Threat of global AIDS epidemic over, says WHO

10 Jun 2008, 0128 hrs IST,Kounteya Sinha,TNN

NEW DELHI: A quarter of a century after AIDS first appeared, the World Health
Organisation has for the first time said the threat of a global heterosexual
pandemic outside Africa might have passed.

According to Dr Kevin de Cock, one of the world's leading epidemiologists and
head of the organisation's HIV/ AIDS department, there has been a shift in the
understanding of the risks posed by the virus.

HIV was earlier regarded as a risk to populations everywhere, irrespective of
the percentages that practised unsafe sexual behaviour. But experts now believe
that outside of sub-Saharan Africa, the disease is largely confined to high-risk
groups like men having sex with men, sex workers and their clients.

Speaking to TOI from New York, Dr de Cock said, "If the virus had to cause an
epidemic among the general population in India and China, as originally feared,
why hasn't it happened till now? It doesn't look likely anymore."

Dr de Cock, who expressed doubts about predictions of an Africa-type situation
developing in India, said prevention strategies need to be focused where HIV
transmission is occurring. "India needs to look at who are getting infected more
often and then target that section of society," he said. He called for massive
investments in educating those most at risk rather than focus on a school AIDS
programme. "Countries need to go where transmission is occurring, which they
have not always been good at," he said.

The WHO expert said that unlike Africa, specially in its southern and eastern
parts, where the virus has been found to be "self-sustaining" in the general
population, a similar trend has not emerged in Asian countries. In these
nations, the prevalence is mostly concentrated in groups at risk and their
partners. "It is very unlikely that there will be a heterosexual epidemic in
other countries outside Africa," Dr de Cock said, while emphasising that this
should not breed complacency.

UNAIDS chief Dr Dennis Broun, too, agreed with Dr de Cock. He told TOI, "We made
a mistake with our predictions.

However, the gloomy predictions were made seeing evidence that was available to
us 10 years ago, which was minimal. Today, with all the accumulated information,
it is unlikely that Asian countries will see a generalised epidemic."

Nearly 2.45 million Indians live with HIV with prevalence rate in the general
population of 0.36%.


India is also home to nearly two lakh IDUs. Over 20% of them are HIV positive
solely due to sharing of contaminated needles. India is also home to 2.5 million
MSMs with HIV infection rates as high as 16%.

Critics of the global Aids strategy have always cried foul of the vast sums
being spent educating people who were not most at risk from the disease when a
far bigger impact could be achieved by targeting groups who are more vulnerable.

Dr de Cock admitted there were "elements of truth" to such criticism.

There has been a view that UNAIDS had deliberately exaggerated the size and
trend of the projected pandemic, besides hyping the potential for HIV in general
populations creating an impression that just about everyone was at risk of AIDS.

"This led to billions of dollars being spent on AIDS rather than on other
serious illnesses which face an acute fund crunch," a health ministry official
said.

India's worries are concentrated in six states — Maharashtra, Tamil Nadu, Andhra
Pradesh, Manipur, Karnataka and Nagaland.

http://timesofindia.indiatimes.com/articleshow/3115367.cms