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| New Report to Show U.N. Overestimated AIDS Epidemic |
| 2007-11-19 |
| By Craig Timberg JOHANNESBURG, Nov. 19 -- The United Nations' top AIDS scientists this week plan to acknowledge that they long have overestimated both the size and course of the epidemic, which they now believe has been ebbing for nearly a decade, according to U.N. documents prepared for the announcement. AIDS remains a devastating public health crisis in the most heavily impacted areas of sub-Saharan Africa. But the sweeping revisions amount to at least a partial acknowledgment of criticisms long leveled by outside researchers who disputed the U.N.'s portrayal of an ever-rising epidemic on the march across the globe. The latest estimates, due to be released publicly Wednesday, put the number of annual new HIV infections at 2.5 million, a cut of more than 40 percent from last year's estimate, documents show. The worldwide total of people infected with HIV -- estimated a year ago at nearly 40 million and rising -- now will be reported as 33 million, with the numbers of new infections falling. Having millions of fewer people with a lethal, contagious disease is good news. However, some researchers have contended that persistent overestimates in the U.N.'s widely quoted reports have skewed funding decisions while also obscuring potential lessons about how to slow the spread of HIV. Critics also have said that U.N. officials overstated the epidemic to help gather political and financial support for combating AIDS. "There was a tendency toward alarmism, and that fit perhaps a certain fundraising agenda," said Helen Epstein, author of the book "The Invisible Cure: Africa, the West and the Fight Against AIDS." "I hope these new numbers will help refocus the response in a more pragmatic way." Annemarie Hou, spokeswoman for the U.N. AIDS agency, speaking from Geneva, declined to comment on the grounds that the report is not yet public. In documents obtained by The Washington Post, U.N. officials say the revisions came mainly from better measurements rather than from fundamental shifts in the epidemic. They also say that they are continually seeking to improve their tracking of AIDS with the latest available tools. Among the reasons for the overestimate is methodology; U.N. officials traditionally based their HIV estimates for nations on the infection rates among pregnant women receiving prenatal care. As a group, they were more urban, wealthier and likely to be more sexually active than populations as a whole. The U.N.'s AIDS agency, known as UNAIDS and led by Belgian scientist Peter Piot since its founding in 1995, has been a major advocate for increasing spending to combat the epidemic. Over the past decade, global spending on AIDS has grown by a factor of 30, to $10 billion a year. But in its role in tracking the spread of the epidemic and recommending strategies to combat it, UNAIDS has drawn criticism in recent years from Epstein and others who accused it of being politicized and not scientifically rigorous. For years, UNAIDS reports have portrayed a sprawling, rising epidemic that threatened to burst beyond its epicenter in southern Africa to create widespread illness and death in other countries. In China alone, one report warned, there would be 10 million infections -- up from 1 million in 2002 -- by the end of the decade. Piot often wrote personal prefaces to these reports warning of the dangers of inaction, saying in 2006 that "the pandemic and its toll are outstripping the worst predictions." But by then several years' worth of newer, more accurate studies already offered substantial evidence that the U.N.'s tools for measuring and predicting the epidemic were flawed. Newer studies commissioned by governments and relying on random, census-style sampling techniques found consistently lower infection rates in dozens of countries. In India, the U.N. cut its estimate of HIV cases by more than half because of one such study completed this year. The new report also has made major cuts to U.N. estimates in Nigeria, Mozambique and Zimbabwe. The revision affected not just the current number but past ones as well. A UNAIDS report from December 2002, for example, put the number of HIV cases at 42 million. The real number for that year, this week's report says, was 30 million. The downward revisions also affect estimated numbers of orphans, AIDS deaths and patients in need of costly antiretroviral drugs -- all major factors in setting funding levels for the world's response to the epidemic. James Chin, a former World Health Organization AIDS expert long critical of UNAIDS, said even these revisions might not go far enough. He estimated the number of cases worldwide at 25 million. "If they're coming out with 33 million, they're getting closer. It's a little high, but it's not outrageous anymore," Chin, author of "The AIDS Pandemic: The Collision of Epidemiology With Political Correctness," said from Berkeley, Calif. The picture of the AIDS epidemic offered by new studies, and set to be endorsed by U.N. scientists in this week's announcement, shows a massive concentration of infection in the southern third of Africa, with nations such as Swaziland and Botswana reporting that as many as one in four adults is infected with HIV. Rates are lower in East Africa and much lower in West Africa. Researchers say that the prevalence of circumcision -- which slows the spread of HIV -- and regional variations in sexual behavior are the biggest factors in determining the severity of the epidemic in different countries and even within countries. Beyond Africa, the AIDS epidemic is more likely to be concentrated among high-risk groups such as users of injectable drugs, sex workers and gay men. More precise measurements of infection rates should allow for better targeting of prevention measures, researchers say. |
| Posted by:anonymous5089 |
| #3 There was a tendency toward alarmism, and that fit perhaps a certain fundraising All fixed. |
| Posted by: Zenster 2007-11-19 22:00 |
| #2 Because we all know Global Warming is the new Chicken Little to scare the world with and wring out money and power from the |
| Posted by: Procopius2k 2007-11-19 20:23 |
| #1 sex workers = sex industry professionals, in the case you are unfamliar with the first label. ;-) |
| Posted by: twobyfour 2007-11-19 20:21 |