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UN says AIDS deaths at new high

PRETORIA -- The global AIDS epidemic is entering its deadliest phase so far, with high numbers of new HIV infections being matched by an unprecedented number of deaths in many southern African nations, according to a United Nations report released yesterday.

Saying there were no signs of the epidemic abating, the Joint United Nations Program on HIV/AIDS, or UNAIDS, found that one out of every five adults in southern Africa is infected with HIV and that two countries, Botswana and Swaziland, recorded an astounding infection rate of 39 percent of adults last year.

UNAIDS estimated that a record 3 million people will die this year from AIDS-related illnesses, a 10 percent jump from 2002 estimates, and a record 5 million people will become infected with HIV, which causes AIDS.

"The epidemic continues to deepen, to expand, and it is tightening its grip on southern Africa and threatening Southeast Asia," Peter Piot, UNAIDS executive director, told reporters in a conference call from London.

The numbers of those infected in southern Africa, he said, are "a really dramatic illustration how the epidemic is further eroding this part of the continent." Piot also said he was worried about the spread of the virus in China, India, and Russia, in particular. He pointed out that Russia was spending only a "few million dollars" a year on AIDS, while the billion-plus populations of both China and India mean that if the epidemic crosses the 1 percent threshold in those countries, more than 20 million people will be infected.Now, an estimated 40 million people are infected worldwide, according to the report, 7.4 million in Asia alone.The report, released six days before World AIDS Day, also reflected a growing caution about estimating the numbers of those who are infected or have died from the disease. Some critics, pointing to poor record-keeping throughout sub-Saharan Africa, have cast doubt on previous estimates of the impact of AIDS, impact, saying they were vastly inflated.

This year's report, based on data collected from pregnant women at prenatal clinics and from door-to-door surveys in at least seven nations, estimated that the number of people infected was between 34 million and 46 million worldwide. The report selected the midpoint between the estimates, or 40 million. Last year, UNAIDS estimated that 42 million worldwide were infected with HIV or AIDS.

Piot and Karen Stanecki, chief demographer for UNAIDS, stood strongly behind the numbers and stressed that this year's lower estimate did not mean that the epidemic was declining, but rather reflected more accurate statistics gathered in the past year. In particular, demographic studies taken in rural areas found that previous reports had overestimated prevalence rates in those areas.

The report also said that the global response to the virus has begun to increase drastically. Piot said that rich and poor countries will spend $4.7 billion this year fighting AIDS, up from $3.1 billion in 2002. That increase comes from several sources, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the World Bank; the US government; and several developing countries, which boosted spending on AIDS largely to begin treatment programs.

Still, UNAIDS estimates that $10 billion was needed this year to pay for adequate prevention, care, and treatment programs.

"I feel strongly that this year we are really entering a new phase in the global response to AIDS, entering a time of great opportunity and growing political momentum to respond to AIDS," Piot said.

He pointed out that when President Bush and Prime Minister Tony Blair of Britain met last week, the two leaders did not discuss just Iraq and the Middle East, but broadened the discussions to include the AIDS epidemic.

The report included some positive news in the trends of the epidemic. In Uganda, HIV prevalence receded to 8 percent in Kampala last year, the latest proof of a steady and remarkable drop, considering that the rate stood at 30 percent a decade ago. In Addis Ababa, Ethiopia, HIV prevalence among pregnant women dropped to 11 percent this year, from a high of 24 percent in 1995.

And in the Rwandan capital of Kigali, pregnant women found to be HIV positive fell to 13 percent, from a high of nearly 35 percent in 1993. But UNAIDS said such comparisons in Rwanda should be treated with caution, because of the vast population movements after the 1994 genocide.

But in southern Africa, the epidemic's epicenter, the news was uniformly grim.

In four countries with relatively small populations -- Botswana, Lesotho, Namibia, and Swaziland -- the epidemic has reached extremely high levels with no signs of dropping. In Swaziland, for instance, the rate stood at 39 percent infected, up from 4 percent a decade ago.

The prevalence rate in some countries remained relatively stable, the report said, "but it hides the fact that the persistently high number of annual, new HIV infections is matching the equally high number of AIDS deaths."

Stanecki said: "In general, things are plateauing in southern Africa, coming to a stabilization, but it entirely has to do with increasing death rates. People are starting to die in high numbers."

John Donnelly can be reached at

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