Sunday, June 8, 2008

Threat of world Aids pandemic among heterosexuals is over, report admits

A quarter of a century after the outbreak of Aids, the World Health Organisation (WHO) has accepted that the threat of a global heterosexual pandemic has disappeared.

"It is astonishing how badly we have done with men who have sex with men. It is something that is going to have to be discussed much more rigorously."

In the first official admission that the universal prevention strategy promoted by the major Aids organisations may have been misdirected, Kevin de Cock, the head of the WHO's department of HIV/Aids said there will be no generalised epidemic of Aids in the heterosexual population outside Africa.

Dr De Cock, an epidemiologist who has spent much of his career leading the battle against the disease, said understanding of the threat posed by the virus had changed. Whereas once it was seen as a risk to populations everywhere, it was now recognised that, outside sub-Saharan Africa, it was confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients.

Dr De Cock said: "It is very unlikely there will be a heterosexual epidemic in other countries. Ten years ago a lot of people were saying there would be a generalised epidemic in Asia – China was the big worry with its huge population. That doesn't look likely. But we have to be careful. As an epidemiologist it is better to describe what we can measure. There could be small outbreaks in some areas."

[many thanks to ruben del prado, irma member, for putting this article on our radar]

1 comment:

Jim Pickett said...

Here is a letter from WHO's De Cock back pedaling on this story:

Correction to AIDS Story in The Independent, 8 June 2008

New York, 11 June 2008 - We wish to clarify misinterpretations concerning WHO and UNAIDS' positions on the status of the AIDS epidemic in recent media articles.
The story in the Independent on Sunday titled: "Threat of world AIDS pandemic among heterosexuals is over, report admits" contained a few seriously misleading statements that have led to inferences and conclusions that bear no relation to the highly complex realities of the HIV epidemic.

First and foremost, the global HIV epidemic is by no means over. At the end of 2007, an estimated 33.2 million people were living with HIV. Some 2.5 million people became
newly infected that year, and 2.1 million died of AIDS. AIDS remains the leading cause of death in Africa.

Worldwide, HIV is still largely driven by heterosexual transmission. The majority of new infections in sub-Saharan Africa occur through heterosexual transmission. We have
also seen a number of generalized epidemics outside of Africa, such as in Haiti and Papua New Guinea.

Heterosexual transmission continues to drive the epidemic among sex workers, their clients, and their clients' partners. In addition, prisoners, injecting drug users, as well
as men who have sex with men, may also engage in heterosexual relationships. In sub-Saharan Africa almost 60% of adults living with HIV were women, 48% in the Caribbean.

HIV prevention and treatment efforts are showing results. Building on these successes will require improved outreach to populations most at risk with evidence-informed
approaches based on local HIV epidemiology - an approach we call "knowing your epidemic." In all settings, a supportive environment is required, free from stigma and discrimination, legal barriers or other obstacles that prevent access to services. AIDS awareness campaigns and school-based efforts are essential to promote sexual and reproductive health, ensuring young people have the knowledge and ability to protect themselves against sexually transmitted diseases, and teenage pregnancy.

UNAIDS and WHO remain focused on strengthening monitoring of the epidemic to refine responses further and to recognize changes in transmission patterns should they
occur. To recap: AIDS remains the leading infectious disease challenge in global health. To suggest otherwise is irresponsible and misleading.

Dr Kevin M. De Cock


Department of HIV/AIDS

WHO, World Health Organization

Dr Paul De Lay


Department of Evidence, Monitoring and Policy

UNAIDS, Joint UN Programme on HIV/AIDS

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