PRESS CONFERENCE BY JOINT UN PROGRAMME ON HIV/AIDS, WORLD HEALTH ORGANIZATION

PRESS CONFERENCE BY JOINT UN PROGRAMME ON HIV/AIDS, WORLD HEALTH ORGANIZATION

While it was clear that a combined prevention/treatment programme reduced the incidence of HIV/AIDS, the continuing rise in the global infection rate indicated the importance of stepping up the scale and scope of efforts to halt its spread, correspondents were told at a Headquarters press conference this afternoon.

Outlining the global picture at the New York launch of the 2005 AIDS Epidemic Report, Jim Kim, Director of the World Health Organization’s (WHO) HIV/AIDS Department, said that the evidence of the prevention/treatment programme’s success was the bright spot in the report.  But the number of people living with HIV/AIDS this year was over 40 million, up from an estimated 37.5 million in 2003, and 3.1 million people had died of AIDS-related illnesses.  However, without the combination of prevention and treatment measures, the number would have been 3.4 million.  Dr. Kim was accompanied by Desmond Johns, Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) New York Office.

Noting that Kenya, Zimbabwe and some Caribbean countries had shown declining HIV prevalence over the past two years, Dr. Kim said the steepest increases had occurred in Eastern Europe and Central Asia, although Africa remained the hardest-hit region, and the number of those infected had risen to 200,000 in Central America.  In addition, the feminization of the disease continued to endure, with neither marriage nor fidelity seeming to have an impact on the incidence rate of infection.  A combination of deaths from illness, behaviour change and access to treatment was considered to account for the declines.  The behaviour change was a product of the prevention ABCs -- a promotion of abstinence, being faithful and condom use.  That approach had reduced the mother-to-child infection rate to near zero in industrialized countries.

Affirming the effectiveness of prevention, Dr. Johns said, “We now know what works.  We know the course of the disease and what it would take to stop it”.  A sustained application of the prevention/treatment regime into implementable programmes was the obvious path.  However, a survey cited in the report showed that among the people involved in unprotected paid sex, fewer than one in five had indicated that they had access to treatment, and less than one in 10 said they had been tested.  Sex workers, men who had sex with men and drug users were the most vulnerable overall.

Asked how the accuracy of the numbers could be determined, he said there had been a change of governmental attitudes towards public health concerns since the outbreak of Severe Acute Respiratory Syndrome (SARS) and many now offered voluntary testing.  It was now possible to conduct surveys in some countries, rather than rely on extrapolation.  But data varied dramatically, despite the use by expert data collectors of alternative sources and extrapolation.

In response to a question about the factors contributing to the rise of infections in East Europe and Central Asia, Dr. Kim said that drug users who shared needles were most likely to contract the illness and pass it on to children and partners.  The strategy, with regard to that population segment, was to promote “harm reduction” techniques, including methadone-maintenance therapy and distribution of sterile needles, which had been shown not to lead to increased drug use.

When asked to elaborate on the global war against AIDS at the national level, he said the report gave a good picture of the effectiveness of prevention efforts despite weak surveillance mechanisms.  Egypt, for example, was moving rapidly on preventive programmes while the Sudan was not.  China had replaced its policy of obfuscation and denial with a willingness to look at the disease and implement prevention programmes.  Iran, a conservative Middle Eastern country, had surprisingly taken the lead in instituting preventive programmes.

Dr. Johns added that, for cultural reasons, the Russian Federation and Ukraine were reluctant to take action since the increase in HIV/AIDS within their population occurred mainly among prisoners and drug users, neither of which group ranked high among societal concerns.  The strategy there was to retrain attention away from the penal element and focus more on the social health aspect of the need to curb the spread of the disease.  In general, HIV/AIDS was still seen as a barometer of morality, with countries demonstrating sensitivities to the possibility of stigmatization that they did not exhibit with other diseases.

In response to other questions, the two officials said the disease could be attenuating in some places without necessarily having a global impact unless efforts were stepped up.  There were early- and late-peaking epidemics, and it was possible that the epidemic was at a late-peaking stage in Africa, where low-cost drugs should make treatment possible.  Also, efforts were under way in the Gulf States, though there was no great HIV/AIDS crisis in the Middle East region.  In addition, conservatives in the United States had actually helped curb the disease by drawing government attention to the need for action to protect missionaries in poor countries from the disease.  Some conservatives took issue with one or other part of the full prevention regime, which focused on abstinence, behaviour change and condom use.  But removing any component slowed the anti-HIV/AIDS effort, creating the effect of removing one leg from a stool.

Responding to another question about Myanmar’s vulnerability, Dr. Kim said that country had all the factors to make it vulnerable, including its position as a transit State between Thailand and China, its prevailing gender inequality and its poverty.  Now that Myanmar’s Global Fund grant had been cancelled for unknown reasons, bilateral donor grants were the only hope for attenuating the disease there.

Asked for statistics on child brides and efforts to reach them, Dr. Kim reaffirmed that young women were two-and-a-half to six times more susceptible to HIV/AIDS than young men, possibly because of the intergenerational sex factor and women’s greater dependency on men due to their powerlessness.  For example, women could not abstain without empowerment.  Short- and medium-term approaches focused on education, securing property rights and distributing condoms and microbicides.

In response to a question about the distribution of the female condom Dr. Kim said there was a shortage of male condoms, and the situation was much worse for the female version.

For information media • not an official record