Tuesday, November 24, 1998 Published at 12:25 GMT
HIV pandemic tightens its grip
Rwandan refugees: HIV infection increased during war
The HIV virus infected 11 people a minute worldwide during the last year and threatens to destroy the infrastructure of entire countries, a new report has revealed.
Experts described almost six million new cases as the world's "collective failure" to deal with the disease.
Although sub-Sahara Africa continues to be the global epicentre of Aids, the research indicates that the disease is rapidly gaining new footholds in Asia and Eastern Europe.
The reseach shows that:
One in three people aged 15 to 49 has HIV in KwaZulu Natal - one of the highest rates in the world.
Many of the country's infections have come as men in the mostly mining-based economy spend long periods away from home and turn to prostitutes, the report says.
In North America and Western Europe, the availability of new more potent anti-HIV drug combinations has helped people with HIV to live longer and deaths in the US dropped by two-thirds between 1995 and 1997.
However, new HIV infections have remained constant, indicating that preventative programmes are failing.
"Yet almost six million people became infected this year.
"Every one of these new HIV infections represents a prevention failure, our collective failure."
In the worst affected countries, Aids life expectancy has plummetted as infant deaths have taken their toll.
In Namibia alone infant mortality is expected to double by 2010.
Aids is reported to have absorbed one fifth of company earnings in Zimbabwe. Firms in Tanzania and Zambia estimate the cost of Aids illnesses and death was more than their total annual profits.
David Heymann, executive director of the WHO Communicable Diseases Cluster, said: "Aids is a deadly serious public health threat.
"But as the epidemic continues to spin out of control, countries face more than just a health crisis.
"They face a growing threat to human development and to economic and social stability."
War spreads the disease
Conflict has also become a critical factor in the spread of the disease.
In Rwanda, before the political turmoil of the mid-1990s, infection rates were approximately 10% in urban areas and around 1% in the countryside.
Many carriers have no access to voluntary testing or counselling.
Even when these services are offered, many do not want to know or acknowledge their HIV status because of the blame and shame attached to the disease.
In the Zimbabwe city of Mutare, 40% of pregnant women are thought to be HIV-infected, and probably 30,000 have the disease. Yet the sole HIV support group in the city has just 70 members.
In another study of home-based care schemes in southern Africa, fewer than one in 10 people who were caring for HIV-infected relatives acknowledged that they were suffering from the disease.
Dr Piot said: "One might think that in a country with a quarter or third of the population infected, people would become more open about the epidemic.
"Experience teaches us that this does not happen automatically.
"The silence needs to be broken, publicly and courageously, by leaders who encourage their people to face the truth about Aids."