Twenty-five million people have died from HIV/Aids in 24 years, more than three million of whom died this year alone, and at least 40-million people today have HIV, a rise of about five million over the past 12 months.
With just a month left to go, the World Health Organisation’s (WHO’s) goal of providing anti-retroviral drugs for three million poor people with HIV by the end of 2005 is poised to fall dismally short of the mark.
Meanwhile, funding for the war on HIV/Aids, which last year receded as a problem for the first time, is once more becoming a headache.
Money that could have gone to fight HIV/Aids is instead being earmarked for helping survivors of the Asian tsunami, Hurricane Katrina and Kashmir earthquake and for tackling bird flu.
Put all this together, and it is no surprise that World Aids Day on Thursday should carry a dour and rather depressing slogan.
Its message — ”Stop Aids. Keep the Promise” — is aimed at governments and donors, indirectly reminding them that natural disasters are tragic but temporary, and meanwhile a lethal global pandemic is still raging.
Yet even as the Aids pandemic continues to outstrip efforts to roll it back, there is some encouraging news.
The big roll-out of anti-retrovirals to sub-Saharan Africa, which began in 2003 under the WHO’s ”Three by Five” initiative, is building up steam, helping to transform HIV from a death sentence to a chronic but manageable disease.
From tens of thousands a few years ago, more than a million people in low- and middle-income countries now have access to the precious cocktail of drugs that keeps HIV at bay.
”Between 250 000 and 350 000 deaths were averted in 2005,” UNAids proudly said last week in its latest update on the crisis, adding that the full effects of this year’s ”dramatic scaleup” would only start to be seen from 2006.
The Three-by-Five initiative faces an inevitable drubbing for failing to meet its headline-grabbing goal, ”but it should also be lauded for its extraordinary political successes,” says the British medical weekly The Lancet.
Many of the fears that delayed the drug rollout for years have not happened — so far, at least.
Prices for frontline drugs are continuing to fall, although a question mark remains over the prices of second- and third-line anti-retrovirals, to which a patient must turn if the first drugs fail.
And on-the-ground research suggests that, with common sense and basic safeguards, these drugs can be safely and properly used in poor countries.
That is a slap to those in the big pharmaceutical companies who predicted that without advanced medical infrastructure to support them, these complex medications would fail or be abused.
Another bit of good news is action on prevention, not just treatment.
Efforts to discourage infection through condom availability and other safe-sex programmes have helped bring down prevalence in Kenya and Zimbabwe, while the Caribbean, the second-most affected region in the world, was the only part of the planet where HIV incidence has not risen this year as compared with 2003.
And lab research into virus-killing microbicdes is showing some promise, although it will be several years at least before this results in a safe and effective anti-HIV gel that could be used in sexual intercourse.
For all this, HIV/Aids has its steely hooks deep into southern Africa.
Driven by intravenous drug use, it is spreading fast in parts of Eastern Europe.
And China and India, where ignorance of the virus is rampant, are feared to be on the brink of explosive HIV growth.
Even in rich countries, there is a worrying rise among young heterosexuals and gays, for whom the safe-sex message, in the reassuring era of antiretrovirals, is absent or has little impact.
The Global Fund to Fight HIV/Aids, Tuberculosis and Malaria last week put out the begging bowl for $3,3-billion to help meet needs of $7,1-billion in 2006 and 2007.
And this is just a fraction of what is needed. Globally, resource needs are put at $15-billion next year, $18-billion in 2007 and $22-billion in 2008.
”The Aids pandemic is getting worse,” said Genevieve Clark of the British HIV/Aids charity The Terrence Higgins Trust.
”But there are pockets of good news, little glimmers of hope. The task is to learn from what works, and apply these lessons globally.” – AFP