PHA-Exch> Threat of global AIDS epidemic over, says WHO

[Claudio Schuftan]

From: Vern Weitzel <vern.weitzel at gmail.com>
crosposed from: "[health-vn discussion group]" health-vn at cairo.anu.edu.au



Threat of global AIDS epidemic over, says WHO

10 Jun 2008, 0128 hrs IST,Kounteya Sinha,TNN

NEW DELHI: A quarter of a century after AIDS first appeared, the World
Health Organisation has for the first time said the threat of a global
heterosexual pandemic outside Africa might have passed.

According to Dr Kevin de Cock, one of the world's leading
epidemiologists and head of the organisation's HIV/ AIDS department,
there has been a shift in the understanding of the risks posed by the
virus.

HIV was earlier regarded as a risk to populations everywhere,
irrespective of the percentages that practised unsafe sexual behaviour.
But experts now believe that outside of sub-Saharan Africa, the disease
is largely confined to high-risk groups like men having sex with men,
sex workers and their clients.

Speaking to TOI from New York, Dr de Cock said, "If the virus had to
cause an epidemic among the general population in India and China, as
originally feared, why hasn't it happened till now? It doesn't look
likely anymore."

Dr de Cock, who expressed doubts about predictions of an Africa-type
situation developing in India, said prevention strategies need to be
focused where HIV transmission is occurring. "India needs to look at who
are getting infected more often and then target that section of
society," he said. He called for massive investments in educating those
most at risk rather than focus on a school AIDS programme. "Countries
need to go where transmission is occurring, which they have not always
been good at," he said.

The WHO expert said that unlike Africa, specially in its southern and
eastern parts, where the virus has been found to be "self-sustaining" in
the general population, a similar trend has not emerged in Asian
countries. In these nations, the prevalence is mostly concentrated in
groups at risk and their partners. "It is very unlikely that there will
be a heterosexual epidemic in other countries outside Africa," Dr de
Cock said, while emphasising that this should not breed complacency.

UNAIDS chief Dr Dennis Broun, too, agreed with Dr de Cock. He told TOI,
"We made a mistake with our predictions.

However, the gloomy predictions were made seeing evidence that was
available to us 10 years ago, which was minimal. Today, with all the
accumulated information, it is unlikely that Asian countries will see a
generalised epidemic."

Nearly 2.45 million Indians live with HIV with prevalence rate in the
general population of 0.36%.

India is also home to nearly two lakh IDUs. Over 20% of them are HIV
positive solely due to sharing of contaminated needles. India is also
home to 2.5 million MSMs with HIV infection rates as high as 16%.

Critics of the global Aids strategy have always cried foul of the vast
sums being spent educating people who were not most at risk from the
disease when a far bigger impact could be achieved by targeting groups
who are more vulnerable.

Dr de Cock admitted there were "elements of truth" to such criticism.

There has been a view that UNAIDS had deliberately exaggerated the size
and trend of the projected pandemic, besides hyping the potential for
HIV in general populations creating an impression that just about
everyone was at risk of AIDS.

"This led to billions of dollars being spent on AIDS rather than on
other serious illnesses which face an acute fund crunch," a health
ministry official said.

India's worries are concentrated in six states — Maharashtra, Tamil
Nadu, Andhra Pradesh, Manipur, Karnataka and Nagaland.

http://timesofindia.indiatimes.com/articleshow/3115367.cms
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