USIA Washington File - November 29, 199
Washington -- A new report by the United Nations says HIV, the
virus that leads to AIDS, is spreading in the Americas.
The "AIDS Epidemic Update," a report published by the Joint
United Nations Program on HIV/AIDS and the U.N. World Health
Organization, says the prevention challenge for HIV remains
"acute" in the region, against a backdrop of evidence that
infections are on the rise. The report said the Caribbean Basin
ranks second behind the sub-Saharan region of Africa with the
worst HIV epidemic.
In Latin America and the Caribbean combined, some 1.7 million
people will enter the 21st century with the HIV infection --
almost 30,000 of them children, according to estimates cited in
the report. This number, the U.N. said, is somewhat less than
the total given in 1998 because estimates for two populous
countries, Brazil and Mexico, were revised downwards on the
basis of new data.
In Guatemala in 1999, some 2 to 4 percent of pregnant women
tested at prenatal clinics in major urban areas were found to
have HIV. In Guyana, HIV prevalence was recorded at 3.2 percent
among blood donors, who are generally thought to represent a
population at low risk of infection.
The U.N. said the last time Haiti performed HIV surveillance
among pregnant women, in 1996, close to 6 percent tested
positive for the virus. Infection rates approaching 8 percent
had already been registered in some Haitian prenatal clinics as
early as 1993.
Some countries in Latin America have joined the ranks of those
providing antiretroviral treatment for people infected with
HIV, according to the U.N. Brazil, for example, spent $300
million in 1999 providing such drugs for about 75,000 people.
Antiretrovirals are also being used in Argentina, where the
rate of new AIDS cases reported each year fell about 40
percent, from a peak of 71.6 cases per million people in 1996
to 41.3 cases per million people in 1998.
While the antiretroviral treatment is expensive, the savings in
hospitalization and medical care for patients go "a long way
towards justifying the costs of drugs which stave off the
progression of HIV/AIDS," the U.N. said. "There are also
considerable savings of the indirect costs of illness. Without
antiretroviral therapy, many more people with HIV would develop
opportunistic infections associated with a damaged immune
system." The U.N. said estimates show that over a one-year
period between 1997 and 1998, Brazil averted about $136 million
in hospital admission and treatment costs alone for people with
The report said that in Central America and the Caribbean
island states, access to antiretroviral therapy is far more
limited than it is in South America. Guatemala, for instance,
which spends $64 per person per year on health, estimates that
just 185 people have access to antiretrovirals out of an
estimated 50,000 or more people living with HIV and AIDS.
Worldwide, the report said, the HIV-positive population is
still expanding and the number of AIDS deaths can be expected
to increase for many years before peaking. The report said
about 33 million adults and 1.2 million children will be living
with HIV by the end of 1999. This year, some 2.6 million deaths
resulted from HIV/AIDS -- a higher global total than in any
year since the beginning of the epidemic.
The report said the overwhelming majority of people with HIV --
some 95 percent of the global total -- live in the developing
world. That proportion is set to grow even further as infection
rates continue to rise in countries where poverty, poor health
systems and limited resources for prevention and care fuel the
spread of the virus.
The U.N. said this is especially true in Africa -- notably
sub-Saharan Africa -- where social and economic safety nets
that might help families cope with the impact of HIV are badly
frayed, in part because of the epidemic itself.
Following behind sub-Saharan Africa and the Caribbean Basin
with the worse percentages of the HIV/AIDS prevalence rate were
South Asia and Southeast Asia, East Asia and the Pacific, and
The report concluded that the huge gap in HIV infection rates
and AIDS deaths between rich and poor countries is likely to
grow even larger in the next century. However, on a positive
note, the report said "massive national and international
efforts may yet help to end the stifling silence that continues
to surround HIV in many countries, and to explode myths and
misconceptions that translate into dangerous sexual practices."
A trail of successful responses to fighting HIV/AIDS has
already been "blazed by a small number of dedicated communities
and governments," the U.N. said. The "challenge for the leaders
of Africa and their partners in development is to adapt and
massively expand successful approaches that make it harder for
the (HIV) virus to spread, and that make it easier for those
affected to live full and rewarding lives."
(The Washington File is a product of the Office of
International Information Programs, U.S. Department of State.)