News Analysis
News: AIDS, HIV
>> = Important Articles
** = Major Articles
Supplemental Articles in a separate file (click here to read)
>>UN Finally Drops PC AIDS Estimate (townhall.com, 071127)
>>As Complicated as ABC (Christianity Today, 040204)
**World Distribution of HIV/AIDS
**Quick Facts on AIDS (971114)
**Key Events in the Spread of AIDS (980702)
**A new realism in the struggle (Washington Times, 040723)
**Uganda Defends AIDS/HIV Policy of Abstinence First (Christian Post, 050407)
**U.N.: HIV Infections Hit Record High (Foxnews, 040706)
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By Michael Fumento
The UN AIDS program has issued its annual report in which, finally, it doesn’t say how many more current HIV infections there are this year. Instead it drops the figure by over six million from its 2006 estimate – from 39.5 million to 33.2 million. Further, the agency now admits the number of new HIV infections per year peaked way back around 1998.
For years, some of us have dared write that worldwide HIV and AIDS figures have been grossly exaggerated; that we were being lied to by just about everybody, including – or especially – the UN AIDS program and the World Health Organization.
For example, pious Peter Piot, executive director of the UN AIDS program since its founding, in 2004 bemoaned that “Projections NOW suggest that some countries in sub-Saharan African will face economic collapse unless they bring their epidemics under control.” (Emphasis added.) Obviously he knew whereof he spoke; he’d been using those exact words for at least five years.
Just last year, former President Bill Clinton told attendees at the International AIDS Conference: “It’s difficult to imagine how the world can grow unless we tackle AIDS.” Never mind that world population growth is fastest in areas hardest hit by AIDS.
In 1988, a high Ugandan official on ABC News Nightline said that within two years his nation will “be a desert.” Nightline’s reporter declared that by 2000 “50 million Africans may have died of AIDS.” Yet Uganda’s population has since increased by over a third and is among the fastest-growing in the world. As to the 50 million death figure, seven years after that prediction was to come to fruition, the worldwide AIDS estimate is just over half that.
Those who have criticized such gross exaggerations, as I did in my 1990 book The Myth of Heterosexual AIDS, were labeled liars ourselves, whackos, racists, and variety of other colorful epithets. Perhaps this is an occasion to gloat, but personally I’m too busy shaking my head and wondering how despite our best efforts the AIDS alarmists were able to sustain their fiction for so long. Naturally, those alarmists are now a bit defensive.
“A number of critics have accused the UNAIDS and WHO of distorting figures in the past to push for increased funding to fight AIDS,” says a press release from the International AIDS Society in Geneva. Do tell!
The group, which has been bringing you only the finest AIDS disinformation since 1988, says, “This seems an unnecessary and petty position. The fact is, the evolution of HIV prevention, treatment, and care over the past quarter century is one of the great successes of medical science.”
Ah! Save for the efforts of groups like theirs, their awful predictions would have come true. That echoes the explanation U.S. AIDS alarmists give about why their beloved heterosexual AIDS epidemic never arrived, notwithstanding that they were insistent for years that it already had arrived.
Likewise, the new lowered estimate for worldwide HIV has nothing to do with “prevention, treatment, care.” Infections said to already have occurred never existed.
For its data, UNAIDS relied heavily on “sentinel-site surveillance” at prenatal clinics. This system was described and faulted six years ago in Rolling Stone magazine. “If a given number of pregnant women are HIV-positive, the formula says, then a certain percentage of all adults and children are presumed to be infected, too.” Such an extrapolation from a small non-representative portion of the population to literally the whole world is nonsense.
And UNAIDS knew it because it had been told by a number of careful, knowledgeable scientists such as Berkeley epidemiologist Dr. James Chin.
Chin, when he worked for the UN, was responsible for some of the earliest world AIDS forecasts. Later he watched how politics – not a virus – made those figures zoom into the stratosphere.
Three years ago, Chin told me “They [the UN] don’t falsify per se” but “as an epidemiologist I look at these numbers and how they’re derived. Every step of the way there is a range and you can choose the low end or the high end. Almost consistently the high end was chosen.”
And guess what? Chin, author of The AIDS Pandemic: The Collision of Epidemiology with Political Correctness, still thinks the numbers are too high by about eight million.
