Young bear the brunt as Aids spreads through the world on a biblical scale

WE THOUGHT we had Aids beaten. The worst infectious disease of modern times was in retreat in the West and there were signs that it had peaked in parts of the developing world. New drug combinations had brought spectacular improvements in survival, adding to the impression that a global crisis had been averted.

How wrong we were. In 1998, another 5.8 million people have joined the legions infected with the virus, half of them aged under 25. Today, more than 33 million people across the planet are carrying the disease and the speed at which it spreads shows no sign of slowing. Villages, towns and countries face ruin on a biblical scale.

In Western Europe, the incidence of new Aids cases began falling in 1995 as new drug cocktails improved survival. In the US, the number of people dying from Aids dropped by two-thirds between 1995 and 1997, testimony to the success of the drugs.

But that therapeutic advance has bred complacency on prevention. The dramatic rises in HIV infection in the early Eighties were reversed by the late Eighties because of campaigns that increased condom use among gay men from zero to 50 per cent. But over the past decade, the number of new HIV infections in North America and Western Europe has failed to fall further, with close to 75,000 acquiring the virus this year.

Today almost 1.4 million people in the region are living with HIV and the total is growing because of improved survival, imposing an increasing burden on health services.

In the UK, the drug bill alone is expected to grow to pounds 300m by 2002.

Across the world it is the young who are taking the brunt of the epidemic - an estimated 40 million teenagers and adolescents will have contracted the virus by 2030.

The worst hit region is sub-Saharan Africa, where 70 per cent of all new infections and 80 per cent of the deaths occur. In four countries - Zimbabwe, Botswana, Namibia and Swaziland - more than one in five adults is now infected with HIV.

"If we do not invest in HIV prevention today we will have to invest in food aid tomorrow," Peter Piot, executive director of UNAids, the world Aids campaign, said yesterday as the latest figures were released.

Clare Short, the Secretary of State for International Development, declared the picture the statistics revealed "truly terrible" and said gains in life expectancy and infant mortality were being wiped out. "This is a further obstacle to Africa's liberation and development," she said.

There is, however, cause for hope. Although countries of the developing world will never be able to afford the expensive drug cocktails now saving lives in the West - if only 25 per cent of Malawi's HIV-infected population was prescribed the drugs it would consume 84 per cent of the country's Gross Domestic Product - there are other measures that have been proved to work.

In Uganda, the first African country to be ravaged by Aids in the Eighties, infections among pregnant women have fallen from 30 per cent to 10 per cent. As families have watched their breadwinners suffer a lingering and distressing death, the messages about safe sex have got through.

Backed by political and religious leaders, there has been a huge increase in condom use, a reduction in the number of sexual partners and a postponement by two years of the age at first intercourse.

In Tanzania, studies have shown that early treatment of sexually transmitted infections with cheap antibiotics cuts the spread of HIV by almost half.

In Senegal in west Africa, where Aids struck later than in east and southern Africa, 66 per cent of men now use condoms, compared with less than 5 per cent at the start of the decade, which has prevented the epidemic taking off.

Young women, who are often infected by older men, are at greatest risk. The first sexual experience of between a third and a half of all girls is from coercion or violence. "That alone is bad enough, but with Aids it becomes a lethal thing," said Mr Piot.

He added: "We have to do something about older men but their behaviour is the most difficult to change. It requires a major cultural shift."

The prospect of an Aids vaccine remains a distant hope. One candidate is on trial in the US and is about to be tested in Thailand, and several others are in the pipeline, but no product will be available for at least four to five years. Ms Short said: "Because Aids kills poor people, the market will not bring a vaccine. Science suggests it is possible... the World Bank is involved - but we must mobilise countries to put money in."

Until a vaccine is developed, condoms and sex education remain the best defence. The music television channel, MTV, has joined forces with UNAids and is to broadcast an Aids series fronted by the British pop star George Michael to a billion viewers round the world.

William Roedy, the president of MTV Networks International, said: "We try to use the influence of pop culture to deliver a message. Condoms are cool, and using them is cooler. We want to make it trendy, hip and cool to use condoms."

