PRESS CONFERENCE ON JOINT HIV/AIDS REPORT

 

The 2007 AIDS epidemic update contained encouraging trend information on the epidemic and also reflected a major adjustment in overall numbers as a result of new methodologies in data gathering, journalists were told today at a press conference via video link between Headquarters and HIV/AIDS experts in Geneva.

Participating in the event, which launched the annual collaborative report of the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), were Paul De Lay, Director of Evidence, Monitoring And Policy of UNAIDS; Kevin De Cock, Director of the HIV/AIDS Department at WHO; Karen Stanecki, Epidemic and Impact Monitoring at UNAIDS; and Peter Ghys, Epidemic Monitoring and Prevention at UNAIDS.

In an opening briefing, Mr. De Lay said the global prevalence of the disease, or the number of people living with it, had stabilized or levelled off, and even declined in sub-Saharan Africa, over the last four or five years.  Further, data indicated there were declines in new infections and some recent declines in mortality due in part to the scaling up of antiretroviral therapy.  And, while it was too early to tell whether some of the trends would continue -- and it was important to keep the regional and global trend from masking what was happening in individual countries -- the data in this year’s report also reflected a downward adjustment of the overall numbers, due to an improved methodology for gathering data.

Therefore, he said, data had been back-estimated and the year-by-year data in the report represented a new, better understanding of how the estimates were prepared.  This year, they had been derived from new population-based surveys that focused on the incidence of the disease in the general population.  Previously, the data had been derived from sentinel-based surveys or information from a targeted high-risk population, such as sex workers, intravenous drug users or men who had sex with men.  Further, the data was the best ever gathered, with more data available at the country level and new ways of analysing the data, along with a better understanding of the natural history of HIV/AIDS, particularly concerning survival times.  All those factors weighed into the fact that the estimated number globally of people living with HIV/AIDS was 33.2 million as compared with the 39 million reported in 2006.

That 6 million fewer cases estimated was the result of the methodology, he continued.  Seventy per cent of the difference between the two published reports represented six countries, and half the data difference came from adjustments that had been made on India over the last six months.  The other countries with adjustments in overall numbers were Angola, Kenya, Mozambique, Nigeria and Zimbabwe.  The adjustments had been extensively reviewed by internal reference groups, as well as external consultants and independent experts.  All had agreed that the new methodology was an improvement over the previous.

In addition, he said, there were still countries where the incidence of the disease was still increasing.  It was on the rise in Asia, including in Viet Nam, Indonesia and Papua New Guinea.  In central Asia, it was increasing in Uzbekistan.  In Eastern Europe overall, it was still increasing, though the 150 per cent rate increase that had begun in 1991 had now started to slow.  But, overall, the figures represented programmatic impact -- the fact that declines were partly attributable to strong prevention and treatment programmes.  Reports from countries such as Thailand and Kenya also showed that behavioural data supported the epidemiological, and also represented returns on investments -- on the massive increases in resources and political commitment that was becoming stronger in most parts of the world.

In response to a question about reported inflation of figures to increase funding for addressing the disease, Dr. De Cock said that would be quite difficult to do.  There were simply too many people who would have to be involved at too many levels.  Also, money for AIDS research was not disbursed to WHO, but to the Global Fund or another mechanisms.  The difference in data was simply a function of using the best method available at the time.  The household surveys had been initiated for the most HIV/AIDS-affected countries.

In response to further questions, Dr. Stanecki said the household surveys were expensive to carry out and relied on the involvement of Governments.  Also, they were not the gold standard for surveys.  There was a high rate of non-response, for example.  That’s why the new methodology relied on an analysis and synthesis of information from both kinds of surveys.  Dr. Ghys said the population surveys had been in use since 2001 to augment the obvious weakness of the sentinel surveys, in which figures were projected estimates from gathered data.  The high correction on India showed the positive value of using both types of surveys.

Did the term “stabilized prevalence” of the disease mean that HIV/AIDS was no longer spreading? a journalist asked.  Dr. De Cock said the number of new infections of HIV/AIDS had peaked in the late 1990s.  However, new infections were still occurring and increasing as populations grew, even as the number of deaths from the disease declined.  Therefore, a stable prevalence of 25 per cent was not good news, since that meant the number of new infections was balancing out the number of deaths.

There were two lessons to be learned from the report and the new figures contained in it, he added, in response to another question.  First, HIV/AIDS was still the major infectious disease confronting humanity today.  Second, there needed to be an even greater investment in addressing the disease, both in terms of human resources and in relation to epidemiology.  Communication about the disease had made an impact on the intensity of the response.  That should not stop.

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For information media • not an official record