Threat of global AIDS epidemic over, says WHO

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Threat of global AIDS epidemic over, says WHO

10 Jun 2008, 0128 hrs IST,Kounteya Sinha,TNN

NEW DELHI: A quarter of a century after AIDS first appeared, the World

Health Organisation has for the first time said the threat of a global

heterosexual pandemic outside Africa might have passed.

According to Dr de Cock, one of the world's leading

epidemiologists and head of the organisation's HIV/ AIDS department,

there has been a shift in the understanding of the risks posed by the

virus.

HIV was earlier regarded as a risk to populations everywhere,

irrespective of the percentages that practised unsafe sexual behaviour.

But experts now believe that outside of sub-Saharan Africa, the disease is

largely confined to high-risk groups like men having sex with men, sex workers

and their clients.

Speaking to TOI from New York, Dr de Cock said, " If the virus had to

cause an epidemic among the general population in India and China, as

originally feared, why hasn't it happened till now? It doesn't look

likely anymore. "

Dr de Cock, who expressed doubts about predictions of an Africa-type

situation developing in India, said prevention strategies need to be

focused where HIV transmission is occurring. " India needs to look at who are

getting infected more often and then target that section of

society, " he said. He called for massive investments in educating those most at

risk rather than focus on a school AIDS programme. " Countries need to go where

transmission is occurring, which they have not always been good at, " he said.

The WHO expert said that unlike Africa, specially in its southern and

eastern parts, where the virus has been found to be " self-sustaining " in the

general population, a similar trend has not emerged in Asian

countries. In these nations, the prevalence is mostly concentrated in

groups at risk and their partners. " It is very unlikely that there will be a

heterosexual epidemic in other countries outside Africa, " Dr de Cock said, while

emphasising that this should not breed complacency.

UNAIDS chief Dr Dennis Broun, too, agreed with Dr de Cock. He told TOI, " We made

a mistake with our predictions.

However, the gloomy predictions were made seeing evidence that was

available to us 10 years ago, which was minimal. Today, with all the

accumulated information, it is unlikely that Asian countries will see a

generalised epidemic. "

Nearly 2.45 million Indians live with HIV with prevalence rate in the

general population of 0.36%.

India is also home to nearly two lakh IDUs. Over 20% of them are HIV

positive solely due to sharing of contaminated needles. India is also

home to 2.5 million MSMs with HIV infection rates as high as 16%.

Critics of the global Aids strategy have always cried foul of the vast

sums being spent educating people who were not most at risk from the

disease when a far bigger impact could be achieved by targeting groups

who are more vulnerable.

Dr de Cock admitted there were " elements of truth " to such criticism.

There has been a view that UNAIDS had deliberately exaggerated the size and

trend of the projected pandemic, besides hyping the potential for HIV in general

populations creating an impression that just about everyone was at risk of AIDS.

" This led to billions of dollars being spent on AIDS rather than on

other serious illnesses which face an acute fund crunch, " a health

ministry official said.

India's worries are concentrated in six states — Maharashtra, Tamil

Nadu, Andhra Pradesh, Manipur, Karnataka and Nagaland.

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K

Bangalore, India