So at some point the authorities will be forced to lower the figures again. But they’ll hold off as long as possible in order to continue to bring more attention to this problem at the expense of shortchanging attention and funding to other problems that are much more readily preventable, treatable, or both – such as tuberculosis and malaria.
The epidemic of falsehoods coming from official organizations, NGOs, politicians, and the media has yet to peak.
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Condoms and abstinence can both play a role in AIDS prevention.
An interview with Anne Peterson
A little over a year ago, President Bush announced an ambitious plan to triple funding for AIDS prevention and treatment efforts, to $15 billion. On December 1, World AIDS Day, a coalition of religious leaders called on the administration to keep its promises and appropriate the money.
Anne Peterson is a former missionary doctor to Zimbabwe and Zaire who was appointed by the Bush administration as head of global health for the Agency for International Development (USAID). She spoke with Timothy C. Morgan, CT’s deputy managing editor, about what she believes are the key ways to push the administration’s AIDS policy forward.
What is the best way to spend money fighting the AIDS pandemic?
It’s going to be a matter of keeping the balance. How do we begin to do treatment, deal with all of the difficult systems issues, make treatment available fairly—while still not losing the key prevention messages, as well as the orphan care and dying-patient care?
If we ever want to be able to address all of the treatment needs for people living with HIV and AIDS, then we have to work desperately hard on prevention. We have to make sure there are the fewest number of people getting HIV/AIDS so that we can manage to do that scope of treatment. So we need to do both, and we need to do them carefully and effectively and fully.
The promise that I can make is that whatever Congress chooses to appropriate, we will work very, very hard to make sure it is very well used.
The other bottom line is, whether it’s AIDS or whether it’s child health or tuberculosis, or infectious disease, or agriculture, the scope of the need out there is way more than the available resources. So there isn’t a single area of international endeavor that couldn’t use more funds.
Is condom use effective against HIV?
Condoms clearly can reduce transmission of HIV/AIDS sexually. The question is how correctly and consistently they are used, and by whom and where. We have evidence that shows that if couples—in which one is HIV-positive and the other is negative—use the condoms correctly every single time, they get a lot of protection. This is especially true for married couples. Evidence from Thailand and Cambodia shows that 100% condom use in brothels, together with reducing the number of partners, made a huge difference for an entire country.
Are condoms perfect? No. Are they 100% effective? No. Do people always use them correctly and consistently? No. But there is a role. This can be an effective tool in specific situations. So for high-risk populations, for encounters with a nonregular partner, they are a good idea; they are better than nothing—as long as you make clear that they have to be used consistently and correctly.
Now the flip side. When I was in Kenya in the ‘80s there was the question, “Why do the Americans keep bringing condoms to us? This doesn’t fit with our culture.” In a generalized epidemic, 50 to 69% of new infections are in youth. For most of that population, abstinence—delaying sexual activity—is a fully appropriate message. So is “zero grazing,” the emphasis on remaining sexually faithful in ongoing relationships.
Such messages reduce the number of partners, thus reducing exposure to the disease. We have seen in places like Uganda, and now starting in Kenya, that people will respond to such messages. In a generalized epidemic, this is the strategy I would recommend most strongly.
Why does prevention work? Is it an issue of morality, or fear of disease?
It depends on where the person is coming from. In Zimbabwe I worked with a Scripture Union program that talked about abstinence as God’s law, though we also talked about it as a public health issue—that God asks you to respect and care for your body, so you shouldn’t expose yourself to disease. That worked there. But the USAID programs we support in Zambia come at it as merely the right way to live, also noting that it will protect you from disease. So there, it’s a combination without a specific spiritual mandate. Still, it has been very effective.
Why do scholars and researchers object to abstinence and fidelity as a primary way to stop HIV/AIDS?
The public health community for a very long time did not believe that you could get youth to abstain or to wait. Because they did not believe it was possible to do it, they saw it as a philosophical or religious push.
What changed is that both in the U.S. and internationally, we’re seeing data that people will change their behavior. They will choose to abstain or wait or stay faithful within marriage. And that does make a difference in disease transmission.
