The estimated number of AIDS cases worldwide to date has gone up by 60% since this time last year, according to figures released (1 July) by the World Health Organization Global Programme on AIDS.*
From July 1993 to today, the global estimate of the number of AIDS cases since the pandemic began has increased from 2.5 million in July 1993 to around 4 million cases today. The largest number of estimated AIDS cases - over 2.5 million - is in sub-Saharan Africa but as the epidemic takes hold in south and south- east Asia there has been an eight-fold increase in the past year in the number of AIDS cases in Asia, from more than 30,000 to about 250,000. This means that the proportion of AIDS cases in Asia has risen from 1% to 6% of the total.
"This latest estimate of AIDS cases shows us two things", says Dr Michael Merson, Executive Director of the Global Programme on AIDS. "First, the epidemic of AIDS in which people infected with HIV begin to fall sick and die is really with us in Africa with the continent facing a huge burden of suffering and death. Second, if anyone needed proof that the AIDS epidemic is established in Asia they need look no further."
AIDS cases are the visible part of the epidemic, but because there is on average 10 years between infection and the onset of AIDS, they reflect the HIV situation a decade ago. Today's HIV situation is that there have been an estimated 16 million adults and over 1 million children infected with HIV since the beginning of the pandemic. This is an increase of approximately 3 million adult infections since 1 July 1993, of which almost half occurred in women. The end of the epidemic is nowhere in sight. By the end of the century WHO predicts that the current global total will more than double, and that 30 to 40 million people will have been infected with the virus.
The total number of adult HIV infections in sub-Saharan Africa, since the late 1970s to date, is more than 10 million. But the epidemic expansion will be most dramatic in Asia. Today's cumulative total of over 2.5 million infections, with about 40% infections in women, is expected to increase four-fold to over 10 million infections by the year 2000.
* The number of AIDS cases actually reported to WHO since the start of the pandemic is 985,119. However, because of under diagnosis, incomplete reporting, and reporting delay the true number of people with AIDS is believed to be much higher, hence the estimated total of around 4 million cases. Press Release WHO/53 Page 2 "The Global AIDS epidemic is now spreading in Asia faster than anywhere else in the world", says Dr Merson. "Soon more Asians than Africans will be getting infected each year. The potential impact on families and society that severe disease and death among young adults will have is likely to be enormous. While Africa experiences increases in AIDS cases as a result of HIV infections that occurred about 10 years ago, south and south-east Asia are seeing an explosive increase in infections among vulnerable population groups."
Heterosexual transmission of HIV has been expanding in the region, with significant levels of infection in female sex workers in several states of India, in various cities of Myanmar and across Thailand. HIV infection has also been detected among female sex workers in Cambodia, as well as among fishermen working off both the eastern and the western reaches of the Indonesian archipelago. In many states of India, such as Tamil Nadu, Gujarat, Karnataka and Punjab, prevalence levels in patients with sexually transmitted diseases are now estimated to be about 1%.
In Thailand, HIV infection is now spreading in the general population. Over 3.5% of military recruits aged 21 years were reported to be infected in many parts of the country from the 1992 round of surveys, with a prevalence rate close to 20% in Chiang Rai, northern Thailand. In women attending antenatal clinics in Chiang Rai province, the prevalence rate is now 8%.
Significant levels of HIV infection have recently been detected among injecting drug users in Ho Chi Minh City, Vietnam, peninsular Malaysia and Yunnan province, China. In Ho Chi Minh City, prevalence rates among groups of IDUs rose from 2% in late 1992 to more than 30% in the third quarter of 1993. In Bangkok, Thailand, in Manipur, northeast India and Yangon, Myanmar, HIV prevalence rates among injecting drug users rose to 50% between the late 1980s and 1992.
"There is still great uncertainty about how far HIV might spread in large and populous areas of the world. For example, the increasing rate of sexually transmitted diseases in many parts of China is an ominous sign for those areas which are entering a new era of economic growth. I have great concern about the serious potential for the spread of HIV in that country and other countries in Asia."
In parts of Asia today, HIV is spreading as fast as it did in Africa a decade ago. If effective HIV prevention programmes are not put in place, Asia will overtake Africa by the mid to late 1990s in terms of the number of newly infected people per year.
For further information please contact the Public Information Office, Global Programme on AIDS, Geneva, Switzerland, telephone (41 22) 791 4673, fax (41 22) 791 0107.