AFRO-NETS> Kaiser Daily HIV/AIDS Report - Thu, 29 Nov 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Thu, 29 Nov 2001
-----------------------------------------------

* UNAIDS Releases Updated Global AIDS Figures That Show Rising Number
  of Infections in Eastern Europe, Asia
* 'Fatalism', Poverty Create 'Cynicism' About Condoms Among South
  African Men, New York Times Series Says
* Catholics for a Free Choice Launch Ad Campaign Aimed at Ending
  Bishops' Ban on Condoms
* Political Will to Fight HIV/AIDS Epidemic Must be Sustained, U.N. 
  Secretary-General Kofi Annan Says


--
UNAIDS Releases Updated Global AIDS Figures That Show Rising Number 
of Infections in Eastern Europe, Asia

HIV infection rates in Eastern Europe are rising faster than anywhere 
else in the world and the HIV/AIDS epidemic continues to grow in 
Asia, surpassing one million newly infected people this year for the 
first time, according to UNAIDS' annual report, "AIDS Epidemic Update 
2001," released yesterday in preparation for World AIDS Day on Satur-
day (UNAIDS release, 11/28). Forty million people worldwide now have 
HIV/AIDS and approximately three million people will have died of 
AIDS-related complications this year. Eastern Europe has now become 
the region with the fastest growing number of HIV infections (BBC 
News, 11/28). "HIV is spreading rapidly throughout the entire Eastern 
European region -- a quarter of a million new cases only this year," 
UNAIDS Executive Director Peter Piot noted, adding that the epidemic 
"will get worse before it gets better" (UNAIDS release, 11/28). Two-
hundred and fifty thousand new infections were reported this year in 
the Russian Federation (Reuters Health, 11/28). Half of those infec-
tions occurred in people under the age of 20, reflecting a worldwide 
trend. "About one-third of those living with AIDS are aged 15-24," 
the report states, emphasizing that most of those infected are un-
aware of their status and could continue to infect others (Maugh, Los 
Angeles Times, 11/29). A combination of "economic insecurity, high 
unemployment and deteriorating health services," along with a rise in 
intravenous drug use, has contributed to the rise of new infections 
in the region, U.N. officials in Moscow said. Ukraine has the highest 
HIV prevalence in region, with 1% of adults infected (Bellaby, 
AP/Fresno Bee, 11/28). 

Success and Leadership

Poland, where HIV prevalence remains 0.07%, has been the one excep-
tion to the trend in Eastern Europe, largely due to an aggressive 
government campaign to reach drug users. "When the first data came 
out about the spread of HIV among injection drug users, the Polish 
government appointed a priest ... as head of their AIDS program, 
which I think was a very smart political move," Piot said, explaining 
that it "allowed [the] program to be very open about harm reduction 
(including) methadone treatment, needle exchange ... and an aggres-
sive promotion of condoms" (Brown, Washington Post, 11/29). Piot, 
speaking in Moscow, called for "vigorous leadership at the top level" 
in Eastern Europe and specifically asked Russian officials to "put 
together a high-level committee that would include all the key minis-
tries, to define what can be done." According to Piot, there are 
"many good, small projects going on in Russia ... [b]ut now it has 
got to get to a scale that will make a difference." Russian officials 
must "recognize at the highest political level and in the legislature 
that AIDS is a matter of national priority for the security and fu-
ture of the nation," he said, adding that a "mass education program 
for the general public" was in order (Besserglik, Agence France-
Presse, 11/28). He noted that the president of Ukraine has been the 
only head of state in the region to address HIV/AIDS and said "it is 
still too much business as usual" with regard to the disease in East-
ern Europe (Altman, New York Times, 11/29).

Newly Infected in Asia Reach One Million

Nearly 1.1 million people in Asia and the Pacific were infected with 
HIV in 2001, bringing the total of HIV/AIDS cases in the region to 
7.1 million. The Asian epidemic had been largely contained in Cambo-
dia, Myanmar and Thailand, but has now spread to China, India and In-
donesia. There are probably more than one million HIV-positive indi-
viduals in China, according to the report. Seven Chinese provinces 
are experiencing "serious local HIV epidemics," and nine more "are 
possibly on the brink" (Agence France-Presse, 11/28). The report also 
estimated that 3.86 million Indians had HIV/AIDS, second only to 
South Africa. Although less than 1% of the Indian population is in-
fected, the "seemingly low" overall level may "mask" localized epi-
demics. The states of Maharashtra, Andrha Pradesh and Tamil Nadu all 
had prevalence rates of "at least" 2% among pregnant women and more 
than 10% among people with STDs other than HIV (New York Times, 
11/29). Meanwhile, Indonesia, the world's fourth most populous coun-
try, saw a "surge" in new infections among sex workers and intrave-
nous drug users, "offer[ing] an example of how suddenly an HIV/AIDS 
epidemic can emerge," the report states (Agence France-Presse, 
11/28). "Few countries are acting vigorously enough to protect sex 
workers and clients. Yet it is from the comparatively small pool of 
sex workers first infected by their clients that HIV steadily enters 
the larger pool of still-uninfected clients who eventually transmit 
the virus," Piot noted. However, there are signs of progress in Asia. 
Large-scale prevention campaigns in Cambodia and Thailand have dra-
matically lowered HIV infection rates in those countries, and infec-
tion rates among pregnant Cambodian women dropped to 2.3%, down a 
third from 1997 (New York Times, 11/29). 

