to slash the prices of AIDS drugs. Today, while some progress has been made, the major global programs are falling short -- either in getting funding, reaching treatment targets, or both. Since the Sept. 11, 2001, attacks in the U.S., the war against terror has overshadowed the AIDS crisis on the global political agenda.
The World Health Organization estimates that more than 93% of the six million AIDS patients in the developing world who urgently need drugs aren't getting them. "The situation will get worse before it gets better," said Peter Piot, head of UNAIDS.
The fastest-growing epidemics today can be found in Asia and Eastern Europe. Even in the U.S. and Western Europe, where most people who need antiviral therapy have access to it, infection rates are on the rise. World-wide, nearly half of all new HIV cases are young people aged 15 to 24, according to the report.
The disease is erasing decades of health, economic and social progress in the hardest-hit countries of eastern and southern Africa. "AIDS is an extraordinary kind of crisis; it is both an emergency and a long-term-development issue," the UNAIDS report concludes.
The meeting in Thailand is expected to grapple with two of the biggest questions facing public-health experts: Can HIV infection rates be reduced? And for those in developing countries who already are infected, will the Western world provide enough money to buy low-cost drugs that can prolong life?
Comprehensive prevention programs could avert 29 million of the 45 million new infections projected to occur between 2002 and 2010, UNAIDS estimates. While AIDS-awareness programs have made a significant difference so far, plenty remains to be done. Only one of every five people world-wide has access to HIV-prevention services, according to the report. In sub-Saharan Africa, only 8% of out-of-school young people and slightly more of those in school have access to education on prevention.
For the longer term, many public-health experts believe a vaccine represents the best hope for reducing the infection rate. While there are efforts to increase spending toward the development of an HIV vaccine, only a fraction of global AIDS spending is devoted to this area.
While funding isn't at the levels that many would hope, the report cited "important progress" in the financial response to the AIDS crisis by Western governments, nongovernmental organizations and other groups. UNAIDS notes that in 1996 about $300 million was spent on AIDS globally. By 2003, that figure had risen to about $5 billion.
"We're entering a completely different response to AIDS," said Mr. Piot of UNAIDS. "There is now finally some money and a lot more political awareness. That's the biggest change."
Last month, one key fund-raiser, the Global Fund to Fight AIDS, Tuberculosis and Malaria, agreed to provide AIDS-stricken countries with $968 million in new grants over two years. Last year, the U.S. government pledged $15 billion over five years to fight AIDS.
Nonetheless, a big funding gap looms. According to new estimates contained in the UNAIDS report, $12 billion will be needed in each of the years 2005 and 2006 to provide HIV prevention and care in low-and middle-income countries. From 2007 onward, that figure is expected to jump to $20 billion annually as more patients are supplied with life-saving drugs. Financing commitments from governments and other groups are nowhere near meeting those requirements.
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