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The Lancet: AIDS Reports - 2002-07-04

Two new reports say a massive expansion of the HIV/AIDS pandemic is “not inevitable.” But the studies say in order to avoid tens of millions of new infections, “existing HIV prevention strategies must be “substantially scaled up.” The reports are published in the July 6th edition of the medical journal The Lancet. VOA’s Joe De Capua has the story.

The reports are being published shortly after a dire warning from the United Nations AIDS program, UNAIDS, that nearly 70-million people will die from the disease over the next 20 years unless prevention and treatment programs are expanded.

While the reports also warn that if the status quo continues there will be many new infections, they also say something can be done about it. One of the reports appearing in The Lancet is the work of The Global HIV Prevention Working Group, consisting of 37 international experts on HIV prevention. It has the support of the Kaiser Family and Bill and Melinda Gates Foundations. The other comes from a research team led by UNAIDS and the World Health Organization, the W-H-O.

Dr. Bernhard Schwartlander of the W-H-O says the knowledge currently exists to greatly curtail the spread of the AIDS virus.

He says, "You know, without major interventions, basically just going on with business as usual, we would probably expect another 45 million new infections in the coming eight years, between now and the year 2010. However, the most important part of the article is certainly that if we scale up interventions, starting now rapidly and aggressively, we could avoid the majority of these infections. And we would estimate at least 29 million of these 45 million infections could be avoided."

Dr. Schwartlander says the strategy to accomplish this was laid out a year ago in the Declaration of Commitment from the U-N General Assembly Special Session on HIV/AIDS. That strategy includes mass media campaigns, condom promotion, voluntary counseling and testing programs, prevention of mother to child transmission of HIV and treatment of sexually transmitted diseases among others.

The UNAIDS/WHO report estimates the cost of “scaling up and sustaining the effort to 2010 is 27 billion dollars.” Or to put it another way, a cost of one thousand dollars for every infection that is prevented. However, Dr. Schwartlander says despite the emphasis on prevention, the effort must include care and treatment for those already infected.

The second report is entitled, “Global Mobilization for HIV Prevention: A Blueprint for Action.” One of authors is Dr. Helene Gayle, formerly of the U-S Centers for Disease Control and Prevention, and now with the Bill and Melinda Gates Foundation.

Dr. Gayle says, "The top line finding is that HIV prevention works. And that there is overwhelming evidence now to that effect. And that in many ways the key challenge is access to effective prevention. Estimates are that only one in five people at risk have access to prevention. So there’s a huge gap in access to prevention."

The Blueprint for Action’s recommendations include a “substantial increase in prevention funding,” training local personnel on the latest medical technology, encouraging political leaders to speak out on HIV/AIDS, increasing access to treatment and confronting stigma and discrimination.

The reports have been released prior to the 14th International AIDS Conference in Barcelona, which gets underway July 7th.