Bird flu - real risks to personal lives, business, society

What will happen if bird flu mutates into a rapidly spreading epidemic? Death toll estimates from governments and how society is most likely to be impacted - even if death rates turn out to be very low. Video comment by Futurist physician Dr Patrick Dixon.

Future of Dentistry - digital dentists and dental ...

Future of dentistry, dental practice and dentists. Health care trends,oral care and mouthcare products. Digital imaging and dental diagnostics. Prosthetics, milling, machining and manufacture of bridges, crowns and dental devices. Porceline and polymers with nanotechnology, nanoparticles - polishing, shaping, machining, finnishing. Dental techniques and future of cosmetic dentistry. 3M video and 3D imaging, three dimensional video imaging in real time. Digital dental patient records and future of data systems. Innovation in dental practice. Video by keynote conference speaker Patrick Dixon.
Dentists, dentistry, digital, imaging, video, 3D, dental, health, care, innovation, conference speaker

Cure for rheumatoid arthritis?

Cure for autoimmune diseases such as psoriasis, rheumatoid, Crohn's disease, ulcerative colitis, multiple sclerosis? Targetting specific immune cells to restore normal immune system with potentially very few side effects. Medical research using immunology. But will pharmaceutical companies wish or be able to fund such research? It will be a technique not a therapy to be sold.

Staying Young - anti ageing research

Science of ageing. How to stop getting old. Medical research into physiology of ageing. How cells get old. Tissue regeneration of heart, muscle, retina, spine, brain and other organs. Repair of tissue damage. Organ regeneration. Cure for blood pressure? New facelift therapy? Humpback whales, Rockfish Project and slow ageing in turtles and parrots. Human impact of anti-aging therapy. Social impact of living longer. Impact on longevity forecasts for life insurance and pensions risk. Cure for deafness and cure for macular degeneration. Conference keynote speaker and Futurist Dr Patrick Dixon.

Life insurance and life expectancy -- conference speaker

Life expectancy and life insurance, pensions. High net worth clients live longer -- better educated. Impact of future health care improvements. Actuarial forecasts, government planning. Government and social impact, pensions crisis and risk management. Science and research trends into longevity. Patrick Dixon, conference keynote speaker and futurist.

Joint replacement for rheumatoid and osteoarthritis

Growing need with older population. Largest market in US. New treatments and methods. Plastic and metal hips wear out, need revision, complications, infection, dislocation. Preserve neck of femur. Using adult stem cells to regrow joint surfaces. Grow new cartilage. Repair knee, hip, shoulder repairs. Chronic pain and disability, lack of mobility, improving mobility and function, range of movement. Medical research. Orthopaedics / orthopaedics and rheumatology future trends. Patrick Dixon, conference keynote speaker and futurist.

Future of the pharmaceutical industry -- conference ...

Generic competition and product recalls. Patent expiry and intellectual property protection. Legal challenges and research scandals. Biogenerics and large molecule therapeutics. Cellular mechanisms of disease. Unmet needs. Government purchasing policies and insurance cover. Online pharmacy price pressures. Search for new blockbusters. Chronic disease and orphan therapies. Rheumatoid and asthma. Antibiotics and multiple resistance problems. Search for powerful antiviral therapy. Future health funding and ageing populations. Contrast with emerging nations. Treatment access and justice issues. Pharmacogenomics and gene prophecy. Ethical issues. HIV and AIDS.

Human cloning - part one - who is doing human cloning

Who is doing human cloning research and why. Explanation of science behind human cloning and what it means for medical research - or does it? Do we really need human cloning to solve health problems? Reasons for and against human cloning. Video comment by Dr Patrick Dixon

The Future of Nanotechnology - investment grows but nature has beaten the scientists with the world's first nanobots

I am often asked about nanotechnology: load of hype? Industrial miracle? Future threat to human health? The US government has been investing more than $1 billion per year and the EU, Japan, China and other countries are investing over $6 billion per year.

Nanotechnology is the understanding and control of matter at dimensions of roughly 1 to 100 nanometres. At this level of engineering we are beginning to see spectacular advances, particularly in surface coatings, but also in processes which could give a further massive step forward in making things smaller eg computer memory chips.

We can expect to see all kinds of domestic applications – for example fabrics which are better at repelling stains or can be cleaned in jets of compressed air, or new kinds of non-stick, easy to clean surfaces. We will see advances in lubricants and so on.