Some prominent Christian leaders such as Bruce Wilkinson, Rick Warren, Franklin Graham, Rich Stearns from World Vision, and Clive Calver from World Relief have recently seized on this issue. What do you see as their role in addressing the HIV/AIDS problem?
I think there’s a huge role, because this is an issue that fits with the Christian message. And the prevention of AIDS fits with the righteous living and moral standpoint [of Christianity]. But equally important is the church’s role in giving a message of forgiveness, of compassion, of caring for the sick, of caring for the widows and orphans; there’s almost no part of the AIDS epidemic where the faith orientation doesn’t have a very, very strong message. I think there is an absolutely huge role, and I am thrilled to see this outpouring of interest.
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HIV Prevalence Rates: (UNAIDS December 1997)
Latin America: 0.5%
Caribbean: 1.9%
Sub-Saharan Africa: 7.4% (South Africa: 10%, Botswana: 25-30%, Zimbabwe: 20%)
North Africa/Middle East: 0.13%
India: 0.9%
China: 0.1%
South and Southeast Asia: 0.6%
Death in Africa: (Source: Census Bureau)
|
Country |
Life Expectancy (years) |
|
|
|
Without AIDS |
With AIDS |
|
Angola |
41.3 |
35 |
|
Botswana |
74.4 |
26.7 |
|
Lesotho |
67.2 |
36.5 |
|
Malawi |
59.4 |
36.9 |
|
Mozambique |
42.5 |
27.1 |
|
Namibia |
68.8 |
33.8 |
|
Rwanda |
54.7 |
38.7 |
|
South Africa |
68.5 |
36.5 |
|
Swaziland |
74.6 |
33 |
|
Zambia |
58.6 |
34.4 |
|
Zimbabwe |
71.4 |
34.6 |
People with HIV/AIDS at the end of 1999: (Source: WHO/UNAIDS)
|
|
|
|
Sub-Saharan Africa |
24.5 million |
|
South and Southeast Asia |
5.6 million |
|
Latin America |
1.3 million |
|
North America |
900,000 |
|
East Asia and Pacific |
530,000 |
|
Western Europe |
420,000 |
|
Eastern Europe and Central Asia |
420,000 |
|
Caribbean |
360,000 |
|
North Africa and Middle East |
220,000 |
|
Australia and New Zealand |
15,000 |
|
TOTAL |
34.3 million |
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What is AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome.
What causes AIDS?
AIDS is a collection of illnesses caused by a virus called human immunodeficiency virus, or HIV. HIV is found in the blood, semen and vaginal secretions of an infected person.
How is AIDS spread?
The HIV virus is mainly spread by unprotected sex and sharing needles with an HIV-infected person. Babies born to HIV-infected women may become infected. You do not become infected by casual contact or insects.
How many people have HIV?
548,102 AIDS cases in the United States have been reported to the Centers for Disease Control and Prevention (CDC). The CDC lists 343,000 AIDS deaths.
Worldwide, the Joint United Nations Program on HIV/AIDS estimates 21.8 million people are living with HIV/AIDS. Of that number, the majority (21 million) are adults, and women are approximately 42%.
During 1995, HIV-associated illnesses caused the deaths of 1.3 million people, including 300,000 children under age 5. Since the beginning of the global AIDS epidemic, over 9 million children under age 15 have lost their mothers to HIV/AIDS.
How is HIV/AIDS diagnosed?
A test for the HIV antibody shows who is infected with the virus.
What is the prognosis for people with HIV/AIDS?
There is no cure for AIDS, however the FDA has approved the use of certain prescription drugs such as AZT in the treatment of AIDS-related illnesses.
Source: The Centers for Disease Control and Prevention
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AIDS has claimed nearly 12 million lives since the early 1980s. Experts estimate some 40 million people will be infected with HIV by 2000.
Source: Reuters
Ten million people have contracted HIV since the 11th World AIDS Conference met in Vancouver in 1996.
Source: 1998 conference chairman Bernard Hirschel
Worldwide, 30.6 million people are known to have contracted HIV, or full-blown AIDS; 21 million of them live in Africa.
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LONDON — Nearly 12 million people have died since the AIDS epidemic began two decades ago. Although the illness is on the decline in the developed world, it is spreading rapidly in developing countries.
