UNITED NATIONS – New evidence shows that the HIV/AIDS epidemic has not peaked and the HIV virus is now spreading rapidly in the world's most populous countries, including China, India and Indonesia, according to a U.N. report.
The UNAIDS report on the HIV/AIDS epidemic released Tuesday also warned that unsafe sex in Europe and North America was leading to higher rates of infection, with Eastern Europe suffering from the highest increase in new infections.
"Collectively, we have grossly, grossly underestimated how bad this was going to be," said Dr. Peter Piot, head of UNAIDS, the U.N. agency that coordinates the global AIDS-fighting efforts.
"The unprecedented destruction wrought by the HIV/AIDS epidemic over the past 20 years will multiply several times in the decades to come, unless the fight against this disease is dramatically expanded," Piot said.
The figures speak horrors: 68 million people will die of AIDS in the 45 most affected countries between 2000 and 2020 — five times the number of deaths in the previous two decades. In 2001, an estimated 3 million people died of AIDS.
Most of those infected live in the developing world, where less than 4 percent had access to HIV-fighting antiretroviral drugs at the end of last year, the report said. It appealed for greater involvement of governments and the private sector.
The virus not only feeds off poverty but also increases it, the report said. In the Ivory Coast, income of AIDS-affected households is half that of the average household.
There is some encouraging news, with UNAIDS reporting that almost 100 countries have established national AIDS strategies.
Some countries succeeded in reversing the spread of the virus: Zambia became the second African country after Uganda to see a decrease in the number of cases in young urban women — from 28 percent in 1996 to 24 percent in 1999.
Poland has curtailed the epidemic among injecting drug users and prevented it from gaining a foothold in the wider population, the report said.
Outside of Poland, however, Eastern Europe has the world's fastest growing rate of infection — with 250,000 new cases last year.
Although funding to fight the epidemic has increased six-fold since 1998, $7 billion to $10 billion are needed each year to fight HIV/AIDS in low and middle-income countries, the report said. The countries spent some $2.8 billion in 2001.
Piot said he hoped to see the funding reach $10 billion a year by 2005.
The report also argues against the idea that the epidemic had reached its "natural limit" in southern Africa. For example, the 38.5 percent infection rate among Botswana's pregnant women in urban areas in 1997 reached 44.9 percent in 2001, while in Zimbabwe it climbed from 29 percent in 1997 to 35 percent in 2000.
UNAIDS warned of dangerous increases in China, which registered a 67 percent increase in reported HIV infections in the first six months of 2001. China is home to a fifth of the world's population.
Piot underlined that even if only one percent of China's population were to become infected, that would translate into 13 million people — more than in any of the most affected countries in Africa.
A U.N. study released last week warned that if no effort is made to step up prevention and education, the number HIV-infected people in China could jump from up to 1.5 million estimated today to 10 million by 2010.
The Chinese government rejected the report, calling its conclusions and predictions inaccurate.
Piot said that the report had not criticized the Chinese government but lamented the lack of action on the provincial level.
Elsewhere, the report said India was home to almost 4 million infected people — more than any other country except South Africa.
In Indonesia, negligible HIV prevalence has given way to rapid increases among drug users and prostitutes, with up to 40 percent of patients at a Jakarta drug treatment center infected, the report said.
Particularly at risk are children and young people, said a UNICEF report also released Tuesday. The UNICEF study found that most of the world's youth "have no idea how HIV/AIDS is transmitted or how to protect themselves."
A survey carried out by 60 countries shows that more than half of those aged 15 to 24 have serious misconceptions about HIV/AIDS, UNICEF said.
UNAIDS appealed for renewed prevention efforts in rich countries, where unsafe sex practices appear to be triggering higher rates of sexually transmitted infections "eclipsing the safer-sex ethic promoted so effectively for much of the 1980s and 1990s."
Piot said that although the rate of AIDS-related deaths has fallen in the United States due to progress in treatment, 60,000 Americans get infected with the virus each year — a figure that has remained constant over the past 10 years.
"So there has been basically no progress in prevention," Piot said, adding that it would be one of the main issues discussed at the International AIDS conference in Barcelona that opens Sunday.