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Confronting the AIDS Pandemic
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10511 |
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CURRENT ISSUES
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1 / 1993 |
2,409 Words |
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Daniel J.M. Tarantola And Jonathan M. Mann
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In 1986, the world undertook to mobilize, against the AIDS pandemic in an effort that continued to grow until the beginning of this decade, when it began to stall. Today, the global HIV/AIDS pandemic is spinning out of control--its broad course has yet to be influenced in any substantial way by policies and programs mounted against it.
In 1991-1992, the Harvard-based global AIDS policy coalition undertook a review of the state of the AIDS pandemic. The findings of this review, which appear in our new book AIDS in the World (Harvard University Press, December 1992), raise the alarm and call for an urgent revival of the response to AIDS.
The magnitude of the pandemic has increased over 100-fold since AIDS was discovered in 1981. From an estimated 100,000 people infected with HIV worldwide in 1981, it is estimated that by early 1992, at least 12.9 million people around the world (7.1 million men, 4.7 women, and 1.1 million children) had been infected with HIV. Of these, about one in five (2.6 million) have thus far developed AIDS, and nearly 2.5 million have died.
The spread of HIV has not been stopped in any community or country. In the United States, at least 40,000 to 80,000 new HIV infections were anticipated during 1992; in 1991, more than 75,000 new HIV infections occurred in Europe. In just five years, the cumulative number of HIV-infected Africans has triple, from 2.5 million to over 7.5 million today. HIV is spreading to communities and countries around the world--in some areas with great rapidity. An explosion of HIV has recently occurred in Southeast Asia, particularly in Thailand, Burma, and India, where, within only a few years, over one million people may have already been infected with HIV. HIV/AIDS is now reported from areas that, so far, had been left relatively untouched, such as Paraguay, Greenland, and Pacific island nations of Fiji, Papua New Guinea, and Samoa. The global implications are clear: During the next decade, HIV will likely reach most communities around the world: geographic boundaries cannot protect against HIV. The question today is not if HIV will come, but only when.
INCREASED COMPLEXITY
The pandemic becomes more complex as it matures. Globally it is composed of thousands of separate and linked community epidemics. Every large metropolitan area affected--Miami, New York, Bangkok, London, Amsterdam, Sydney, Rio de Janeiro--contains several subepidemics of HIV going on at the same time. The impact of
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