UN ranks India worst for AIDS

Peter Foster, New Delhi
June 1, 2006

INDIA has overtaken South Africa as the country with the most people living with the AIDS virus.

And Papua New Guinea's HIV/AIDS epidemic is spreading at an alarming rate, the latest United Nations report on AIDS says.

PNG accounts for more than 90 per cent of HIV infections in the southern Pacific region.

HIV diagnoses have been increasing by about 30 per cent a year since 1997, and an estimated 60,000 Papua New Guineans are living with HIV, a prevalence rate of 1.8 per cent, the report says.

High levels of sexual violence against women are reported in PNG, paid and casual sex liaisons feature prominently and condom use is erratic, it says.

The UN report on the progress of the global epidemic estimates that 5.7 million Indians were infected at the end of last year, compared with an estimated 5.5 million South Africans.

But it also found that the world's overall HIV infection rate has stabilised.

The UNAIDS organisation says more than 25 million people have died from AIDS since it was identified in the early 1980s. However, the total number of infected people has been revised down from 40 million to 38.6 million.

"Overall, the HIV incidence rate (the proportion of people who have become infected with HIV) is believed to have peaked in the late 1990s and to have stabilised subsequently, notwithstanding increasing incidence in several countries," the UNAIDS report concludes.

But UNAIDS executive director Dr Peter Piot said public health efforts were reaching only a small proportion of people at risk.

AIDS could no longer be considered as a single epidemic but as many diverse ones, he said. "It's a very complex epidemic."

By percentage of population, Africa remains the continent where AIDS has the greatest impact — 0.9 per cent of Indians carry HIV, compared with 18.8 per cent of South Africans.

Some of the more alarmist predictions a few years ago about rampant progress of AIDS in India and other Asian countries have not been borne out, the report shows.

The most promising news, Dr Piot said, was that the number of new HIV infections had dropped in three African countries — Kenya, Zimbabwe and urban areas of Burkina Faso. Earlier, Uganda reported decreases.

Cambodia and four states in India showed a drop in new infections, joining Thailand's earlier success, he said.

In the Caribbean, the world's second most affected region, new infections have declined in the Bahamas and parts of Haiti. AIDS is the region's main cause of death in people aged 15 to 44.

The UN disputed contentions by some observers that the leveling off showed a turning point in the epidemic in Africa. "Available evidence does not offer grounds for such conclusions," Dr Piot said, in part because "the actual number of people infected continues to rise because of population growth".

UNAIDS said improving prevention and treatment could save up to 29 million lives by 2020.

In India it is estimated that only 7 per cent of those who need antiretroviral drugs receive them, and only 1.6 per cent of pregnant women who need treatment receive it.

TELEGRAPH, NEW YORK TIMES