It is the time of year for UNAIDS -- sometimes known as the Joint United Nations Programme on HIV and AIDS -- to issue its global AIDS epidemic report
. The UNAIDS report over the years has been reliably depressing and horrifying, as the mortality statistics and rate of new infections are counted in millions. In some respects, this year's edition is no break from the past. Approximately 2.9 million people will have died of HIV/AIDS in the world this year, and 2.1 millon of them (or 72%) were sub-Saharan Africans. It does not speak well of the millions of dollars poured into HIV prevention programs around the world that approximately 4.3 million people were newly infected with the virus. Uganda seems to have taken a backward step: a prevalence of 5.6% infection among men and 6.9% among women in 2000 has rise to 6.5% in men and 8.8% in women by 2004. The Guardian
is quick to judge that the regression is due to the commitment of the Ugandan government -- strongly backed by the Bush administration -- to abstinence promotion at the expense of other ways of preventing HIV. Another alarming note is the rise of HIV infections via injection drug use in Africa, which has not been much recorded before -- what Africa does NOT need is another vector of HIV transmission. Some see glimmers of hope
in the report, such as the decline in HIV infection among youth (15-24) in African cities in Ivory Coast, Malawi and Zimbabwe, and rural areas of Botswana.
But overall, it is not a rosy picture: HIV prevention is stagnant or faltering, while the increased access to AIDS treatment and care in sub-Saharan Africa is not keeping up with the march of death. The piecemeal initiatives of HIV/AIDS superstars (Gates, Clinton, Bono) cannot substitute for major economic, social and political changes needed in Africa and between Africa and the rich countries of the north. Until then, it seems we will be faced with the symptoms of global inequality, in the form of grim reports by UNAIDS.