Following are some of the key events in the development and spread of the epidemic:
1981
Outbreaks of two rare illnesses are reported among young homosexual men in the United States. The disorders, a respiratory infection called pneumocystis carinii pneumonia and a cancer, Kaposi’s sarcoma, usually infect older men.
1981-1983
Scientists and researchers start to recognize the emergence of a new disease that is destroying the body’s immune system, preventing sufferers from fighting simple infections. The illness is also found to affect intravenous drug users and blood transfusion recipients.
1983
Researchers isolate a virus that is linked to the disease.
1984
The human immunodeficiency virus, or HIV, is identified as the cause of the disease. Scientific papers suggesting that AIDS is spread through blood are published in The Lancet and New England Journal of Medicine.
1985
Scientists develop a diagnostic test for the virus. First World AIDS Conference is held in Atlanta, Georgia. Blood screening for HIV is introduced in North American and European countries.
1986
United Nations establishes a joint program on AIDS.
1987
Zidovudine (AZT), the first treatment for HIV, is launched.
1988
December 1st is designated World AIDS Day.
1992
Experts at the World AIDS Conference in Amsterdam warn that women, the fastest-growing group of AIDS cases worldwide, are being overlooked in the prevention, diagnosis and treatment of the disease.
1993
World Health Organization says 14 million people are infected with the HIV virus and estimate that there are more than 2.5 million AIDS cases worldwide.
1991
Videx (ddl), like AZT a member of a class of drugs called reverse transcriptase inhibitors (RTIs), is launched.
1994-1995
Zerit (d4T) and Epivir (3TC), other RTIs, are launched, increasing the choice of treatments.
1996
Triple drug cocktails including protease inhibitors that block the replication of the HIV virus in the body are revealed at the 11th World AIDS Conference in Vancouver, Canada.
1997
Indinavir and saquinavir, two protease inhibitors, are launched. Patients start to show first serious side effects and resistance to the latest drug treatments.
1998
U.S. doctors volunteer to act as guinea pigs to try out an experimental AIDS vaccine. Scientists image the crystalline structure of the gp120 protein the HIV virus uses to break into the human immune system cells it attacks. U.N. AIDS prevention agency UNAIDS releases latest figures showing rates of infection are stabilizing or falling in rich nations and parts of Latin America due to new treatments. But the killer disease is spreading at an alarming rate in the developing world. Figures show 11.7 million people have died since the start of the epidemic and over 30 million people are infected with the HIV virus. First large-scale test for AIDS vaccine begins in the United States 12th World AIDS Conference in Geneva, Switzerland.
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It has been long in coming, but finally delegates to the 15th International AIDS Conference, which just closed in Bangkok, gingerly faced up to the most effective way to deal with the global pandemic. Some 37.8 million men, women and children worldwide have HIV which causes AIDS and 2.9 million died last year alone. Tropical Africa and Asia have been hit hardest.
Until very recently, political leaders, medical experts and AIDS activists have focused almost exclusively on ways to mitigate the ravages of the deadly virus. Some Third World leaders, notably in South Africa, were in denial about how the AIDS virus was contracted and transmitted and what might be done to mitigate its deadly toll.
The United States, working with other developed countries, has committed substantial funds and personnel to meet the scourge. Until now, however, most of the effort has been devoted to mitigating the suffering of those who already have the disease. Even the most sophisticated — and expensive drugs — cannot cure the disease, but only mitigate suffering and postpone death.
The HIV-AIDS crisis in tropical Africa is especially grievous because it comes on top of a succession of other man-made tragedies that have dashed hopes for postcolonial Africa. Tribal wars and genocide have killed millions. The megalomaniac Mobutu Sese Seko plundered the Congo. The late Idi Amin of Uganda slaughtered hundreds of thousands. Most other countries have been burdened by corruption and mismanagement.
As early as March 1990, Archbishop Desmond Tutu of South Africa said: “God’s children in Africa suffer because there is less freedom in their countries than during colonial times... there is totalitarianism and despotism nearly everywhere.”
The AIDS epidemic in Africa has been exacerbated by poor or nonexistent health care, poverty, malnutrition and ignorance. But these depravations are not its cause, which is man-made and preventable.
