AIDS: a global response [editorial]

Piot P
SCIENCE. 1996 Jun 28; 272:1855.

There are an estimated 21 million people infected with at least one of the 10 known subtypes of HIV worldwide, with more than 8500 people newly infected daily. The US Centers for Disease Control and Prevention estimate that 40,000 US citizens became infected last year with HIV. In heavily affected countries in Africa and Asia, where 33% of urban adults may be infected, AIDS deaths among young and middle-aged adults are threatening health systems, economies, and national stability. Global travel facilitates the spread of HIV worldwide. For the first time, however, a number of developing countries are registering a drop in new HIV infections, suggesting that prevention efforts focused upon safer sexual and drug-related behavior are working. Recent scientific breakthroughs are encouraging. Combination therapy with antiretroviral drugs may be able to not only defer the progression of disease and improve the quality of life, but turn HIV infection into a chronic nonprogressive condition. Furthermore, it has been determined that zidovudine can interrupt mother-to-child transmission of HIV. Research, however, remains central to preventing future HIV transmission. The development of accessible vaccines and vaginal microbicides are especially needed. The author notes that although 90% of HIV infections worldwide are in developing countries, AIDS intelligence and research and development are overwhelmingly concentrated in the industrialized world. In this context, efforts must be made to ensure the development of vaccines and therapies which are accessible and effective against AIDS in the developing world. The new Joint United Nations Program on HIV/AIDS (UNAIDS) has an important role to play in establishing a much needed partnership between developing and developed countries.

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