The United Nations has reduced its global estimate of the number of people infected with HIV/AIDS from nearly 40 million in 2006 to 33 million this year, saying a major reassessment of HIV prevalence in India accounts for much of the decrease.
The United Nations has reduced its estimate of the number of people infected with HIV and needing lifesaving treatment now or in the near future, from 39.5 million in 2006 to about 33.2 million in 2007. Significantly revised figures for India -- from to 5.2 million to about 2.5 million cases -- account for much of the decrease, say experts.
The decreased numbers reflect new research and analysis methods rather than representing a real decline in the pandemic, said UNAIDS, the UN's coordinating body for fighting HIV/AIDS, while releasing its annual AIDS Epidemic Update on November 20.
However, the substantial drop in numbers will provoke critics of the UN, some of whom have accused its AIDS-combating arm of artificially inflating the scale of the pandemic in order to attract more funds.
But the rate of new cases and mortality levels is declining, although figures still show that there are 6,800 new cases each day and over 5,700 deaths. Africa has by far the most number of cases, while parts of Asia have the fastest growing rates of infection.
In sub-Saharan Africa, 22.5 million people have HIV but the number of new cases -- 1.7 million a year -- is a smaller increase than in previous years.
The latest figures show that the number of people living with HIV in Europe and parts of Asia has gone up from 1.25 million in 2001 to about 2.4 million.
The update gives Asia a mixed report card with an estimated 4.9 million people with HIV this year, including 440,000 newly-infected people. Education programmes for sex workers have helped arrest the spread of HIV/AIDS in some Asian countries, but drug use and unprotected sex between men threaten to reverse the gains across the region, said UNAIDS.
Pakistan is one of several countries where HIV prevalence is increasing among drug users. The disease typically spreads when needles used for intravenous injections of drugs like heroin are shared among users. One study cited by the report showed the HIV prevalence rate in Karachi rising from under 1% in early 2004 to 26% in March 2005.
Thailand, Cambodia and Myanmar have registered declines. All three countries have major prevention programmes aimed at sex workers. "The trends suggest that HIV prevention efforts are making a difference," said Peter Ghys, chief of UNAIDS' epidemiology and analysis division. But HIV is rising in Thailand among men who have sex with men, and remains high -- as high as 50% -- among injecting drug users, he said.
Indonesia and Vietnam are two countries where the HIV epidemic is still evolving, said Ghys. "The HIV epidemic in Indonesia is among the fastest growing in Asia," says the report. "The majority of HIV infections are estimated to occur through the use of contaminated injecting equipment, unprotected paid sex and, to a lesser extent, unprotected sex between men."
The report cites Vietnam's health ministry as saying that the estimated number of people living with HIV in Vietnam has more than doubled to 260,000 in 2005, from 120,000 in 2000.
Health officials warn against any complacency in the fight against the disease, in light of the latest statistics, stressing the need for vigilance and ever more reliable monitoring mechanisms. UNAIDS executive director Dr Peter Piot said: "The improved data presents us with a clearer picture of the AIDS epidemic, one that reveals both the challenges and the opportunities. Unquestionably, we are beginning to see a return on investment. But we must expand our efforts in order to significantly reduce the impact of AIDS worldwide."
WHO/UNAIDS figures show there were 2.5 million new cases in 2007, down from a peak in the late-1990s when there were over 3 million new infections a year. The fall in annual deaths to 2.1 million has been attributed to wider access to antiretroviral drug treatments.
The revised figure means that there are around 33.2 million people living with HIV/AIDS, down from 39.5 million in 2006. UNAIDS said the figures for 2006 were likely to be inaccurate after an intensive assessment exercise in India showed fewer cases than estimated. Angola, Kenya, Mozambique, Nigeria and Zimbabwe also had their figures reduced.
Experts say they arrived at the new figure as a result of better information and a greater understanding of the disease. Kevin de Cock, director of HIV/AIDS at the World Health Organisation, said: "This remains the leading infectious disease challenge to global health. We have to recognise the very long-term nature of the HIV pandemic. We're facing decades of this problem... Of the 33.2 million infected, some of them require treatment now and all of them will in time. The qualitative implications have changed very little. We are very well aware of AIDS fatigue and the situation in the industrialised world where the advent of treatment has dampened enthusiasm for prevention."
Paul De Lay, UNAIDS director of evidence, monitoring and policy, warned that new infections hit 2.5 million last year, with 2.1 million deaths: "We do not have a curative intervention," he said. "We have repeated evidence from countries that as we back away and become less vigilant, and our programmes start to diminish, we are seeing a return of the epidemic."
For instance in the USA, the UK, Germany and also in Uganda, which was once lauded for bringing down its HIV rates, prevalence was rising again.
Treatment programmes in sub-Saharan Africa, where 1.5 million people are now on antiretroviral drugs, are yielding results, the UNAIDS report says. But death rates remain high because of the large numbers who cannot access drugs.
There is also evidence in some countries of a reduction in high-risk behaviour such as having many sexual partners, as a result of education efforts. The report cites Botswana, Cameroon, Chad, Haiti, Kenya, Malawi, Togo, Zambia and Zimbabwe.
Source: The International Herald Tribune, November 22, 2007
www.bbcnews.com, November 21, 2007
www.guardian.co.uk, November 21, 2007
AFP, November 21, 2007
www.telegraph.co.uk, November 21, 2007
Reuters, November 21, 2007