As AIDS Experts Meet in Africa, What Should Americans Do?
Monday, July 10, 2000 By Marian Jones
NEW YORK — AIDS is going to be on the tip of everyone's tongue at the 13th International AIDS Conference, which began Sunday and runs through Friday, July 14.
But this conference, in which over 10,000 AIDS experts from around the world are convening to announce the latest discoveries and discuss strategies for treating AIDS in the developing world, is taking place in Durban, South Africa, far from American shores.
Southern Africans now make up over 90 percent of the world's 34 million-plus AIDS cases. So why should this epidemic be of interest to Americans?
One reason, public health experts say, is that AIDS is not exactly disappearing from America.
While the number of AIDS cases and deaths dropped steadily throughout the 1990s, this trend has begun to level off. Since 1998, the number of new cases and deaths has remained stable, according to a new Centers for Disease Control and Prevention study released Saturday at the conference.
"Despite the dramatic benefits new treatments have had in extending the lives of individuals with HIV, the overall shortfalls of AIDS treatments are becoming increasingly apparent, and HIV infection and risk behavior continues at levels far too high," said CDC researcher Dr. Helene Gayle.
There continue to be 40,000 new cases of HIV infection in the United States every year, according to the CDC. While HIV rates have dropped substantially among intravenous drug users, they have remained stable among gay men and have even risen among younger gay men in San Francisco, according to data published last week.
This recent rise has caused some Americans to question whether we should be spending so much money on HIV.
Gayle insists more funding and prevention efforts are needed to stem this rise in HIV rates. She pointed out that infection rates among gay and bisexual men dropped after intense prevention campaigns were launched in the late 1980s, and that more of this type of campaigning is needed. "We have the tools to essentially stop the U.S. epidemic," she said. "What we need is the will and the resources to do it."
What About Africa?
Meanwhile, the AIDS epidemic rages on unabated in sub-Saharan Africa and Asia.
In comparison to the 40,000 new U.S. HIV infections, there were close to 4 million new cases in sub-Saharan Africa last year. Over a third of today's 15-year-olds in southern African countries are expected to die prematurely of AIDS, according to a United Nations Joint Commission on AIDS report released June 27. Most of the countries are too poor for their citizens to pay for life-prolonging treatments.
UNAIDS has called upon richer nations to forgive the international debts of the developing countries so that they can spend more money on health care and less on paying back their debts.
"African governments are paying out four times more in debt service than they now spend on health and education," said Dr. Pier Piot, executive director of UNAIDS. "If the international community relieves some of their external debt, these countries can reinvest the savings in poverty alleviation and AIDS prevention and care," Piot said.
Piot estimated that a minimum of $3 billion per year would be would be needed to support effective AIDS prevention and treatment programs for Africa. These programs, he said, should include blood safety programs, prevention and treatment of mother-to-child HIV transmission, as well as education.
Currently, countries and private donors have contributed than $350 million for these programs, according to the White House Office on National AIDS policy. The United States has spent a total of $1 billion since 1986 on AIDS and HIV measures, and contributes 25 percent of UNAIDS' budget. Congress granted President Clinton's request for an additional $100 million in the fiscal year 2000 budget to fight the sub-Saharan AIDS epidemic. The president has asked for another $100 million in the fiscal year 2001 budget.
But as AIDS policymakers and scientists meet in South Africa, one of the countries hardest hit by AIDS, Piot's call for dramatic increases in funding will doubtless be echoed by others.
Should America — and its wealthier neighbors — respond to these calls?
At least one public health expert thinks so.
"Americans cannot afford to ignore the important developments in other countries," wrote Ellen Maclachlan of the CDC division of STD prevention in international activities in an e-mail to FOXNews.com. "In the context of HIV/AIDS, its enormous social and economic destabilizing effect will be felt by countries all over the world," she said. |