A sexually transmitted disease, HIV-AIDS is a preventable plague. It is spread mainly by multiple sex partners. Studies suggests tropical Africa has a highly promiscuous culture. Widespread sexual intercourse outside of marriage is rooted in traditional customs and practices and exacerbated by the AIDS plague itself.
Evidence of increasing promiscuity in Africa is offered by Dr. Holly Burkhalter, an AIDS specialist with Physicians for Human Rights. (“The Politics of AIDS,” Foreign Affairs, January-February 2004, Pages 8-14) She cites Dr. Karl Peltzer of Cape Town, South Africa, who said the widespread pursuit of young women by older men “has led to a disproportionate number of girls becoming infected.” Young girls — some under age 5 — are often raped by men, purportedly because of a widespread myth that sex with a virgin can cure or prevent AIDS. This assault has generated “millions of orphans and street children... who are especially vulnerable to rape and to being forced into the commercial sex industry.”
Dr. Burkhalter adds: “The predators who sustain the forced-sex trade and child rape industry ... should be punished severely,” but this “almost never occurs.” She calls for new strategies to fight AIDS transmission among both forced prostitution and “voluntary sex workers.”
Uganda shows the way: In striking contrast, the AIDS situation in Uganda under President Yoweri Museveni has been radically different. The country’s HIV infection rate plunged from 22% in 1992 to 7% in 2002, winning plaudits from the World Health Organization.
Finally, at the Bangkok AIDS Conference, Mr. Museveni was given a global platform for his remarkable story.
In 1986, Mr. Museveni launched a vigorous program to stem promiscuity by promoting abstinence before marriage, faithfulness in marriage, and if these traditional moral restraints failed to hold, he advocates using condoms. He calls this his “ABC” strategy, or “Abstinence, Being Faithful and Condoms.”
Mr. Museveni has been accused of naivete, but his initiative has yielded startling results. And if it were widely emulated, it would drastically reduce the toll of AIDS throughout Africa. His program underscores the perennial public health the struggle between therapy and prevention. In this case, an ounce of prevention is worth a great deal more than a pound of cure.
Of course, research for a cure to AIDS must go forward apace, but a larger portion of the resources in the global struggle against AIDS should be devoted to prevention. Is it not more humane to prevent AIDS than to treat its ravages? Obviously, both endeavors deserve our commitment.
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Ugandan officials are defending the nation’s AIDS/HIV prevention policy, which encourages abstinence and faithfulness as the primary weapons in the battle against the virus.
Last week, New York-based Human Rights Watch released a report saying that Uganda is shifting toward an abstinence-only policy that would “leave Uganda’s children at risk of HIV.”
Dr. Alex Opio, the assistant commissioner for National Diseases Control insisted that there had been no change in the government’s “ABC” approach to fighting AIDS.
“The government policy is A for abstinence, B for be faithful and C for condom for those who are high risk,” he said. “There has been no change.”
HRW admits that “some experts” have credited the ABC as a factor in reducing HIV prevalence in Uganda from “about 15% in the early 1990s, to less than 10% today.”
However, Tony Tate, a researcher for HRW Children’s Rights division said in a statement, “Uganda is gradually removing condoms from its HIV/AIDS strategy, and the consequences could be fatal.”
The report also says the President, Yoweri Museveni and his wife, Janet Museveni are putting millions of lives at risk by affiliating with U.S. Christian conservatives, according to AP.
For the past 10 years, the President and his wife have promoted the True Love Waits program in speeches and ad campaigns, according to the Baptist Press. True Love Waits advocates abstinence until marriage.
Janet Museveni said, “The truth is, there is no safe sex outside of faithfulness in marriage.” reports BP.
The Ugandan presidential spokesman Onapito Ekomoloit denied the claims, saying that the government had been consistent in advocating a multi-pronged approach – “those who are sexually active should be faithful to their partners, others should abstain and those who cannot abstain should use condoms,” according to the Independent Online.
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LONDON — New HIV infections hit a record high last year as the virus continues to outpace the global effort to contain it, according to a U.N. report published Tuesday.
