UN Cries Wolf About AIDS

[Guest guest]

UN CRIES WOLF ABOUT AIDS

The UN agency coordinating global action against AIDS is wiping egg

off its face after reluctantly admitting it had overestimated India's

AIDS problem by more than half--following numerous similar exaggerations

world-wide.

In 2005 the Joint United Nation's Programme on AIDS (UNAIDS) claimed

there were 5.7 million infected with HIV in India, giving India the

highest number in the world, but the Indian National AIDS Control

Organisation (NACO)figures for 2006 released on Friday lowered the

number to 2.5 million--and UNAIDS has had to admit the new estimate

is more accurate.

Director Piot, speaking to an AIDS conference in South Africa

in June said UNAIDS's work " ...is further complicated by the mixed

messages circulating around the world " and " denialist statements such

as that UNAIDS overestimates the size of the epidemic…. " The HIV

overestimates made or accepted by UNAIDS in recent years total about

10 million--so who is the real denialist?

Since 2001, UNAIDS has been forced to acknowledge drastically-reduced

HIV prevalence estimates in over a dozen African, Caribbean and Asian

countries, as a result of well-designed " population-based " HIV surveys

(randomly selected samples of urban and rural populations). Kenya's

HIV estimate was reduced from about 2.3 million to 1.1 million in

2003.

Ethiopia's estimate was reduced from nearly two million to about a

half million in 2005. Haiti's estimate of almost 250,000 HIV-infected

adults in 2001 was cut to less than 100,000 in 2006.

However, UNAIDS continued to defend its exaggerations up through

2006, as I pointed out earlier this year in my book " The AIDS

Pandemic: the collision of epidemiology with political correctness. "

UNAIDS were quick to respond to my charges, with spin rather than

substance, referring vaguely to their " scientific approach " to

calculating HIV numbers and the fact they collaborate with experts

and governments. They refused to acknowledge that their approach was

wrong or that the figures were bogus until the Indian revision

exposed both. UNAIDS has simply glossed over the new estimates as

being the result of better data and improved methods that

are constantly evolving.

Some AIDS activists say there is no harm in overestimating the current

size and potential severity of the AIDS pandemic since such

exaggerations have successfully provided AIDS programmes with

unprecedented global priority and support.

It needs to be recognized that UNAIDS was established in 1995 as an

advocacy and coordinating agency that almost immediately turned over

responsibility for AIDS programme funding and technical guidance to

other international agencies and donors. However, UNAIDS did not turn

over responsibility for the estimation and projection of HIV/AIDS

numbers.

Since UNAIDS has declared itself to be primarily an advocacy agency,

its objectivity in making or accepting high HIV estimates and

projections needs to be questioned.

UNAIDS, AIDS programme advocates and activists have certainly used

inflated HIV numbers effectively in their aggressive struggle for an

increasing share of the limited international health budget. This

success, however, has come at the expense of other equally urgent

public health needs.

Regardless of UNAIDS's systematic overestimation of HIV numbers, the

severity of the AIDS pandemic in sub-Saharan Africa requires that AIDS

programmes in this region continue to receive the highest public

health priority. In India too, whether HIV prevalence is close to six

million or " only " 2.5 million, AIDS remains a serious public health

problem in this populous country.

A UNAIDS spokesperson has said that the new calculation for India

reduces the world estimate to about 37.5 million people and that

UNAIDS does not expect any more revisions from countries with major

HIV and AIDS epidemics: " India was the last unknown. "

As of 2007, there are about 50 countries where HIV prevalence has been

estimated to be more than one percent of the adult population. More

than half of these countries have had their HIV prevalence estimate

based on the flawed method that relied on " sentinel surveillance

sampling " of mostly urban antenatal clinics: this was extrapolated to

the total national adult population, although towns have the highest

HIV prevalence.

So how can UNAIDS be so confident that there will not be any more

revisions from countries with major HIV epidemics?

Exaggerating the numbers, whether unintentionally due to honest

misunderstanding or intentionally by deliberate exaggeration, may

work in the short term. In the long term, it will cause a backlash

and damage support from the public and policymaker.

If UNAIDS persists with ignoring inflated HIV estimates, it risks

losing credibility and the support of the rich governments that fund

the global fight against AIDS. Whatever the purpose, crying wolf is

neither good science nor good politics.

Professor Chin of the University of California at Berkeley is a former

Chief of the Surveillance, Forecasting, and Impact Assessment unit of

the Global Programme on AIDS of the World Health Organization. His

book " The AIDS Pandemic: the collision of epidemiology with political

correctness " (Radcliffe, Oxford), http://www.theaidspandemic.com, was

published in January.

Story from MODERN GHANA NEWS:

http://www.modernghana.com/GhanaHome/NewsArchive/news_details.asp?

id=VFZSTk5VMVVRVFE9 Published: Thursday, July 12, 2007