But when it comes to manufacturing tiny nanotech machines, the talk is far further ahead than the reality. We are not going to see nanobots made by humans anytime soon – except of course by imitating the powerful nanobots which nature makes.

As a physician as well as a futurist I am particularly interested in this – especially through my work with AIDS and the charity ACET – http://www.acet-international.org.

Viruses are essentially nanotech machines which are capable of being carried around around the body, so that they are then able to identify individual cells by their surface characteristics. Once the identification test is passed, the virus legs become firmly attached, and then bend, allowing a needle-like device to puncture the cell surface, injecting the core material of genetic code.

This is then activated automatically inside the cell, taking over command of the cell brain, and turning the cell into a factory of hundreds of millions more identical virus nanobots…

Cancer from electromagnetic radiation? Power lines and children

The UK government announced yesterday that no more homes should be built near high voltage overhead power cables, following a report suggesting that the risk of leukaemia in children is significantly greater amongst those living under or near power lines.

If it is true - uncertain still - then the mechanism remains unknown. While it could be a direct effect of electromagnetic radiation, it could also be linked to ionisation of molecules in the air around the cables.

Expect more research into this - as well as more studies into whether mobile phone radiation, or mobile phone masts also cause health risks in humans. Some studies already show quite convincing effects on living tissue and on other animals when subjected to high radiation levels for long periods. However the risk to humans is probably very small.

Teenagers getting fatter in spite of health drive - Britain - Times Online

Obesity will be a major problem in future not only in wealthy nations, but also in emerging economies among the increasingly affluent.

One third of babies born today in the United States will develop diabetes during their lives as a direct result of being overweight, and obesity is estimated already to cost the US health care system many billions of dollars a year, plus lost productivity to the economy.

Expect to see many innovative approaches by pharmacuetical companies in addition to other control measures by governments such as additional regulations on marketing junk food to children.

Creative solutions could include developing new drugs which are similar to thyroxine. One such compound causes monkeys to lose a significant amount of their body weight on a normal diet in just a couple of weeks, without the normal toxic effects that one might expect on the heart.

Deadly bird flu found in Nigeria

It was almost inevitable that bird flu would hit Africa. Containing spread in this continent will be a near impossible task since many countries are very poor with little or no infrastructure to monitor outbreaks, educate people about what to do, or to remunerate them for slaughtering their birds.

WHO Tries to Calm Bird Flu Fears After Turkey Outbreak - CME Teaching Brief - MedPage Today

WHO Tries to Calm Bird Flu Fears After Turkey Outbreak - CME Teaching Brief - MedPage Today

The greatest immediate risk is that bird flu will spread into parts of Africa where there is extensive human - bird contact, and very few resources for tracking and elimination of infected birds. This will greatly increase the risk of a human mutation which could result in very rapid spread across human populations.

Bird flu: human pandemic could disrupt a country for more than six months - New Zealand's leading news and information website

Extract from Manawatu Standard New Zealand which indicates how another government is thinking about the threat of bird flu spreading amongst humans. As I have always said, the biggest impact is likely to be from an emotional reaction amongst people at home and at work, which will propel governments to drastic measures such as border closure even where such measures have been largely overtaken by events. The most likely scenario is a mutation into human form of bird flu (100% likely according to the World Health Organisation - only a matter of time) but in a far less dangerous way than worst case scenarios, perhaps with a death toll equivalent to 2-5 times a normal annual flu epidemic.

Text of the news bulletin:


Emergency managers are warning that a bird flu pandemic could last up to six months and people should be prepared to stay indoors that long.


Ministry of Civil Defence and Emergency Management readiness manager Mike O'Leary said a bird flu pandemic could strike in multiple waves, lasting up to six months.

"Three waves of approximately eight weeks each is what we are planning for," Mr O'Leary told Human Resources magazine.

Local Government Online chief executive Jim Higgins said it is rubbish to think a pandemic would last a few days.

". . .I've heard people on television speaking of a pandemic lasting a week or two, and I think, 'That's complete rubbish.' More likely a pandemic is going to last for three to six months, with two or three waves of infection."

Local Government Online would be key to providing information during an pandemic.

New Zealand's existing emergency response planning is for short, sharp disasters, such as earthquakes or floods, with mop-up afterward.

"When you think about all the (emergency response) planning that's been done to date, none of it includes anything about not being able to go outside for an extended period of perhaps three to six months. This threat is unique," Mr Higgins said.

Mr O'Leary also warned New Zealand would largely have to manage alone: "Public expectations will be high that relief will come to them, but there will be no cavalry coming over the horizon."

