Wall Street Journal - July 6, 2004
Gautam Naik, gautam.naik@wsj.com

LONDON - Despite a huge global push in recent years to fight HIV in developing countries, the virus continues to infect a growing number of people and claim millions of lives each year, according to new data published Tuesday by UNAIDS, an AIDS program sponsored by the United Nations and other groups.

In its report released ahead of a major AIDS conference starting this weekend in Bangkok, UNAIDS estimates that five million people last year were newly infected with HIV -- the largest number in any single year since the epidemic began two decades ago. Another three million died in 2003 because of AIDS, the disease caused by the HIV virus. Another approximately 38 million are currently living with HIV, up from 35 million in 2001.

REPORT ON THE AIDS EPIDEMIC Read the executive summary of the UNAIDS study, or visit the organization's Web site to download the entire report.

"The situation will get worse before it gets better," says Peter Piot, head of UNAIDS, in an interview.

The fastest-growing epidemics today can be found in Asia and Eastern Europe. Even in the U.S. and Western Europe -- where most people who need antiviral therapy have access to it -- infection rates are on the rise. World-wide, nearly half of all new HIV cases are young people aged 15 to 24, according to the report.

The disease is already erasing decades of health, economic and social progress in the hardest hit countries of eastern and southern Africa. "AIDS is an extraordinary kind of crisis; it is both an emergency and a long-term development issue," the UNAIDS report concludes.

This month's big AIDS meeting in Bangkok is expected to grapple with two of the biggest questions facing public health experts: Can HIV infection rates be reduced? And for those in developing countries who are already infected, will the Western world provide enough money to buy low-cost lifesaving drugs?

Comprehensive prevention could avert 29 million of the 45 million new infections projected to occur between 2002 and 2010, UNAIDS estimates. For the short term, AIDS awareness programs have made a significant difference, but plenty remains to be done. Only one out of five people world-wide has access to HIV prevention services, according to the report. In sub-Saharan Africa, only 8% of out-of-school young people and slightly more of those in school have access to education on prevention.

For the longer term, many public health experts believe a vaccine represents the best hope for reducing the infection rate. While there are efforts to ramp up spending towards the development of an HIV vaccine, only a tiny amount of global AIDS spending is currently devoted to this area.

One area of "important progress" outlined by the report is the financial response to the AIDS crisis by Western governments, non-governmental organizations and other groups. UNAIDS notes that in 1996 about $300 million was spent on AIDS globally. By 2003, that figure had risen to about $5 billion.

But here, too, a big gap looms. According to new estimates contained in the report, $12 billion will be needed in each of the years 2005 and 2006 to provide HIV prevention and care in low- and middle-income countries. From 2007 onwards, that figure is expected to jump to $20 billion annually as more patients are supplied with drugs. Current financing commitments from governments and other groups are nowhere near closing that gap, although the U.S. government's pledge to provide $15 billion to fight AIDS will help.

Still, public health experts hold out hope that millions of early AIDS-related deaths could still be averted, provided governments, donor countries and other groups build on current momentum. "We're entering a completely different response to AIDS," says Mr. Piot of UNAIDS. "There is now finally some money and a lot more political awareness. That's the biggest change."

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