African Life Expectancy Cut

About 28.1 million people in sub-Saharan Africa are now infected with 
HIV, and lacking proper treatment and care, "most of them will not 
survive the next decade," the report states. Life expectancy has 
dropped from 62 years to 47 years in the region because of HIV/AIDS, 
and gross domestic product in the most heavily affected countries 
could drop by more than 20% by 2020, according to the report (Agence 
France-Presse, 11/28). "AIDS has become the biggest threat to the 
continent's development and its quest to bring about an African Ren-
aissance. Essential services are being depleted at the same time as 
state institutions and resources come under greater strain and tradi-
tional safety nets disintegrate," the report states (MSNBC.com, 
11/28). The number of new infections dropped to 3.4 million this year 
from 3.8 million in 2000, but the "extremely high numbers 'show that 
there is still an enormous potential for spread of AIDS in Africa,'" 
Piot acknowledged. Areas of North Africa are showing signs of in-
creasing infection, with Algeria registering a 1% infection rate 
among pregnant women and Libya experiencing HIV outbreaks among in-
travenous drug users (New York Times, 11/29).

Amassing Resources to Fight HIV/AIDS

Piot called the Sept. 11 attacks on the World Trade Center and the 
Pentagon a "major blow to the global (AIDS) agenda," diverting fund-
ing and "interrupting the momentum" that had begun to build in the 
international community after last year's Durban AIDS Conference 
(Sternberg, USA Today, 11/29). Donations to the Global Fund to Fight 
AIDS, Tuberculosis and Malaria have declined since the attacks, with 
only Italy having handed over money to the fund since Sept. 11. About 
$1.5 billion has been pledged so far (Garrett, Newsday, 11/29). "Peo-
ple aren't putting up the bucks right now," Paul Zeitz of the Global 
AIDS Alliance, which on Friday will release a report "sharply criti-
cal" of the funding "shortfall," said. Piot also "lament[ed]" the 
lack of access to affordable AIDS drugs in the developing world, de-
spite price concessions from many major pharmaceutical firms (USA To-
day, 11/29). 

Reason for Hope

Despite the growing number of people with HIV/AIDS, 2001 marked a 
"turning point" in the fight against the disease, U.N. Secretary-
General Kofi Annan said in his World AIDS Day message. "At no time in 
the two decades of dealing with this catastrophe, has there been such 
a sense of common resolve and collective possibility -- among govern-
ments, civil society and the private sector; among foundations, opin-
ion makers and people living with the disease," he said, citing the 
"impressive" amount of money pledged to the Global Fund in its first 
few months of existence. "Thanks to the United Nations General Assem-
bly's special session on HIV/AIDS last June, we now have globally 
agreed goals. All of us have a part to play in reaching those goals. 
On this World AIDS Day, let us all pledge to translate our concern 
into action; let us resolve that we care enough to build a world free 
of AIDS for future generations," he concluded (Annan release, 11/20). 
The full UNAIDS report is available online.


--
'Fatalism', Poverty Create 'Cynicism' About Condoms Among South Afri-
can Men, New York Times Series Says

The New York Times, in today's installment of its "Death and Denial" 
series about AIDS in Hlabisa, South Africa, reports that "everyone in 
Hlabisa has been advised to use condoms, but few do." Poverty, igno-
rance, "fatalism," myths and "cynicism" all play a role in residents' 
decisions not to use condoms. Although some men interviewed in local 
bars said that they may use condoms "20% to 50% of the time," they 
added that "[b]ecause we are Zulus, we don't believe AIDS can affect 
us. We see our sisters dying, but we don't believe it's AIDS. We 
think it's TB or pneumonia." Some of the men said that "sex with a 
condom is not really sex," and some believe that "the white man" pro-
vides condoms to prevent Africans from reproducing, or that AIDS is 
actually inside condoms. Several women interviewed by the Times said 
that they cannot ask a partner to use condoms, as he "would accuse 
her of being promiscuous or infected." The Times concludes that the 
"common element" among men and women in Hlabisa "is that poverty and 
tradition have made safe sex almost impossible" (McNeil, New York 
Times, 11/29).