Bird flu is now only a threat, but health experts are worried that a small mutation of the H5N1 virus could let it transmit between humans, and humans have no natural immunity to it.

Health Ministry senior clinical adviser Andrea Forde said the key to surviving any pandemic will be in how well prepared people are, how quickly people can respond and how soon recovery happens.

A pandemic outbreak would see quarantine measures imposed, closing schools and workplaces to prevent infection from spreading. International borders would also be closed, affecting exports and imports. The experts say it could take months to get business functioning again. Getting back to normal would take longer.

Mr Higgins said businesses had to accept the pandemic is going to happen and to start planning.

"It's not a Y2K scenario. If businesses fail to heed this and do not have contingency plans in place, they will most likely grind to a halt."

Ministry of Economic Development resources and networks director Tony Fenwick said a pandemic would see businesses close either because they had to or through reduced demand.

Key industries must plan now for a pandemic, Mr Fenwick said.

"Undisrupted provision of key infrastructure services, the food-supply chain, the capacity of the health sector, the continued operation of banking-payments systems and the legal system are areas we must focus on," he said.

Mr Higgins said the chance of containing bird flu, as Sars was contained, may be remote because of the more infectious nature of influenza.

". . .so we have to look at ways to ride a pandemic out. One of the best ways to do that will be to limit personal contact," he said.

That means businesses have to immediately start looking at ways staff can work from home. Email and telecommunications will be the top tools to keep functioning.

"This really is the sort of line we have to follow to avoid unnecessary infection."

See also http://www.globalchange.com/birdflu.htm

Reuters AlertNet - Latest bird flu cases in humans

Dec 7 (Reuters) - A 10-year-old girl in the southern Chinese province of Guangxi is the latest human victim of H5N1 avian influenza, the World Health Organisation confirmed.

The girl developed symptoms of fever and cough on Nov. 23, followed by pneumonia and is being treated in hospital, the WHO said.

Comment: initial reports have suggested that the girl is in an area where no birds are sick, raising questions about whether she caught the infection from a bird or another person.

Continued concerns that milder cases of humans with bird flu may be being missed, and that human to human spread could begin without being obvious, if the illness is insufficiently serious to raise suspicion.

China senior official resigns over Harbin toxic spillage

China's chief environment official, Xie Zhenhuahas, the director-general of the State Environment Protection Administration (SEPA), has resigned in the wake of sharp public criticism of the handling of a toxic spill into the Songhua river, which supplies water to millions of farmers and city dwellers, including Harbin, in north-east China.

The resignation was announced tonight in a statement through the official Xinhua news agency. Mr Xie has been forced out and is to take responsibility for the damage caused by the spill into the Songhua river, near Harbin, and SEPA?s mishandling of its aftermath, according to the statement.

Comment: Central government is taking strong measures to show that action is being taken in an effort to maintain trust.

Europeans reject abstinence message in split with US on Aids

We continue to see a polarised debate about how to prevent HIV transmission between some of those in developed nations who tend to favour condoms above all else (sometimes perhaps to the exclusion of other options), and those in the poorest nations who often feel the case for abstinence and faithfulness is being ignored (and sometimes feel uncomfortable talking about condoms).

The dispute is confusing and in many ways unecessary.

We need a reality check: as the work of the AIDS foundation ACET (which I started in 1988) has found, the realities on the ground tend to impose their own solutions. Rhetoric and political posturing disappears when you are confronted by the magnitude of the disaster in countries with very few resources and health budgets of maybe only a couple of dollars per person a year.

Take for example the plight of Africa where at least 10% of the population in vast rural areas is already infected. Those that promote condoms as (virtually) the only way to halt spread don't seem to have worked out the logistical and economic challenge of applying a condom-dominated message across an entire low-income region.

The world AIDS budget is insufficient to supply every sexually active adult in Africa with as many condoms as they may need to protect every sexual encounter. Such a policy also assumes perfect distribution channels to villages which may be almost entirely cut off from Western-style supplies, and even date-checking of condom packets which deteriorate in tropical heat.

In any case, such an approach is deeply insulting to many in Africa since it ignores religious and other cultural values which in many places give honour to those who abstain before marriage and are faithful within it. There have been (totally false) widespread rumours that condom-dominated programmes are a front for secret Western attempts to stop babies being born in Africa. But these rumours have influenced many, and have come about because of mistrust of "imperialistic" wealthy nations.

And then there is the sensitive issue of youth. Even if one were to say that a condom-dominated message is the only right one for adults, and older teenagers, how about younger ones?

