AIDS Experts: The Worst Is To Come

Tuesday, June 27th 2000, 12:00 am

By: News On 6

GENEVA (AP) â€” AIDS has killed 19 million people worldwide, but the worst is yet to come, the United Nations predicted Tuesday: the disease is expected to wipe out half the teen-agers in some African nations, devastating economies and societies.

``There is a whole generation which is being taken out,'' said Peter Piot, head of the U.N. Joint Program on HIV/AIDS. He said vulnerable countries in Asia, Eastern Europe and the Caribbean risk a similar catastrophe unless they act now to control infection rates.

In its 135-page report released Tuesday, UNAIDS estimates:

â€”The virus has killed 19 million people worldwide, up from 16.3 million at the end of 1998. It has infected 34 million more, including 5.4 million last year alone.

â€”More than 13 million children have been orphaned by AIDS.

â€”In 16 sub-Saharan African countries, more than one-tenth of the population ages 15-49 carries the Human Immunodeficiency Virus, or HIV.

â€”In seven of those countries, at least one-fifth of the population is infected.

One of the countries where 20 percent of the population is infected is South Africa, which has 4.2 million people who are HIV positive â€” the largest single national total. The southern African nation of Botswana has the worst rate, with more than one in three adults infected. That is the equivalent of 90 million people out of the U.S. population of 270 million.

``The probability that you die from AIDS when you are 15 today is over 50 percent in these countries,'' Piot told a press conference.

``We are going into societies where there are more people in their 60s and 70s than there are in their 40s and 30s,'' he said. ``This is unheard of.''

With dwindling numbers of economically active adults left to support the rest of the population, the impact on poor African nations is devastating.

Agricultural production in nations like Zimbabwe, where 2,000 people die each week of AIDS, is falling. Businesses are going bankrupt because of the deaths of skilled, educated staff members, according to the report.

Hopes of better education are also in tatters. The number of new teachers trained in Zambia is just keeping pace with the number felled by AIDS. Children are leaving school because they are orphaned or forced to work to support their families.

Hospitals are overwhelmed by AIDS patients. Many have inadequate supplies of even basic antibiotics to fight the pneumonia, tuberculosis or mouth fungus that accompany AIDS, let alone the sophisticated drugs which have eased suffering in rich countries, the report said.

Denial continues to be a problem. The report cited a 1999 survey of 72 minors orphaned by AIDS in a hard-hit Kenyan community: Although all knew of the disease, none of them believed their parents had died of it. Most thought witchcraft or a curse was to blame.

Piot said one of the reasons for the explosion of cases in southern Africa is the legacy of apartheid, which separated men from their families in rural areas and forced them to work in towns, with only prostitutes for relief. But he said governments were also to blame for ignoring the problem for too long.

``What is happening in southern Africa should be a lesson for countries today which don't have a big problem yet,'' he said. ``I'm thinking of Asia, I'm thinking of eastern Europe, I'm thinking of the Caribbean.''

About $4 billion is needed annually for prevention and education programs to turn the tide, Piot said. He called for debt-relief programs for poor countries.

Although Asia has relatively low infection rates overall, there are fears that could change because of the density of its population. Some 0.7 percent of the Indian population is HIV-positive, or 3.7 million people overall. The disease has so far been largely confined to drug addicts.

Infections in the former Soviet bloc are soaring because of drug addiction. Piot said the number of new HIV cases in Moscow last year far outstripped all previous years combined. And the disease is proliferating in Caribbean countries like Haiti and Barbados because people have multiple sexual partners from an early age.

Despite the gloom of the report, Piot said there are signs of hope.

Uganda, which used to be the worst-affected country, has slowed new infections thanks to strong prevention campaigns and increased condom use. Zambia is following suit.

In Washington on Tuesday, the Peace Corps announced a worldwide campaign to push similar measures â€” training its 2,400 volunteers in Africa in preventive techniques and forming a 200-member ``crisis corps'' to help educate communities.

``There is no option for any organization working in development other than to play a role in helping these countries confront the HIV-AIDS crisis,'' Peace Corps Director Mark Schneider said.

Cambodia, which has the highest rate of infection in Asia at 4.4 percent, is copying Thailand's successful campaign of promoting condom use. And Brazil's policy of prevention coupled with locally produced alternatives to high-cost anti-AIDS drugs has halved the number of deaths and led to huge savings in hospital bills, the report said.

``In the West and in Europe, the impact of treatment has been spectacular,'' Piot said. ``Mortality has really collapsed. There is a longer and better life for people with AIDS.''

Ironically, the report cited studies from Australia and San Francisco showing that the very success of AIDS therapies has encouraged a revival in risky behavior, with growing numbers of young homosexual men having unprotected intercourse and multiple partners.

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On the Net:

U.N. AIDS site, http://www.unaids.org