Prostitutes Face Deadly Decisions on Condom Use

In an accompanying article, the Times reports that prostitutes at 
truck stops in the KwaZulu-Natal province have seen an increase in 
the number of men willing to use condoms, although there have been 
"few changes in the attitudes of the truckers." Thandi, who has been 
a prostitute for 13 years and discovered she was HIV-positive in 
1994, said, "Now maybe seven men in 10 will agree to use a condom. 
When I started, it was two in 10." Thandi and other women working at 
the truck stops say that some men continue to refuse to use condoms, 
or they poke holes in the condoms that they provide. Several of the 
women insisted that they would not have sex with a client without a 
condom, no matter how much money he offered. Faith, a prostitute who 
insisted that she is HIV-negative, said, "If a man doesn't want to 
use one, I say he can't sleep with me," adding, "Life is more impor-
tant than money" (McNeil, New York Times, 11/29). Both articles, in 
addition to the previous articles in the series, are available online 
at nytimes.com/international.


--
Catholics for a Free Choice Launch Ad Campaign Aimed at Ending Bish-
ops' Ban on Condoms

Catholics for a Free Choice tomorrow will launch an "unprecedented 
worldwide public education effort" aimed at ending Catholic bishops' 
ban on condoms, a CFFC press release states. The campaign, which will 
feature billboards, newspaper ads and ads in subways with the slogan 
"Banning Condoms Kills," targets Catholics and non-Catholics alike. 
The campaign will be carried out in the United States and other coun-
tries, including Mexico, the Philippines, Kenya, South Africa, Chile 
and Zimbabwe, with "significant" Catholic populations or high levels 
of HIV/AIDS. The ads ask people to log on to a special Web site, con-
doms4life.org, and contact their local lawmakers to voice their sup-
port of condom programs and their concern that Catholic bishops par-
ticipating in the ban may "undermine responsible public health policy 
on HIV/AIDS." CFFC President Frances Kissling states in the release, 
"The Vatican and the world's bishops bear significant responsibility 
for the death of thousands of people who have died from AIDS. For in-
dividuals who follow the Vatican policy and Catholic health care pro-
viders who are forced to deny condoms, the bishops' ban is a disaster 
... We can no longer stand by and allow the ban to go unchallenged." 
The release notes that UNAIDS Executive Director Peter Piot has ac-
knowledged the effect of the bishops' ban. "When priests preach 
against using contraception, they are committing a serious mistake 
which is costing human lives. We do not ask the church to promote 
contraception, but merely to stop banning its use," Piot said. The 
campaign kicks off Friday in Washington, D.C., with ads in 50 bus 
shelter and 225 subway ads. An ad will also run in the Washington 
Post and a full-page ad today will run in Europe in the Guardian 
Weekly. In January, billboards will appear in major cities in Bel-
gium, South Africa, Kenya, Zimbabwe, Bolivia, Chile, Mexico and the 
Philippines, accompanied by newspaper ads. The ads are available 
online (CFFC release, 11/21).


--
Political Will to Fight HIV/AIDS Epidemic Must be Sustained, U.N. 
Secretary-General Kofi Annan Says

"Just as life -- and death -- goes on after Sept. 11, so must we con-
tinue our fight against the HIV/AIDS epidemic," U.N. Secretary-
General Kofi Annan writes today in a Washington Post op-ed, adding 
that to lose the "tremendous momentum" gained in the fight against 
AIDS before the terror attacks on the World Trade Center and the Pen-
tagon would be to "compound one tragedy with another." UNAIDS statis-
tics released in advance of Saturday's World AIDS Day show that more 
than 40 million people worldwide are currently living with HIV/AIDS, 
a majority of them in sub-Saharan Africa. However, "not far behind" 
are the Caribbean, Asia and Eastern Europe, where the epidemic is 
"spreading at an alarming rate," he notes. In June, the United Na-
tions' General Assembly in a special session on HIV/AIDS in New York 
City "adopted a powerful declaration of commitments" to fighting the 
AIDS epidemic. Annan writes that the Global Fund to Fight AIDS, Tu-
berculosis and Malaria, which aims to collect $7 billion to $10 bil-
lion but currently totals just more than $1.5 billion, "cannot be the 
only channel of resources for a full-scale global response to AIDS." 
He adds, however, that it is "most heartening" to see the range of 
pledges to the fund: "from the world's wealthiest nations ... but 
also from some of its poorest, as well as from foundations, corpora-
tions and private individuals." Annan concludes, "It is clear that we 
have the road map, the tools and the knowledge to fight AIDS. What we 
must sustain now is the political will. Life after Sept. 11 has made 
us all think more deeply about the kind of world we want for our 
children. It is the same world we wanted on Sept. 10 -- a world in 
which a child does not die of AIDS every minute" (Annan, Washington 
Post, 11/29).

--
The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, 
a free service of The Henry J. Kaiser Family Foundation, by National 
Journal Group Inc. c 2001 by National Journal Group Inc. and Kaiser 
Family Foundation. All rights reserved.

--
To send a message to AFRO-NETS, write to: afro-nets@usa.healthnet.org
To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
in the body of the message type: subscribe afro-nets OR unsubscribe afro-nets
To contact a person, send a message to: owner-afro-nets@usa.healthnet.org
Information and archives: http://www.afronets.org