Is it right with a class of 11 year old girls to only talk about condoms, without raising the possibility that they might have an option to say no to sexual activity at such an age?

In practice, the pro-condom campaigners, and pro-abstinence activists tend to share common ground when tackling HIV education and prevention amongst those at such a young stage in life.

At the other extreme, most pro-abstinence activists also recognise that adults are determined to take a risk that could end their lives should be told about all the ways that such a risk can be reduced, including how to get hold of what they need eg condoms.

And between these two extremes, you will find the vast majority of HIV prevention programmes in Africa and Asia, looking to co-operate in doing all they can to educated people about risks, enabling them to take their decisions about how to stay healthy, in a culturally sensitive way, encouraging every avenue to save lives, whether condom use, refraining from risky sexual activity, not sharing needles and so on. And when it comes to avoiding sexual risk, as the World Health Organisation has always pointed out, there are two options: abstaining from penetrative sexual activity if the person could be infected (recognising you may never know), or being in a faithful relationship where both are known to be uninfected, and are both continuing to take every step to avoid becoming so.

We need every approach: sexual health clinics have a vital role to play in helping reduce other infections and an important co-factor for HIV spread; schools have a central task in informing young people about all health risks; parents have perhaps the greatest opportunity of all with young people growing up; the media, government, churches and other faith-based or community-based organisations likewise all have roles to play. Detached teams can target particular at-risk groups and so on.

This is not a time for disputes over how to put out the forest fire. We need everyone to pull together.

Unfortunately many people on every side of the debate tend to try to produce statistics to back their case. The trouble is that much of the science of prevention has been very weak. It is almost impossible to separate two different groups so that the only variable is your own programme. In almost all cases there are many other factors which could be operating to explain outcome differences. That is why so many of the studies show apparently conflicting results.

Rigorous studies are very hard to do and data that exists needs to be looked at very carefully.

However one thing is clear: advertisers have for years persuaded companies to spend huge amounts of money by proving that messages can change behaviour. Prevention programmes are an extension of the same process. They work.

We can debate about which approaches are most cost-effective, sustainable or culturally appropriate but as we have seen, when all parts of a community pull together, AIDS can be beaten.






Thursday December 1, 2005
The Guardian


Europe, led by the UK, last night signalled a major split with the United States over curbing the Aids pandemic in a statement that tacitly urged African governments not to heed the abstinence-focused agenda of the Bush administration.

The statement, released for World Aids Day today, emphasises the fundamental importance of condoms, sex education and access to reproductive health services. "We are profoundly concerned about the resurgence of partial or incomplete messages on HIV prevention which are not grounded in evidence and have limited effectiveness," it says.


While the US is not named, there is widespread anxiety over the effect of its pro-abstinence agenda in countries such as Uganda, where statements by Janet Museveni, the president's wife, and alleged problems with supply have led to a serious shortage of condoms.

The US has pledged $15bn (?8.6bn) over five years to fight the disease, most of which is channelled through the President's Emergency Plan for Aids Relief (Pepfar). Pepfar grants come with conditions, however - two thirds of the money has to go to pro-abstinence programmes, and it is not available to any organisations with clinics that offer abortion services or even counselling. The US is also opposed to the provision of needles and syringes to drug users on the grounds that it could be construed as encouraging their habit.

But the statement from 22 EU member states, released at a meeting under the UK presidency in London yesterday, calls on developing world governments to use every prevention tool, from condoms to clean needles to sexual health clinics, in a bid to slow down ">Google Desktop Search: Europeans reject abstinence message in split with US on Aids: "Thursday December 1, 2005
The Guardian


Europe, led by the UK, last night signalled a major split with the United States over curbing the Aids pandemic in a statement that tacitly urged African governments not to heed the abstinence-focused agenda of the Bush administration.

The statement, released for World Aids Day today, emphasises the fundamental importance of condoms, sex education and access to reproductive health services. 'We are profoundly concerned about the resurgence of partial or incomplete messages on HIV prevention which are not grounded in evidence and have limited effectiveness,' it says.


While the US is not named, there is widespread anxiety over the effect of its pro-abstinence agenda in countries such as Uganda, where statements by Janet Museveni, the president's wife, and alleged problems with supply have led to a serious shortage of condoms.

