Aids epidemic 'bringing social collapse'

UN demands urgent action as virus kills 3 million a year, takes hold in eastern Europe and risks pandemic in Asia

Sarah Boseley, health editor
Wednesday November 27, 2002

The Guardian

The Aids epidemic is causing the spiralling disintegration of some of the poorest countries in Africa, precipitating famine and social, political and economic collapse, says the latest official United Nations update.

The UN Aids report takes a more somber tone than ever before as it lays out the increasing scale of the global epidemic which last year killed 3.1 million people, of whom 610,000 were children.

A further 5 million people were infected with the deadly virus in 2002, bringing the world total living with HIV to 42 million. Most of the 29.4 million with HIV in sub-Saharan Africa are likely to die - only about 300,000 currently receive life-saving drugs.

But the report also warns that what is happening now in Africa may prefigure a similar pandemic in the populous countries of Asia.

India already has the second highest number of people - nearly 4 million - living with HIV and the largest number of Aids orphans. A recent US intelligence report estimated the number could surge to 25 million by 2010.

World leaders have been warned of an "explosive" spread of the disease into new areas unless more resources are freed up to fight Aids.

Launching the report ahead of World Aids Day on Sunday, the executive director of UN Aids, Peter Piot, said there was a direct relationship between HIV/Aids and the famine in southern Africa - in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe.

"Aids is fuelling the food crisis in sub-Saharan Africa," he said. "This is the first large-scale sign of what the impact of Aids can and will be for society as a whole."

The report says that the six countries have more than 5 million adults and 600,000 children living with HIV/Aids out of a population of 26 million, more than one person in five.

A generation of once-fit young adults who were the farm workers, parents and teachers of southern Africa are falling ill and dying. A study this year in Malawi showed that about 70% of households had suffered labour losses due to sickness. Some had been forced to neglect their farms to try to earn cash to buy food.

Alan Whiteside, director of HIV/Aids research at South Africa's University of Natal in Durban, said that Aids was causing crises not just in health but in development, economics and politics as well.

"Today in [southern Africa] over 15 million people are facing food shortages. Sure, the rain hasn't come, but people are unable to plant the fields. They are unable to get to the fields," he said, adding that there could be a window of only four to six weeks when seed could be sown.

"Agricultural workers are lost. The learning from generation to generation is lost."

He said there was a crisis of orphans, too. "Children are growing up unloved, unsocialized and uneducated."

For the first time in the epidemic, as many women worldwide are infected with HIV as men, largely because in sub-Saharan Africa, women account for 60% of infections. Yet it is the women who care for the sick, look after the children and, in many regions, labor in the fields, so their loss is a major blow.

The epidemic in parts of Africa is overwhelming the coping mechanisms of whole countries, said Dr Piot.

"We must act now, on a much larger scale than anything we have done before, not only to assist those nations already hard hit, but also to stop the explosive growth of Aids in the parts of the world where the epidemic is newly emerging."

The UN price tag put on the battle against Aids is $10bn (6.4bn) a year. - the world has paid only $3bn this year.

"There is clearly a major resource gap," said Dr Piot. "We are not doing enough. There is definitely a case for increasing awareness among the public in developed countries that the Aids epidemic even very far away in Africa or India is affecting stability in the world where we are.

"There is a responsibility on governments and the public in countries like Britain or western Europe to contribute to the fight against Aids in developing countries.

"It is not only a moral responsibility. This is becoming one of the greatest threats to stability in the world - and now I'm quoting Colin Powell in a speech last week. 'Not enough is being done.' "

The report shows the epidemic taking off quickly in eastern Europe and the central Asian republics. In 2002, there were an estimated 250,000 new infections there, bringing the region's total to 2.5 million. But in some countries the spread has been phenomenal, with almost as many new infections in Uzbekistan in the first six months of this year as in the entire previous decade.

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