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JAMA. 2004 Jan 7; 291(1):31-32.The global AIDS epidemic infected an estimated 5 million individuals in 2003, bringing the world total of individuals living with human immunodeficiency virus (HIV) and AIDS to 40 million, said officials from the Joint United Nations Programme on HIV/AIDS (UNAIDS). The disease claimed about 3 million lives--the highest toll ever for a single year. Although sub-Saharan Africa remains the most severely affected region, tallying two thirds of all infections and more than two thirds of all deaths, HIV also is spreading rapidly in Eastern Europe and making worrisome inroads in Asia, threatening the immense populations of China and India. (excerpt)
NEW YORK TIMES. 1992 Jun 4; A1, B10.The international AIDS Center at the Harvard School of Public Health led a coalition of AIDS research from around the world in an analysis of more than 100 AIDS programs and discovered that the HIV/AIDS pandemic is more serious than WHO claims. Its findings are in the book called AIDS in the World 1992. AIDS programs do not implement efforts that are known to prevent the spread of HIV. For example, clinicians in developing countries continue to transfuse unscreened blood to many patients, even though HIV serodiagnostic test have existed since 1985. Further, programs do not evaluate what works in other programs. As long as people debate whether or not to distribute condoms, exchange needles, or offer sex education and whether people with AIDS deserve care, the fight against HIV/AIDS is hindered. The report recommends that leader come up with a new strategy to address the AIDS pandemic. WHO claims to have done just that at its May 1992 meeting. An obstacle for WHO is political pressure from member nations. On the other hand, the private Swiss foundation, Association Francois-Xavier Bagnoud, finances the Harvard-based AIDS program, allowing members more freedom to speak out. The head of the Harvard program believes the major impact of AIDS has not yet arrived. Contributing to the continual spread of HIV is the considerable difference of funding for AIDS prevention and control activities between developed and developing countries (e.g., $2.70 per person in the US and $1.18 in Europe vs. $.07 in sub-Saharan Africa and $.03 in Latin America). Even though developed countries provide about $780 million for AIDS prevention and care in developing countries, they do not enter in bilateral agreements with developing countries. 57 countries limit travel and immigration of people with HIV/AIDS. Further, efforts to drop these laws have stopped. Densely populated nations impose travel constraints to prevent an explosive spread of HIV.
BMJ. British Medical Journal. 1992 Aug 8; 305(6849):325-6.The press widely publicized investigative findings at the international AIDS conference in Amsterdam, the Netherlands about patients with signs or symptoms consistent with AIDS or AIDS-related complex but who did not have HIV-1 or HIV-2 antibodies or the viruses themselves. Yet the formal scientific sessions ignored this topic and the conference summaries only casually mentioned it. Tests used to try to detect HIV were antibody testing, virus isolation, or molecular detection techniques. The press suggested several emotive questions not based on clinical data such as the safety of national blood supplies. 4 of the 5 patients in New York City had HIV risk factors. The only clinical indications of immunodeficiency in 1 patient was Mycobacterium tuberculosis infection and 2 somewhat low CD4 counts which may have actually been due to tuberculosis. Laboratory personnel have not yet reconfirmed reverse transcriptase activity of lymphocytes from 2 patients. So far these cases do not exhibit epidemiological criteria for a new transmissible agent. There has been no case clustering or a pattern of sexual or vertical association of cases. These cases may only be more detections of cases of rare spontaneous primary or secondary immunodeficiency disease. If epidemiological support does suggest a transmissible agent, laboratory personnel may find it difficult to isolate and identify agent. The US Centers for Disease Control and WHO wants to coordinate reporting and classification of cases so epidemiologists can quickly verify or reject laboratory findings based on a larger series of cases. Only with full evaluation of ongoing research and development of sensitive and specific detection systems for new pathogens can the scientific community address questions concerning the safety of blood supplies. This reaction of the press indicates a need for the peer review system to continue to establish the soundness of research before its release to the press to avoid undue concern.