The US has pledged $15bn (?8.6bn) over five years to fight the disease, most of which is channelled through the President's Emergency Plan for Aids Relief (Pepfar). Pepfar grants come with conditions, however - two thirds of the money has to go to pro-abstinence programmes, and it is not available to any organisations with clinics that offer abortion services or even counselling. The US is also opposed to the provision of needles and syringes to drug users on the grounds that it could be construed as encouraging their habit.

But the statement from 22 EU member states, released at a meeting under the UK presidency in London yesterday, calls on developing world governments to use every prevention tool, from condoms to clean needles to sexual health clinics, in a bid to slow down "

Another chemical explosion in China -

An explosion at a chemical plant in southwest China killed one worker and forced thousands of people to evacuate their homes, Agence France-Presse reported.

The explosion happened yesterday at Yingte chemical plant at a town near Chongqing, AFP said. A female worker died and more than 10,000 residents were evacuated.

An initial explosion went off near barrels of benzene, sparking a second one which created a yellow cloud. Officials ordered people to stop using water from taps and started gathering water and air samples.

A previous explosion on November 13th at a chemical plant in the northeast of the country spilled nitrobenzene into the Songhua River, leading to reports of contamination of the drinking water of Harbin, a city of 3 million.

These kinds of accidents are to be expected in a vast country, growing rapidly, populated by millions on low incomes who are struggling to survive economically, and for whom short cuts may bring promise of higher productivity and wages.

Accidents can happen in any country and any industry and it is easy for smaller nations to point the finger, when the main reason they have fewer accidents is the relative size of their industries - together witht the fact that they have had the benefit of relative wealth for some decades.

It is hard for the government when accidents happen because the lines of authority may be long, information may not always be available and when announcements are made, they may not always be believed by citizens who suspect local officials are playing down the situation. The result can be rumour and panic.

One way to deal with this problem would be to allow greater freedom in the media to investigate and criticise. A free media might be more trusted at such times - for example over whether local drinking water is safe. However, freedom in the media may bring other challenges, making it easier for organised protest movements to develop, perhaps leading to destabilisation. These are the dilemmas facing government leaders as they seek to lead the country along the delicate path of rapid growth, job creation, digital revolution, internet access and mobile telephone on the one hand, and secure, stable party rule on the other.

AIDS pandemic is still out of control in many countries

Text of UNAIDS press release on World AIDS Day 2005..... Note: ACET International Alliance has been involved in the fight against AIDS for 17 years (I started ACET in 1988) and we have also seen signficant falls in HIV in places like Uganda. However we have also seen rapid spread recently in places like India and Russia.

Press Release:



HIV infection rates decreasing in SEVERAL COUNTRIES

but global number of people living with HIV

CONTINUES TO RISE



Increased HIV prevention and treatment efforts needed to slow and reverse AIDS epidemic, according to new UNAIDS/WHO report





GENEVA, 21 November 2005 ? There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection?such as increased use of condoms, delay of first sexual experience and fewer sexual partners?have played a key part in these declines. The new UN report also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.



Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.


These latest findings were published in AIDS Epidemic Update 2005, the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). The joint report, which this year focuses on HIV prevention, was released today in advance of World AIDS Day, marked worldwide on the first of December.



Several recent developments in the Caribbean region (in Bahamas, Barbados, Bermuda, Dominican Republic and Haiti) give cause for guarded optimism?with some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expansion of voluntary HIV testing and counselling.



Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. There were an additional five million new infections in 2005. The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these, more than 500000 were children.



According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25% increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally? with 64% of new infections occurring here (over three million people).





?We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it,? said UNAIDS Executive Director Dr Peter Piot. ?It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed. We must move from small projects with short-term horizons to long-term, comprehensive strategies,? he added.



Impact of HIV Treatment



The report recognizes that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250 000 to 350 000 deaths were averted this year because of expanded access to HIV treatment.



Commenting on the potential enhanced impact of integrating prevention and treatment, the 2005 report emphasizes that a comprehensive response to HIV and AIDS requires the simultaneous acceleration of treatment and prevention efforts with the ultimate goal of universal access to prevention, treatment and care.



"We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions," said WHO Director-General Dr LEE Jong-wook. "Treatment availability provides a powerful incentive for governments to support, and individuals to seek out, HIV prevention information and voluntary counselling and testing. Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable."



Future challenges for strengthening HIV prevention



New data show that in Latin America, Eastern Europe and particularly Asia, the combination of injecting drug use and sex work is fuelling epidemics, and prevention programmes are falling short of addressing this overlap. The report shows how sustained, intensive programmes in diverse settings have helped bring about decreases in HIV incidence?among young people in Uganda and Tanzania, among sex workers and their clients in Thailand and India, and among injecting drug users in Spain and Brazil.



