Since the beginning of the epidemic, 50 million people worldwide have been infected with HIV, of whom more than 16 million have died, according to a report by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The report, AIDS Epidemic Update—December 1999, shows that AIDS deaths reached a record 2.6 million in 1999 and that new HIV infections continued unabated, with an estimated 5.6 million adults and children becoming infected worldwide during the year.
“With an epidemic of this scale, every new infection adds to the ripple effect, impacting families, communities, households and increasingly, businesses and economies. AIDS has emerged as the single greatest threat to development in many countries of the world,” said Peter Piot, Executive Director of UNAIDS.
In sub-Saharan Africa—still the global epicenter of the epidemic— new evidence shows that women infected with HIV outnumber men. “Ten years ago, it was hard to make people listen when we were saying AIDS wasn’t just a mans disease,” said Dr. Piot. “Today, we see the evi¬dence of the terrible burden women now carry in Africa’s epidemic.”
UNAIDS and WHO estimate that 12.2 million African women and 10.1 million African men ages 15-49 were living with HIV at the end of 1999. Yet there is reason for optimism. “I believe we are now at a turning point in the 20-year history of the AIDS epidemic in Africa,” said Dr. Piot, noting that African leaders are speaking out about AIDS as the major threat to the continent’s development.
The report reveals that for 1999 the world’s steepest HIV curve was recorded in the newly independent states of the former Soviet Union, where the proportion of the population living with HIV doubled between 1997 and 1999. In the Russian Federation, nearly half of all reported cases of HIV infection since the start of the epidemic were recorded in the first nine months of 1999.
Preliminary studies suggest that injecting drug use is becoming increasingly common among unemployed young people in many of the industrial cities of the Russian Federation and Ukraine. Injecting drug use appears to be well established even among Russian schoolchildren. An outreach program for drug injectors in St. Petersburg reported that its caseload of clients younger than age 14 increased 20-fold from 1997 to the first quarter of 1999.
On the positive side, strong prevention programs in Thailand and the Philippines have had sustained success in lowering or stabilizing HIV rates. Still, notes Peter Piot, ‘There is no room for complacency in any discussion of this epidemic. The threat of HIV has not diminished in any country. We have even seen evidence from North America and Western Europe suggesting that availability of life-prolonging therapies may be contributing to an erosion of safer sexual behavior. This is tragic.” “While antiretrovirals have brought hope to many people with HIV who are fortunate enough to have access to them, they are not a panacea, and they are not available in most of the world,” Dr. Piot said.
“The key to fighting AIDS is preventing new infections. For this more resources are needed—to implement the prevention strategies we have today, and to develop new and better tools, such as microbicides and a vaccine.”