New HIV/AIDS Figures – Same Old Story

Well, for a change there's a little bit of good news in the world. The 2008 Report on the Global AIDS Epidemic by the United Nations agency responsible for AIDS—UNAIDS—shows that efforts around the world are finally starting to pay off as there are declines in both the numbers of people being infected with, and dying from the virus. On top of that, the number of people living with AIDS has stabilized and more people are receiving proper treatment as well.

While Paul De Lay, Director of Evidence, Monitoring, and Policy at UNAIDS, said that the increased efforts in teaching people prevention methods are beginning to make a difference, as shown by the drop in the infection rate, he also cautioned that the epidemic was not over in any part of the world. The number of cases may be stabilizing— i.e. not showing any increases—but that number is still very high, and there are parts of the world and marginalized communities where the virus continues to run rampant. As an example, he cited the figure that two of every three new cases of AIDS occurs in the Sub-Saharan region of Africa.

Some of the figures the report cites show improvement on various fronts: actual number of people living with HIV/AIDS is 33 million, new infections are down to 2.7 million from 3 million in 2001, total deaths are down from 2.2 million in 2005 to 2 million in 2007, number of children infected is down from 410,000 to 370,000 in the same period, and the percentage of infected pregnant woman receiving anti-viral drugs has risen to 33% from 14% in those two years.  They also show just how far we have to go in order to bring the disease under control. With a new infection rate of 2.7 million people each year and no cure in sight for the disease, it means that any let-up in prevention efforts could see the numbers spiraling upwards again.

An example of the breadth of the problem that's still being faced can be found in another figure quoted by Dr. De Lay: for every two new people receiving treatment in the world there are still five new people contracting the disease. Treatment is very expensive, and according to Purmina Mane, Deputy Executive Director of the United Nations Population Fund, the cost to supply everybody currently infected with the disease would be 11 billion dollars American annually. That's a cost that will continue to rise substantially of course, unless something is done to reduce the annual infection rate.

While it's possible that the United Nations might reach the target date of 2015 for achieving an actual decline in the numbers of people living with HIV/AIDS, its goal of universal access to treatment, prevention, care, and support for all those living with the disease by 2010 is not looking good. That makes me wonder how much of the first goal will be met by people currently infected dying, and how much by any actual reduction in new cases of infection. If we can't provide universal prevention, how can we possibly stop the spread of the disease?

The problem is that universal prevention isn't going to happen given the current political climate in the world. The simple facts of life when it comes to HIV/AIDS is that nothing has changed since the 1980s, and in order for the virus to spread you need an infected person, an uninfected person, and an exchange of bodily fluids between the two of them. The most common ways that happens is through unprotected sex and intravenous drug users sharing needles. Theoretically it should be easy to prevent the disease from spreading; simply ensure that neither of those events occur.

Unfortunately there is quite a bit of disagreement on how you prevent unprotected sex or intravenous drug use. According to the Catholic Church, the current American administration, certain conservative Christian groups, and various Muslim sects, the use of condoms is worse than spreading disease, so they recommend abstinence. Actually, they insist on it, at least as much as they are able to. In the case of the current American administration, that includes refusing to fund any program that advocates condom use anywhere in the world.

While some countries have remarkably sane attitudes towards ensuring a supply of clean needles for intravenous drug users, Iran has needle dispensers on the streets of Tehran and a needle exchange program in its prison system.  Others are like Canada and the United States where needle exchanges are barely tolerated and they refuse to admit that drug use even exists in prisons. Of course, the prisoners don't have sex either, so there's no point in supplying them with condoms.

The solution offered by these folks is for everybody to abstain from pre-marital sex and using intravenous drugs. While the second suggestion is noble, and a good idea, the former is utterly ridiculous, and both deny reality. In the United States itself, only twenty-seven percent of those people who sign so-called abstinence oaths promising to refrain from pre-marital sex actually follow through on their vows. Even more unfortunate is the fact that the majority of those who succumb to temptation don't use a condom, so not only do they risk contracting a sexually transmitted infection, but also the other more traditional side-affect of sex, pregnancy. If the program's success rate is that poor in the U.S. among those who are supposedly willing, what does that say about its validity as a means of prevention elsewhere?

I started off by saying that there was some good news for a change, and have pretty much gone on to refute that statement with the balance of the article. However, any signs that in-roads are being made against the spread of HIV/AIDS are positive and a reason for hope. The problem is that the position is still very precarious and it's not being helped by those who are willing to risk other people's lives by imposing their morality on the world. If you don't want to use a condom when you have sex that's your choice, but don't force somebody else to risk their life for a little pleasure.

As former UNAIDS employee Elizabeth Pisani says commenting on the report at her "Wisdom Of Whores" Web site, "…somewhere between two and three million people are still getting infected every year with a completely preventable disease that we are spending over 10 billion dollars a year on. That’s a scandal that no amount of report-writing has been able to change."

We've known for close to thirty years how to prevent the spread of HIV/AIDS, yet the disease was allowed to reach epidemic proportions because of so-called moral issues, and those attitudes haven't changed. The miracle is that there has been any decline in the number of deaths and infections—thank God for the immoral people out there passing out condoms and making a difference.