The HIV virus infected around 5 million people last year.© Getty Images

The HIV epidemic is worse than ever. A new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows that the virus is overriding attempts to contain it, despite billions of dollars of funding.

The latest numbers allow only one conclusion: that AIDS has become a global phenomenon. It was once seen as predominantly an African issue, but now an estimated 38 million people worldwide are HIV positive, and infection rates are rising on every continent. Last year, around 5 million people became infected with HIV, more than in any previous year.

"The report is not bringing too much good news," says Peter Piot, executive director of UNAIDS. "These numbers demonstrate the enormity of the challenge in both preventing millions of infections and treating those living with HIV."

Officials believe that strong leadership is needed to curtail the virus's spread. In Asia, where over 1 million people were infected with HIV last year, some countries' policies on AIDS are weak or absent. "The issue needs to be taken up as a national cause," says Piot. He wants governments to start talking about HIV, commit budgets and draw up action plans.

Global snapshot

The report reveals the most accurate picture of the AIDS pandemic to date¹. The fastest growing HIV epidemic is in Eastern Europe, where the number of infections has nearly doubled in the last two years. Transmission here is mainly linked to prostitution and intravenous drug use, both of which have flourished since the dismantling of the Soviet bloc.

The report also highlights the plight of women. Although the disease initially spread largely among men, women increasingly bear the brunt of the disease. In Africa, many women find it hard to negotiate safe sex and so cannot protect themselves against the virus. And the disease is passed down generations as young girls have sex with older men.

As a result, women account for nearly half of all people living with HIV and for 57% of them in sub-Saharan Africa. "These are shocking statistics," says Hilary Benn, Britain's secretary of state for international development. This week he pledged an extra £116 million (US$213 million) to two major UN agencies to help tackle the global AIDS pandemic.

But more cash is needed. UNAIDS estimates that annual global spending on AIDS prevention and treatment will have to rise to US$20 billion a year if the developing world's needs are to be met. Currently, the figure stands at just US$5 billion.

Success stories

There is some good news, however. In Uganda, there are 70% fewer HIV cases now compared with ten years ago. Prevalence has dropped as people have begun to talk openly about HIV and limit their number of sexual partners.

In Thailand, too, infection rates have dropped. Last year, 21,000 people became infected, compared with 140,000 people in 1996; an increase in condom use and a decrease in the sex trade have contributed to the trend.

"Prevention strategies, such as improved education, condoms and clean needles, do work," says international public health expert James Whitworth from the London School of Hygiene and Tropical Medicine, but they need to be effectively targeted.

At present, only one in five people who need access to HIV prevention get it, but treatments are becoming more readily available. Some 440,000 AIDS patients in developing countries now have access to antiretroviral drugs, twice the number two years ago. Philanthropic organizations have negotiated price reductions and today treatment can cost as little as US$140 a person annually.

As developing countries begin to invest in AIDS prevention and treatment activities, hopes are high that the disease will be curtailed. However, "AIDS, without any doubt, is still the largest epidemic in human history," says Piot. 

UNAIDS

• References

  1. 2004 Report on the global AIDS epidemic, (Joint United National Programme on HIV/AIDS, 2004). http://www.unaids.org/bangkok2004/report.html