by Bob Roehr
Estimates of the number of people living with HIV throughout the world have been lowered from roughly 40 million to 33 million, according to figures released by UNAIDS in their annual report on Nov. 20. The correction did not come as a surprise to either supporters or critics of the agency.
The report is a compilation of information provided by national governments. The decrease in estimated infections reflects better gathering of data rather than a change in the epidemic itself.
India saw its estimate of infection cut by more than half, to 2.5 million, in a study that initially was released in July. It was the greatest single contributor to the decline and when combined with five sub-Saharan African countries–Angola, Kenya, Mozambique, Nigeria and Zimbabwe–they accounted for 70 percent of the change.
New infections worldwide are now estimated to be 2.5 million a year, a decrease of about 40 percent from the figure last year. The calculation reflects changes in the assumption of life expectancy from 9 to 11 years for persons not receiving antiretroviral therapy. It is based upon new, not yet published data from several countries. If more people among the total number are living longer with the infection, then fewer of them have been infected recently.
The reduced number of both new and total infections makes the tasks of prevention and treatment more manageable, though still daunting.
The CDC estimates that approximately 40,000 new HIV infections occur in the U.S. each year. That estimate has remained the same since it was first put forward in 1994. Many people believe the number of new infections is higher, perhaps by as much as 50 percent. Some people anticipate that the agency will release new estimates at its big HIV prevention conference in Atlanta, Dec. 2-5.
"Reliable public health data are the essential foundation for an effective response to HIV/AIDS," said Kevin De Cock, director of HIV/AIDS at the World Health Organization. "While these new estimates are of better quality than those of the past, we need to continue investing more in all countries and all aspects of strategic information relating to health."
"For the first time, we are seeing a decline in global AIDS deaths," De Cock said. Much of that is because prices for drugs in the developing world have been slashed, and programs such as PEPFAR and the Global Fund have provided support to deliver that treatment.
Project Inform's Martin Delaney says, "The new numbers are good news for several reasons from a human perspective, but they're bad news politically. The right wing bloggers and commentators are already going nuts with it, arguing that the UN inflated the numbers for funding purposes, while the denialists are screaming 'we told you so, there's no such thing as an AIDS epidemic in Africa, it's just poverty and malnutrition.'"