The number of people living with the AIDS virus has risen in every region of the world. Last year, 5 million people became infected — more than in any single year since the crisis began. Nine out of 10 who urgently need treatment are not getting it and prevention is still only reaching one in five people who should have it, the report said.
“The virus is running faster than all of us,” UNAIDS chief Dr. Peter Piot told The Associated Press. The agency compiles a global AIDS report every two years.
This year’s report provides the most accurate picture yet of HIV’s march across the planet. It says new epidemics seem to be spreading unchecked in Eastern Europe and Asia. To tackle the pandemic, $12 billion a year is needed by next year, instead of the $10 billion that was predicted earlier.
In more revised estimates based on better information than was previously available, the U.N. AIDS agency figures that about 38 million people are infected. Until now, experts had put the ranks of the HIV afflicted at about 40 million.
The cost estimates have increased at the same time that the estimated size of the problem has decreased partly because of the price of delaying action, but also because the planned campaign is now more comprehensive than it has ever been, Piot said.
“We didn’t really fully appreciate the importance of a number of things, like the danger of spreading HIV through normal medical equipment. That’s a new cost. Also, protecting health care workers is more expensive than we thought and ... the cost of taking care of orphans was grossly underestimated before,” Piot said.
However, there have been triumphs.
Many countries, including Brazil, Uganda and Thailand, have reduced HIV infection. Drug prices have dropped dramatically and money is beginning to flow in for the global effort. More politicians are showing commitment to the fight and drugs are becoming increasingly available in poor countries.
Among the major challenges are women and young people’s vulnerability to the disease; ensuring the virus doesn’t become immune to drugs; keeping health workers in the developing world; and tackling stigma and looking after children orphaned by the disease. In some places the size of the health work force needs to quadruple, the report found.
Money remains a significant problem. Funding has increased to about $5 billion a year in 2003, but that is still less than half of what is needed.
By 2007, $20 billion a year will be needed to tackle the problem in developing countries. That money would provide drugs for 6 million people, AIDS tests for 100 million adults, HIV education in schools and care for 22 million AIDS orphans, the report said.
More than 20 million people have died since the disease was first diagnosed in 1981 and about 3 million people are dying each year, the report said.
AIDS remains untamed in Africa. The continent is still seeing increasing rates of infection in the poorest countries, but the disease is spreading fastest in Eastern Europe and Asia, which is home to 60% of the world’s population.
In Asia, the disease is confined mostly to drug addicts, homosexual or bisexual men, prostitutes and their clients, and the sexual partners of people who frequent prostitutes.
Countries such as Thailand that are targeting high-risk behavior have been more successful in fighting HIV, but although visits to brothels are down, casual sex is on the rise, more schoolchildren are having sex, and condom use is consistently low.
India has the highest number of people with HIV outside South Africa — 5.1 million, the report said. Worryingly, knowledge about the disease is still paltry and experts believe the statistics may mask an underlying problem of bisexual men infecting women.
Progress against HIV in Africa has been mixed. Prevalence is still rising in countries such as Madagascar and Swaziland, but declining in Uganda.
In sub-Saharan Africa, the number of people living with HIV appears to have leveled off at about 25 million. However, that stability is deceptive. In fact, both deaths and new infections are up.
In North Africa and the Middle East, experts believe the situation is not being tracked fully. There is concern the disease may be spreading silently among homosexuals there because homosexuality is widely condemned and illegal in many places.
The epidemics in Eastern Europe and Central Asia are still expanding, fueled by injecting drug users. About 1.3 million people there have HIV, compared with 160,000 in 1995. More than 80% of the infected are under the age of 30.
In Latin America, the epidemic is concentrated among drug addicts and homosexuals. Countries have low infection rates overall, but pockets are bad.
In the Caribbean, the disease is mainly spread through heterosexual sex and in many places is focused around prostitution. The worst-affected country is Haiti, which has the highest infection rate outside Africa with 5.6% of the population afflicted.
Infections are on the rise in the United States and Western Europe, particularly among homosexual or bisexual men.
Women continue to be on the front lines of the epidemic.
In sub-Saharan Africa, the infection gap between men and women has widened. There are on average 13 infected women to every 10 infected men, up from 12 for 10 in 2002, the report found.
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Supplemental Articles in a separate file (click here to read)