July 30, 2008

Global Aids Death Rate Declining

Amid feverish global efforts to fight AIDS, the number of people who die from the disease has declined worldwide for the second year in a row, according to a U.N. agency on Tuesday.

The United Nations AIDS agency found fewer people are dying of AIDS, more patients are on HIV medication and the global AIDS epidemic is stable after peaking in the late 1990s.

However, the good news was followed with a warning that governments need to continue to set aside millions of dollars for the disease, as patients live longer on treatment.

"We've achieved more in the past five years than in the previous 20 years," said Peter Piot, the agency's executive director. "But if we relax now, it would be disastrous. It would wipe out all of our previous investments."

Officials with Geneva-based UNAIDS and outside activists said an increased effort is needed to beat this modern scourge.

Dr. Paul Zeitz, executive director of the Washington-based activist group Global AIDS Alliance, said the report showed positive results in sub-Saharan Africa that stemmed from the big increase in spending on prevention and treatment programs.

"Based on this evidence, it's time to ramp up funding from all sources -- not to slow down or go on to other things. We're on the path toward victory here. Let's invest more," he said.

Global AIDS deaths numbered about 2 million in 2007, down from 2.1 million in 2006, according to the group. In 2005, AIDS deaths peaked at 2.2 million after a steady climb since the disease was first identified in the early 1980s.

"A six-fold increase in financing for HIV programs in low- and middle-income countries (from) 2001-2007 is beginning to bear fruit, as gains in lowering the number of AIDS deaths and preventing new infections are apparent in many countries," according to the report.

"Progress remains uneven, however, and the epidemic's future is still uncertain, underscoring the need for intensified action to move towards universal access to HIV prevention, treatment, care and support," the report read.

UNAIDS estimates the number of AIDS case worldwide at 33 million; its previous estimate of 40 million was changed last year because of changes to how it counts cases. HIV is most often spread through sexual contact or injection drug use.

Countries in sub-Saharan Africa including South Africa, Botswana and Swaziland, remain the center of the AIDS epidemic. The region has about 67 percent of all people infected with HIV and 72 percent of all AIDS deaths.

The most noticeable improvements are in treatment where the number of people on AIDS medication jumped by 10 times in the last six years.

In 2003, 300,000 people were taking AIDS drugs compared to about 3 million in 2007. AIDS treatment has become much cheaper and more available because of a variety of government and private programs. But many still lack access.

"There are still five new infections for every two people who are newly added on treatment. So clearly, we're not pushing back the epidemic enough," Dr. Paul De Lay of UNAIDS said.

Rates of new AIDS diagnosis are on the rise in many countries, including China, Indonesia, Kenya, Mozambique, Papua New Guinea, Russia, Ukraine and Vietnam, and even wealthier nations like Germany, Britain and Australia.

UNAIDS said its report used data from 147 countries, but De Lay said he was disappointed the United States did not provide its 2007 AIDS figures because U.S. officials continue to "refine" the numbers and will announce them soon.

Last week, the U.S. Congress passed a bill to triple spending on a program to fight AIDS, malaria and tuberculosis in Africa and other parts of the world.  President George W. Bush is expected to sign it into law this week.
Experts said it's too early to stop worrying about AIDS.

"I'm not sure we will ever get to a point where we can say this is not a public health problem," said James Chin, a clinical professor of epidemiology at the University of California, Berkeley.

The objective of AIDS programs is to provide access to medication to everyone who needs it," Chin said. "Until that's accomplished, this won't go away."

But not everyone is pleased with the progress.

The slow decline of AIDS-related deaths is "dismally disappointing," said Selina Lo, medical coordinator for Medecins Sans Frontiere's Access to Essential Medicines campaign. The group also is known as Doctors Without Borders.

She said the numbers are evidence that strategies need to change.

Also, the Black AIDS Institute activist group issued a report saying the U.S. government had neglected the epidemic among black Americans as it fights the disease overseas.


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