AIDS deaths top 25 million but infections slow

The virus that causes AIDS has killed 25 million people worldwide, but new infections are slowing sharply, the U.N. said Tuesday in an annual report on the crisis that mixed hope with a warning against complacency.

Almost 60 million people have been infected by the human immunodeficiency virus, or HIV, since it was first recorded, but prevention programs are having a significant impact, the UNAIDS agency said in its latest report, released in Shanghai.

Approximately 2 million people died of the disease in 2008, bringing the overall toll to around 25 million since the virus was first detected three decades ago. Some 2.7 million were newly infected in 2008, the agency added, bringing the world total to 33.4 million.

UNAIDS Executive Director Michel Sidibe told a Shanghai news conference on the report’s launch that the number of new HIV infections had been reduced 17 percent over the past eight years.

“The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention,” Sidibe said.

Daniel Halperin, an AIDS expert at Harvard University, said the falling rate of new infections was good news and that access to AIDS drugs was helping to cut the death rate as well. Earlier this year, the U.N. announced there are now 4 million people on lifesaving AIDS drugs worldwide, a 10-fold increase in five years.

Better strategies needed

Some of the most notable progress has been reported in Africa, the report said. HIV incidence has fallen by 25 percent since 2001 in East Africa while the figure for sub-Saharan Africa as a whole was around 15 percent, equating to some 400,000 fewer infections in 2008.

In south and Southeast Asia, the incidence of HIV has declined by 10 percent in the same time period, the report said.

According to Sidibe, better prevention strategies are needed to stop new infections, which stand at 7,400 a day. “Any time we are putting two people on treatment, five people are being infected,” he said. “The findings [of the report] show that prevention programming is often off the mark and that if we do a better job of getting resources and programs to where they will make most impact, quicker progress can be made and more lives saved.”

Whether previous U.N. initiatives are responsible for the epidemic’s downturn is uncertain. Some experts said the drop in HIV cases might simply be a result of the virus burning itself out, rather than of any health interventions.

Ties Boerma, a statistics expert with the U.N.’s World Health Organization, or WHO, said countries where HIV prevalence declined dramatically, such as Zimbabwe, were not always those that got the most AIDS money.

The new report showed that more people than ever are now living with the virus as infected people live longer due to the beneficial effects of antiretroviral therapy. The number of deaths linked to AIDS has declined by more than 10 percent over the past five years as more people have gained access to lifesaving treatment, the report added.

It estimated that around 2.9 million lives have been saved since 1996 when more effective treatment became available. “International and national investment in HIV treatment scale-up has yielded concrete and measurable results. We cannot let this momentum wane,” said Margaret Chan, the head of the WHO. “Now is the time to redouble our efforts, and save many more lives.”

According to Sidibe, AIDS, which was first declared as having reached epidemic proportions in 1981, is evolving and that research in some of Africa’s worst-affected countries has shown it having an increasingly significant impact on maternal mortality. “Half of all maternal deaths in Botswana and South Africa are due to HIV,” he said. “This tells us that we must work for a unified health approach bringing maternal and child health and HIV programs as well as tuberculosis programs together to work to achieve their common goal.”

As an example of how the epidemic was evolving, Sidibe pointed to how transmission in China was shifting from cases mainly involving injection drug use to sexual transmission, which accounted for more than 72 percent of new cases last year.

Similar transitions were seen around the world, he said, demonstrating that health officials needed to overhaul prevention strategies.

Elizabeth Pisani, an epidemiologist who once worked for UNAIDS, said when people with HIV don’t take their drugs exactly as prescribed, they have periods where they become infectious, giving the virus a chance to spread. Most people without treatment die before infecting many others.

“In theory, treatment may have an important preventative effect, but in practice, it can actually make things worse,” Pisani said. “We obviously can’t stop treatment, but we need to do a lot more on prevention.”

More than 3,300 people are HIV+ in Turkey

The number of people diagnosed as HIV-positive in Turkey as of December 2008 is estimated be to 3,370, according to official data from the Health Ministry. Experts have said, however, that the number should be multiplied by 10 to reach a realistic estimate.

Turkey is among the countries with a high-rate of HIV infection. There is an increase in the number of people applying for counseling, said Arzu Kaykı, head of the Positive Life Association, founded to provide support for people who are HIV-positive. Kaykı said the association's physicians have also noticed an increase in the number of cases. “The 3,370 does not reflect reality, because people are still hesitant to get tested,” she said. “There have been serious increases in Turkey and programs are needed to prevent this,” she said. The 2009 data for Turkey is currently not available because the swine flu epidemic has increased the Health Ministry’s work load, the ministry said.

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Compiled from AP and AFP stories by the Daily News staff.