The report notes that, without HIV prevention measures, about 35% of children born to HIV-positive women will contract the virus. While mother-to-child transmission has been virtually eliminated from industrialized countries and service coverage is improving in many other places, it still falls far short in most of sub-Saharan Africa. An accelerated scale-up of services is urgently needed to reduce this unacceptable toll.



Levels of knowledge of safe sex and HIV remain low in many countries ? even in countries with high and growing prevalence. In 24 sub-Saharan countries (including Cameroon, C�te d?Ivoire, Kenya, Nigeria, Senegal and Uganda), two-thirds or more of young women (aged 15-24 years) lacked comprehensive knowledge of HIV transmission. According to a major survey carried out in the Philippines in 2003, more than 90% of respondents still believed that HIV could be transmitted by sharing a meal with an HIV-positive person.



Finally, weak HIV surveillance in several regions including in some countries in Latin America, the Caribbean, the Middle East, and North Africa is hampering prevention efforts and often means that people at highest risk ? men who have sex with men, sex workers, and injecting dug users ? are not adequately covered or reached through HIV prevention and treatment strategies.

AIDS pandemic is still out of control in many countries

Text of press release from UNAIDS:

Background: the AIDS foundation I have been part of for 17 years, and helped found, has also seen dramatic falls in HIV infection in Uganda and some other countries, while places like India and Russia have been losing ground.



UNAIDS Press Release World AIDS Day 2005

There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection?such as increased use of condoms, delay of first sexual experience and fewer sexual partners?have played a key part in these declines. The new UN report also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.



Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.


These latest findings were published in AIDS Epidemic Update 2005, the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). The joint report, which this year focuses on HIV prevention, was released today in advance of World AIDS Day, marked worldwide on the first of December.



Several recent developments in the Caribbean region (in Bahamas, Barbados, Bermuda, Dominican Republic and Haiti) give cause for guarded optimism?with some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expansion of voluntary HIV testing and counselling.



Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. There were an additional five million new infections in 2005. The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these, more than 500000 were children.



According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25% increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally? with 64% of new infections occurring here (over three million people).





?We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it,? said UNAIDS Executive Director Dr Peter Piot. ?It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed. We must move from small projects with short-term horizons to long-term, comprehensive strategies,? he added.



Impact of HIV Treatment



The report recognizes that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250 000 to 350 000 deaths were averted this year because of expanded access to HIV treatment.



Commenting on the potential enhanced impact of integrating prevention and treatment, the 2005 report emphasizes that a comprehensive response to HIV and AIDS requires the simultaneous acceleration of treatment and prevention efforts with the ultimate goal of universal access to prevention, treatment and care.



"We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions," said WHO Director-General Dr LEE Jong-wook. "Treatment availability provides a powerful incentive for governments to support, and individuals to seek out, HIV prevention information and voluntary counselling and testing. Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable."



Future challenges for strengthening HIV prevention



New data show that in Latin America, Eastern Europe and particularly Asia, the combination of injecting drug use and sex work is fuelling epidemics, and prevention programmes are falling short of addressing this overlap. The report shows how sustained, intensive programmes in diverse settings have helped bring about decreases in HIV incidence?among young people in Uganda and Tanzania, among sex workers and their clients in Thailand and India, and among injecting drug users in Spain and Brazil.



The report notes that, without HIV prevention measures, about 35% of children born to HIV-positive women will contract the virus. While mother-to-child transmission has been virtually eliminated from industrialized countries and service coverage is improving in many other places, it still falls far short in most of sub-Saharan Africa. An accelerated scale-up of services is urgently needed to reduce this unacceptable toll.



Levels of knowledge of safe sex and HIV remain low in many countries ? even in countries with high and growing prevalence. In 24 sub-Saharan countries (including Cameroon, C�te d?Ivoire, Kenya, Nigeria, Senegal and Uganda), two-thirds or more of young women (aged 15-24 years) lacked comprehensive knowledge of HIV transmission. According to a major survey carried out in the Philippines in 2003, more than 90% of respondents still believed that HIV could be transmitted by sharing a meal with an HIV-positive person.



Finally, weak HIV surveillance in several regions including in some countries in Latin America, the Caribbean, the Middle East, and North Africa is hampering prevention efforts and often means that people at highest risk ? men who have sex with men, sex workers, and injecting dug users ? are not adequately covered or reached through HIV prevention and treatment strategies.