Health - HIV/AIDS

HIV and AIDS estimates in China

In January 2006, the Chinese government along with WHO and UNAIDS jointly estimated that 650,000 people were living with HIV in China, including about 75,000 AIDS patients. During 2005 there were around 70,000 new HIV infections and 25,000 AIDS deaths. These large numbers have to be considered in the context of China's extremely large population which is estimated at around 1,300 million.

The figure of 650,000 is lower than the previously published estimate of 840,000 in 2003. This is not because prevalence is falling, but is due to better data and improved methods of estimation. The number of reported AIDS cases is lower than the estimated number because of massive under reporting, especially in the rural areas. This is for a variety of reasons which include a shortage of testing equipment and trained health staff, as well as the continuing stigma.
"Exact figures are difficult to arrive at because government at local levels are very reticent to report on actual cases, a situation compounded by individuals who are reluctant to come forward because of discrimination." - Qi Xiaoqiu, director of China's Department of Disease Control.
Estimates of future infections are equally difficult, but UNAIDS and other organisations have estimated that by 2010 there could be a generalised epidemic with between ten and twenty million HIV positive Chinese.

HIV and AIDS estimates in India

There is disagreement over how many people are currently living with HIV in India. UNAIDS (the United Nations agency that co-ordinates global efforts to fight HIV) estimates that there were 5.7 million people in India living with HIV by the end of 2005, suggesting that India has a higher number of people living with HIV than any other country in the world. On the other hand, NACO has established an estimate of 5.2 million people, which indicates that there are less infected people in India than in South Africa. Either way, it is clear that the number affected by the epidemic is huge.
By the end of July 2005, the total number of AIDS cases reported to NACO was 111,608. Of this number, 32,567 were women, and 37% were under the age of 30. These figures are not completely accurate reflections of the actual situation though, as large numbers of AIDS cases go unreported.
Overall, around 0.9% of India’s population is living with HIV. While this may seem a low rate, India’s population is vast, so the actual number of people living with HIV is remarkably high. There are so many people living in India that a mere 0.1% increase in the HIV prevalence would increase the estimated number of people living with HIV by over half a million.
The national HIV prevalence has risen dramatically since the start of the epidemic, but a study released at the beginning of 2006 suggests that the HIV infection rate has fallen in southern India, the region that has been hit hardest by AIDS. In addition, NACO has released figures suggesting that the overall rate of new HIV infections in the country is slowing. Researchers claim that this decline is the result of successful prevention campaigns, which have led to an increase in condom use.
Some AIDS activists are doubtful of the suggestion that the situation is improving, though:
“It is the reverse. All the NGOs I know have recorded increases in the number of people accepting help because of HIV. I am really worried that we are just burying our head in the sand over this.” Anjali Gopalan, the Naz Foundation, Delhi

Future of HIV/AIDS
in India

Various groups have made predictions about the effect that AIDS will have on India in the future, and there has been a lot of dispute about the accuracy of these estimates. For instance, a 2002 report by the CIA's National Intelligence Council predicted 20 million to 25 million AIDS cases in India by 2010 - more than any other country in the world. 51 Yet the government has claimed that these figures are “completely inaccurate”, and has accused those who cite them of “spreading panic”. The government has also disputed predictions that India’s epidemic is “on an African trajectory”, although it claims to acknowledge the seriousness of the crisis.
Ruben del Prado, deputy UNAIDS country coordinator for India, has predicted that “there is going to be a reversal of the epidemic by 2008 and 2009”.
This does not correlate with other UN-related estimates, however, which have suggested that:
India's adult HIV prevalence will peak at 1.9% in 2019.
The number of AIDS deaths in India (which was estimated at 2.7 million for the period 1980-2000) will rise to 12.3 million during 2000-15, and to 49.5 million during 2015-50.
Economic growth in India will slow by almost a percentage point per year as a result of AIDS by 2019.
Whatever the exact figures turn out to be, it is clear that HIV and AIDS will have a devastating effect on India in the future, and that as much as possible needs to be done to minimise this impact.
“The challenges India faces to overcome this epidemic are enormous. Yet India possesses in ample quantities all the resources needed to achieve universal access to HIV prevention and treatment… defeating AIDS will require a significant intensification of our efforts, in India, just as in the rest of the world”
Peter Piot, Director of UNAIDS.

In China

If HIV/AIDS prevention is not made a priority in China, the country will be facing HIV epidemics that will be difficult to contain and expensive to deal with. HIV/AIDS in China could endanger national development and security, both personal and social. It is important to keep in mind that in China, the many millions who are vulnerable to HIV today do not belong to small isolated groups or pockets in society. Instead, vulnerable populations interact extensively with the general population and in fact in many instances they are the general population.
"China has everything to gain if it can stem the tide of the AIDS epidemic, and everything to lose if it fails" - Kofi Annan.
Mother to child transmission of HIV remains limited in China. However, once the number of women of childbearing age infected with HIV from their partners increases, so will the incidence of transmission to children. Also, HIV/AIDS poses a great threat to gains made in child survival.
The Chinese government also estimates that 260,000 children may be orphaned by 2010 although, again, these numbers are disputed, with AIDS activists and NGO workers in Henan estimating that as many as a million children in that province alone are or will become orphans as a result of the blood collection disaster. Many school age AIDS orphans were forced out of school when they could no longer afford school fees, or because they must work and care for sick parents.
Some of the major factors that have contributed to the relatively slow response to AIDS in China include not only a lack of openness in confronting the epidemic, but also a lack of commitment and leadership in many levels of government (provincial and local levels), a lack of adequate resources, a crumbling public health system and severe stigma and discrimination against people infected or affected by HIV/AIDS.
It is feared that China might soon have more people living with HIV than any other country in the world, if the recently improved prevention programmes are not rapidly brought up to scale.
"It would be fantastic if China could show the world how to contain the HIV/AIDS epidemic... However, should we fail, the consequences would not only be catastrophic for China – they would be felt all over the world.” - Richard Feachem, Executive Director of the Global Fund.
"Unless China acts decisively, it will find itself on an African trajectory, just 15 years behind. In Africa, governments and businesses are looking back at what they should and could have done - in China, there is still time to avert the worst-case scenario." - John Ruggie of Harvard University.

(SOURCE: http://www.avert.org/)