As we all know, Bush and Blair are fundies who believe that the AIDS epidemic can be quelled through abstinence alone. And we also know that the US and UK have used this troglodyte philosophy to justify the withholding or misdirection of promised millions in the fight against the disease to Africa and other developing areas. So it comes as no surprise that the BBC and some in the US media have flogged a story claiming that the epidemic "peaked" in the 1990s and "s'all good" now, with just pockets" of problems. It is significant that this bit of "feel good" news was released within a day of another report which found that overall, the war against AIDS is being lost in many regions. Playing down the scope of the AIDS pandemic not only helps justify a slowdown in US/UK aid to afflicted nations, it also provides the pharmaceutical industry with a good excuse for not increasing the availability of more affordable AIDS drugs to developing countries

The assertion that the AIDS/HIV epidemic is improving is based on a phony "averaging" scheme that is chronically used by the Bush administration to lie to the public. Here's how it works: you take an improvement in one narrow area and hype it, weight it heavily, and "average" it into the whole. Thus, although a staggering 38.5-45.9 MILLION people are now living with HIV and at least 2.8 MILLION died last year alone, the fact that there have been major gains in some regions (mostly in highly developed countries) allows you to claim that the epidemic "on average" has slowed, or “already peaked.”

Bush does this sort of thing with the economy all the time - the US Labor Department, for example, recently claimed that "average US salaries" had climbed significantly in 2004-2005. But a little probing and you find that while the top 5% of US wage earners made big gains, the bottom 80% actually experienced a wage LOSS! But using the "averaging scheme," the administration made it come out as a “universal gain” on paper (it’s like claiming that the “average lottery win” for a given week in a given city was in the thousands because one person in that city happened to hit a $300-million jackpot).

Thus the headlines proclaim that the HIV/AIDS epidemic has already peaked. But even this is spinning the spin. Mark Stirling, director of the UNAIDS Regional Support Team for Eastern and Southern Africa said that the increase in new cases is flattening (i.e., holding steady). This is not the same thing as a decrease in the rate of new cases.

In the real world, while a few places have made dramatic inroads against AIDS, the epidemic is dramatically worsening in many regions where it was already bad and becoming a new and critical problem in some places where, in the 1990s, it hadn't yet taken hold. For example, HIV infection in Russia is skyrocketing so rapidly that it is being described as a "catastrophe" in the making. HIV infection is also rising rapidly in Pakistan, Indonesia and Viet Nam.

Another deceptive finding is the "good news" of how much the HIV infection rate has fallen in some areas of Africa, notably Kenya and Zimbabwe. What the statistics for Africa don't take into account is that in a major epidemic, as the death rate climbs, the number of new infections eventually does decrease because the number of available "hosts" has been slashed by mortality. Even the bubonic plague finally died out when it had killed off enough "hosts". So while some of the decrease in infection in Zimbabwe can be attributed to increased safe sex practices, public health officials there admit that much of the drop is also due to "high mortality rates."

In addition, in some African countries, notably South Africa, the toll of HIV is being hidden by death certificate data . A study by Statistics South Africa found that a substantial percentage of death certificates listed TB, pneumonia, and influenza as the cause of death, when these diseases were actually opportunistic infections that had occurred as a consequence of a primary HIV infection. In some countries, HIV/AIDS cases are woefully underreported: According to a 2001 study, up to 70% of all AIDS cases in the Caribbean go unreported.

Some observers say some African nations dependent on US funds are now systematically fudging some HIV/AIDS statistics to pander to Bush’s extortionary approach to aid (under Bush, many third world clinics that offer basic birth control, let alone abortion, may find their funding withheld). Especially suspect are claims by several African countries that rates of any type of sexual activity among young people has declined substantially. This assertion seems a pretty big stretch of “fact” – I mean, just how do you quantify something like that? And claims of a decline of at least 25% in HIV infection rates among 15-24 year-olds by some African nations has been seriously challenged by AIDS workers who see contradictory evidence “in the field.”

But those working in the “HIV/AIDS trenches” are increasingly frustrated by the efforts of some governments and the media to downplay the severity of the situation. In a 2004 newsletter, TAC in South Africa decried a claim by magazine writer Rian Malan that the AIDS epidemic was exaggerated and that less money should be spent on fighting the disease. “Keep the cork on the champagne,” warned TAC. ”Malan's `research', which contains hardly any verifiable references, is shoddy journalism. It is littered with serious errors, one of them highly misleading, as well as obvious upon reading the source he quotes. Certainly Malan is an entertaining read. But unattributed quotes, unnamed science journals, unnamed experts, misrepresentations, leaving out critical evidence and a plethora of incorrect facts have no place in a thesis that purports to be debunking the current orthodox scientific view. "

Some of the assumptions made by the US media are based on equally appalling ignorance. Here’s just the most recent tidbit I ran across: Because the number of new HIV cases among gays in the US is rising, the media concluded that gays in the US are just getting complacent and aren't practicing safe sex anymore. Although complacence may indeed play a role, there is a much more obvious factor at work: The number of gay men is increasing as younger gays (the kids of boomers, a huge demographic group) have become sexually active, and active long enough to increase their changes of exposure to HIV.

