EuropaWorld 30/11/2001 The UN Worries About AIDS, In Eastern Europe Especially

Of all the many and complex problems faced by the world and laid on the UN's doorstep, one remains unique in its ability to afflict populations wherever they live. The millions of victims that have already succumbed are surely only a shadow of what we can expect in the future, barring some miraculous breakthrough, for this accelerating catastrophe shows no sign of halting its headlong rush.

The affliction is, of course, AIDS. In twenty years this disease has grown in the consciousness of mankind from an obscure syndrome - without a name - to the world's number one plague. The acronym AIDS - the initials actually stand for Acquired Immune Deficiency Syndrome - reflects the uncertainty among doctors when the disease first became manifest as to what kind of a malady it was and what damage it did. Well, we know now only too well.

The disease is transmitted by the Human Immunodeficiency Virus - known by its dread initials HIV - which enters the bloodstream and remains more or less dormant for what can be a long period extending to many years. But then the virus begins to attack the immune system - the body's first line of defence against disease. Slowly but surely the patient first weakens and then dies.

No-one knows for sure where the HIV virus came from. There are some clues, however. Similar kinds of viruses exist in African monkeys. Normally viruses find it hard to cross the barrier between one species and another, but it is not impossible. Thus AIDS could have spread from a bite by a monkey already infected with a new strain of monkey HIV that could also live in humans. There are some reports also that suggest that AIDS may have had its genesis in live polio vaccines were being prepared from cultures grown in monkey tissues.

Whatever, AIDS is fast on the march and as yet there is still no cure. The best that medical science has to offer is a cocktail of drugs that delay the onset of the day when the body's immune system begins to break down. Such drugs are expensive and their availability in poor countries is still either very limited or non-existent.

HIV infection rates, on the other hand, continue to rise inexorably in those parts of the world where adequate prevention systems are not in place. The best prevention mechanism is education - AIDS is still a disease that is widely misunderstood, particularly the way in which the virus is transmitted from one person to another. We know that this only occurs through a transfer of body fluids, notably blood or semen, most commonly through unprotected sex or using infected injecting needles. One person cannot infect another through touching and or being close or working together.

Where countries have put in place good quality AIDS awareness programmes, made condoms freely available and actively discouraged the use of injected drugs, the rate of HIV infection remains low. However, as ever increasing numbers of people become infected in a community so transmission rates increase.

Nowhere is the number of HIV infections rising faster than Eastern Europe. This is the surprising conclusion of a new report published by United Nations Programme on AIDS (UNAIDS) and the World Health Organization (WHO).

According to 'AIDS Epidemic Update 2001,' the latest figures -still assumed to be heavily underestimated - reveal that 75,000 new infections had been reported in Russia by the beginning of this month, a 15-fold increase in just three years.

Compared to infection rates in sub-Saharan Africa where this year there were reckoned to be more than 3 million new infections, the Russian figure is not high in absolute terms; nevertheless Dr. Gro Harlem Brundtland, the former Norwegian Prime Minister who is now Director-General of WHO, finds it worrying.

"Low reported national prevalence rates can be misleading because they may be exceedingly high in certain sub-populations," she said. "In many countries, we have to take these figures as warning signs of an impending epidemic, not as excuses for complacency."

In countries with high populations, a few percentage points can translate into millions of individuals infected. In Swaziland, Botswana and some areas of South Africa, more than 30 per cent of pregnant women are HIV-positive. In West Africa, several countries with previously low infection rates - including Nigeria, Africa's most populous nation - have now passed the five per cent infection mark. Almost 2.5 million people will die of AIDS in Africa this year reckons UNAIDS.

One of the most troubling and complex aspects of the spread of HIV/AIDS is its link to the widespread sexual exploitation of children. Said Carol Bellamy, Executive Director of the United Nations Children's Fund (UNICEF) "Whether it is myths about the curative powers of sex with young girls, or macho attitudes that sanction violent sexual behaviour toward women and girls, the links between sexual abuse of children and the spread of HIV/AIDS are clear." She said UNICEF were calling for direct action aimed at challenging accepted sexual behaviours, as well as action to protect children from the sex trade.