Steve Quayle News Alerts

July 5, 2002
By Charlene Laino

BARCELONA, Spain, — The catastrophic forecast: If we sit back and let the epidemic follow its relentless course, as many as 45 million more people will become infected with the AIDS virus by 2010, researchers predicted Friday. The encouraging news: This figure could be slashed by two thirds if prevention programs were stepped up immediately, they said.

“DEVASTATION is not inevitable,” said Dr. Helene Gayle, former director of the AIDS division at the U.S. Centers for Disease Control and Prevention and now HIV chief at the Bill and Melinda Gates Foundation.
In fact, a whopping 29 million new HIV cases could be prevented through programs that incorporate education, condom distribution and better access to testing and treatment, according to research released in advance of the International AIDS Conference, which opens here this weekend.
The programs come with a stiff price tag: Some $27 billion — or about $1,000 per infection averted.
“But the cost of not acting is even higher,” said Drew Altman of the Kaiser Family Foundation.
Time is of the essence, the experts stressed. “If we delay implementation or commitment by just one year, the cost will be five million infections — five million infections that could have been avoided,’ said Dr. Bernhard Schwartlander, director of HIV/AIDS at the World Health Organization. “A three year delay could cut potential gains in half.”
The projections come from two new reports, one published by the Global HIV Prevention Working Group, a group of about 40 experts convened by the nonprofit Gates and Kaiser foundations. The other, which appears in this week’s Lancet medical journal, was written by a team of experts at the World Health Organization, the joint United National Program on AIDS, the U.S. Census Bureau and Futures Group International.
They come on the heels of a U.N. report released Tuesday that predicted that unless prevention efforts are increased, 68 million people will die of AIDS in the next 20 years.
“We failed to act decisively in the early stages of the epidemic in sub-Saharan Africa, and now we are paying the price,” said David Serwadda of Makerere University in Kampala, Uganda, a co-chair of the Working Group.
“But we still have an opportunity to save the next generation in Africa from AIDS, and to prevent runaway epidemics in India, Russia, and China.”

EFFECTIVE STRATEGIES
“We know what works,” said Gayle, whose Working Group offers a blueprint for prevention. “Now we have to act.”
Astonishingly, only one in five people at high risk for HIV infection have access to prevention, be it in the form of condoms or testing, she said.
Based on almost 100 studies that evaluated what works and what doesn’t, the experts arrived at 12 common interventions they say could change the face of the epidemic, including: Condom distribution; educational campaigns; expanded social services; voluntary, rapid testing and counseling; blood screening; school- and work-based programs; use of drugs to protect newborns if their mothers are infected; treatment of sexually transmitted diseases; peer counseling for prostitutes and homosexuals, and needle exchange or other safety programs for IV drug users.
“We know how to halt HIV, how to have an impact,” Gayle said. “The problem is access: Eighty percent of people worldwide who need preventive programs don’t get it.”

PROGRAMS THAT WORK
The Working Group singled out several countries with programs that work and could serve as a model for other nations, developing and developed:
Uganda. Africa’s biggest success story in the fight against AIDS, Uganda has cut annual HIV infections by one half through a comprehensive program that includes a public awareness program, extensive condom promotion and access to free counseling and testing. In urban areas, the HIV rate among pregnant women has been slashed by a stunning two-thirds since the mid-1980s.
Zambia. A multidisciplinary program based on Uganda’s success appears to be bearing fruit, with yearly AIDS cases falling nearly 50 percent between 1993 and 1998.
Brazil. Prevention efforts targeted at high risk groups, universal access to antiviral drugs and supportive counseling has led to significant declines in risk behavior, reductions in new infections and increased demand for voluntary counseling and testing.
Cambodia. HIV among pregnant women dropped by one-third in three years due to comprehensive prevention programs.
In the United States, access to testing, counseling and drugs have cut annual HIV infections by two-thirds since the mid-1980s. Prevention efforts have also contained the epidemic in Senegal and Thailand, the report said.
For more information on countries that have successfully turned the tide in the fight against HIV and other news, check back for MSNBC.com’s and NBC’s onsite coverage of the International AIDS Meeting, beginning Saturday.
The experts stressed that prevention is not simply a matter of money. Strategies will only be effective if they address such broader issues such as training of local health care workers; poor public health infrastructures in which many people don’t have access to clean water, nevermind drugs; the stigma of HIV infection, and women’s lack of empowerment.
Leadership also makes a difference, the experts said, as shown in Uganda, where the successful prevention program was aggressively promoted by President Yoweri Museveni.
“We can all make a difference,” said WHO’s Schwartlander. “We shouldn’t accept that the nature of the disease is to go on. We can do something about it that can substantially alter the course of the epidemic.”

http://www.msnbc.com/news/775410.asp