Here’s another example of media myths – this one from India. A recent article proclaimed that India's rate of HIV infection is slowing due to "spousal fidelity." Spousal fidelity would certainly protect a narrow group - one in which both spouses are 100% faithful and were not exposed to HIV before marriage. But this is unlikely to be statistically significant in the bigger picture of India, where condom use is dismayingly low and the three main groups responsible for the spread of HIV in India are prostitutes, long-distance truck drivers (who commonly use the services of prostitutes), and intravenous drug users.

But the most likely reason for the reported “slowing” of HIV infection rates in India is simply incorrect data. India has a major problem with the underreporting of HIV due to the huge negative stigma attached to the disease. In fact, studies indicate that an alarming number of Indians avoid stigmatization by simply refusing to ever be tested. Their reluctance is understandable: A 2001 UNAIDS report on HIV in India stated: "There is an almost hysterical kind of fear … at all levels, starting from the humblest, the sweeper or the ward boy, up to the heads of departments, which make them pathologically scared of having to deal with an HIV positive patient. Wherever they have an HIV patient, the responses are shameful." (for more see THIS)

As to what the actual global rate of HIV/AIDS may be, it is difficult to say, except that the evidence favors higher, rather than lower, estimates. Unfortunately, there appears to be an astonishing lack of rigorous epidemiological studies of the pandemic. Existing studies often do not take enough relevant variables into account, let alone adjust for them: secondary infections listed as cause of death instead of HIV/AIDS, number of new cases relative to size of a population where mortality is high, differences in infection and progression rates for different groups (women versus men, for example), most common mode of transmission in a region, likely testing rate per 100,000 people in a population, cultural differences (as in India, the degree of stigmatization can powerfully influence reporting, testing rate, etc.), government "disease accounting” practices, political climate (skewing occurs for various political reasons), and other factors.

There is evidence that the situation may get much worse before it gets better. For example, Bush's medieval, magical-thinking approach to fighting AIDS is catching on with some in power in nations that have until recently begun to make inroads against HIV. Kenya's first lady Lucy Kibaki recently announced that she was against the use of condoms - especially among young people - because she believed that condoms promoted non-abstinence.

In addition, developing nations are likely to get caught up in an insidious Catch-22 with the new trend in “results-driven” aid. The Bush administration and many corporate-style “humanitarians” now demand “results” according their personal and usually arbitrary criteria (proof of increased abstinence, for example) as a prerequisite for aid. So poor nations are tempted to create “results” on paper to obtain aid, only to find that, thanks to these phony “results,” aid is soon decreased just as the real conditions are deteriorating.

All other factors aside, if the UN imagines that wealthy corporate nations like the US and UK will be more likely to come across with additional AIDS fighting funding because they are shown "results," they are kidding themselves. What is more likely to happen is a drop in funding as the complacent in the US and UK kick back, reassured that "it's all better now."

A Few Grim AIDS Statistics

*38.5 Million People are now infected with HIV globally. The Global Health Council says the figure is higher than this – over 40.3 million. Some estimates put the number of infected as over 45 million.

*An estimated 4.1 – 4.9 million new HIV cases were reported in 2005; at least 700,000 of these new cases are children.

*The annual mortality rate for AIDS globally is now 2.8- 3.1 million

*Only 1 in 10 people globally infected with HIV have ever been tested.

*The Asia-Pacific region has the fastest-growing rate of HIV infection, and now is second only to Africa in number of people (8.5 million) living with HIV.

*Number of HIV cases in India in 2005: 5.7 million.

*While the rate of new infections is leveling off for now in southern India, it is skyrocketing in the northeastern regions, fueled by intravenous drug use. Meanwhile, an estimated 50% of all sex workers in many large cities are HIV- positive

*The number of pregnant women with HIV in Africa has increased dramatically since the 1990s. For example, in Swaziland the rate rose from 4% in early 1990s to 43% in 2004

*Number of deaths from AIDS in US in 2005: 16,000

*While most cases of HIV occurred in males in Sub-Saharan Africa in the 1990s, today 59% of all cases are women, a substantial number of whom have only had one sexual partner.

*In Karachi, Pakistan 1 in 4 intravenous drug users were HIV-positive in 2004

FOR AN EXCELLENT OVERVIEW OF THE HIV/AIDS PANDEMIC SEE
THIS GLOBAL HEALTH COUNCIL PAGE


globalhealth.org/view_top.php3