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World: Small Signs Of Hope Amid Grim AIDS Statistics


Every year, World AIDS Day is a chance for politicians, health professionals, and activists to draw attention to the global problem of HIV/AIDS. Ahead of World AIDS Day on 1 December, the United Nations and the World Health Organization have released a new report full of the grim statistics we've become all too accustomed to hearing -- just this year alone, for example, there will be more than 3 million AIDS-related deaths worldwide. But there are also some small signs of hope that even in the worst affected areas, the epidemic can be brought under control.

Prague, 29 November 2002 (RFE/RL) -- The news is frighteningly familiar, the numbers staggering.

This year, AIDS will have claimed more than 3 million lives. Some 42 million people are now living with the disease or have the HIV virus -- 5 million of whom were infected this year.

Those figures are in a new report released by the UN AIDS agency and the World Health Organization ahead of World AIDS Day on 1 December.

The report is grim reading. By the end of this decade, another 45 million people in the world's poorer countries will become infected, unless there's a drastic push to prevent the virus from spreading.

Only a lucky few -- mostly from rich countries -- are currently receiving antiretroviral drugs.

The disease continues to ravage sub-Saharan Africa, and is exacerbating the famine in the south of the continent. And the report added another bleak statistic -- for the first time in the 20 years of the epidemic, there are now more women than men infected with HIV.

The report also confirms that Eastern Europe and Central Asia have the world's fastest-growing epidemic. The number of new infections in the region is up by one-quarter this year. Uzbekistan had more new infections this year than in all previous years put together.

American actress and AIDS campaigner Whoopi Goldberg spoke on the disease at the UN this week.

"The fastest growing epidemic is in Russia -- Russia! Who would have thought Russia? Not me, because they never mention Russia. I know it's rampant in Africa, I know that. It's a funny thing, politically, how you get certain pieces of information and why."

But remarkably, amid the gloom, the report's authors spot some glimmers of hope.

In South Africa, the prevalence of the HIV/AIDS among young pregnant women -- while still "unacceptably high" -- has dropped by one-quarter since 1998. A study in the Ethiopian capital Addis Ababa showed a similar drop in infection levels among young, pregnant inner-city women. And Uganda continues to show a decline in recent HIV infections.

To be sure, measured by the overwhelming scale of the epidemic and its aftermath, this all amounts to very limited progress -- and some activists have even questioned the accuracy of the studies. But the report says the findings are "new, hopeful signs" that the epidemic can eventually be brought under control.

UNAIDS epidemiologist Michel de Groulard says, "When you look at some particular other groups of the population, if there is a drop in prevalence, this may mean that most of those who were infected have died. [This] is not the case when we are talking about the younger age groups of the population. It really means that the level of new infections has decreased, so it is an encouraging sign. This, as I said, happened in some parts -- not everywhere -- in some studies that have been done in Zambia, South Africa, and Ethiopia as well as in Uganda. It's also true in some other parts of the world, in Cambodia and Thailand."

The report's authors say these positive trends appear to be taking root thanks to effective campaigns that have increased awareness of the disease and knowledge of how to limit the risk of sexually-transmitted infection through the use of condoms.

De Groulard says this is a lesson for other regions experiencing a rapid rise in HIV infections. And he says it requires a high level of political commitment from governments.

"It is not only to spread the information that is important. It's also [important] to make sure that the message is well-received and can be translated into behavior change. [This] means there is...a better social environment with less stigma and less discrimination towards those who may be more at risk of getting the infection or less stigma on certain sexual behavior, so that people would feel more comfortable in attending the session of education, in sharing information."

Certainly, Eastern Europe and Central Asia present some serious challenges.

The report says that awareness and knowledge of HIV/AIDS remains "dismal" in many places. A study last year showed one-third of young women (aged 15-24) in Azerbaijan and Uzbekistan had never even heard of the disease.

The high rate of sexually transmitted diseases in some countries also suggests that unsafe sex is common, putting people at greater risk of HIV infection.

And a study in the Russian city of Togliatti indicates that the true scale of the epidemic is much larger than that shown by official statistics. It found that more than half of injecting drug users surveyed were HIV-positive -- and most of them were unaware they were infected.

The report says there have been recent heartening efforts to boost efforts against HIV/AIDS in the region. It cites the regional Program of Urgent Response launched by some members of the Commonwealth of Independent States, and efforts to broaden access to treatment and care. But it says these all need to be expanded.

The authors stress the importance of protecting young people, saying this is key for the future of the global epidemic. That's good news when the message is getting through. But the reverse is also true -- if the virus is spreading quickly among younger age groups, then worse is to come.

De Groulard says, "If you have a country in which these younger age groups have a very high level of HIV infection, then this is a very negative sign because then you can expect that in the coming years they will become adults and older adults and then the level of infection not only will be very high but they will also be at risk of transmitting the infection to the younger generations."

And this, unfortunately, adds up to a grim forecast for the future of Eastern Europe. Four out of five new HIV infections registered in the CIS between 1997 and 2000 were among people younger than 29.

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