Even here, commercial imperatives interfere with humanitarian measures.

Although pharmaceutical companies have donated huge sums in drugs to help to eliminate diseases such as tuberculosis from the developing world, no condom company wishes to be associated with the mass supply of cheap sheaths because of the damage it could do to sales at home.

"Condoms have got to be affordable," said Ms Short. "That means in many cases they must be subsidised."

Leading article,

Review page 3

Nigel Wrench, Review page 8

Suggested Topics
Start your day with The Independent, sign up for daily news emails
Arts and Entertainment
Louis Theroux: By Reason of Insanity takes him behind the bars again
tvBy Reason of Insanity, TV review
Arts and Entertainment
Cassetteboy's latest video is called Emperor's New Clothes rap
videoThe political parody genius duo strike again with new video
Sport
Seth Rollins cashes in his Money in the Bank contract to win the WWE World Heavyweight Championship
WWERollins win the WWE World Heavyweight title in one of the greatest WrestleMania's ever seen
News
news
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Sales Consultant - Manchester

£27300 - £36000 per annum: Recruitment Genius: Self-employed B2B Sales Consult...

Recruitment Genius: Sales Call Handler

£14500 per annum: Recruitment Genius: An opportunity has arisen for a Sales Ca...

Recruitment Genius: Support Worker

£14560 - £15000 per annum: Recruitment Genius: This company offers unique pers...

Recruitment Genius: Junior Web Designer - Client Liaison

£6 per hour: Recruitment Genius: This is an exciting opportunity to join a gro...

Day In a Page

No postcode? No vote

Floating voters

How living on a houseboat meant I didn't officially 'exist'
Louis Theroux's affable Englishman routine begins to wear thin

By Reason of Insanity

Louis Theroux's affable Englishman routine begins to wear thin
Power dressing is back – but no shoulderpads!

Power dressing is back

But banish all thoughts of Eighties shoulderpads
Spanish stone-age cave paintings 'under threat' after being re-opened to the public

Spanish stone-age cave paintings in Altamira 'under threat'

Caves were re-opened to the public
'I was the bookies’ favourite to be first to leave the Cabinet'

Vince Cable interview

'I was the bookies’ favourite to be first to leave the Cabinet'
Election 2015: How many of the Government's coalition agreement promises have been kept?

Promises, promises

But how many coalition agreement pledges have been kept?
The Gaza fisherman who built his own reef - and was shot dead there by an Israeli gunboat

The death of a Gaza fisherman

He built his own reef, and was fatally shot there by an Israeli gunboat
Saudi Arabia's airstrikes in Yemen are fuelling the Gulf's fire

Saudi airstrikes are fuelling the Gulf's fire

Arab intervention in Yemen risks entrenching Sunni-Shia divide and handing a victory to Isis, says Patrick Cockburn
Zayn Malik's departure from One Direction shows the perils of fame in the age of social media

The only direction Zayn could go

We wince at the anguish of One Direction's fans, but Malik's departure shows the perils of fame in the age of social media
Young Magician of the Year 2015: Meet the schoolgirl from Newcastle who has her heart set on being the competition's first female winner

Spells like teen spirit

A 16-year-old from Newcastle has set her heart on being the first female to win Young Magician of the Year. Jonathan Owen meets her
Jonathan Anderson: If fashion is a cycle, this young man knows just how to ride it

If fashion is a cycle, this young man knows just how to ride it

British designer Jonathan Anderson is putting his stamp on venerable house Loewe
Number plates scheme could provide a licence to offend in the land of the free

Licence to offend in the land of the free

Cash-strapped states have hit on a way of making money out of drivers that may be in collision with the First Amendment, says Rupert Cornwell
From farm to fork: Meet the Cornish fishermen, vegetable-growers and butchers causing a stir in London's top restaurants

From farm to fork in Cornwall

One man is bringing together Cornwall's most accomplished growers, fishermen and butchers with London's best chefs to put the finest, freshest produce on the plates of some of the country’s best restaurants
Robert Parker interview: The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes

Robert Parker interview

The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes
Don't believe the stereotype - or should you?

Don't believe the stereotype - or should you?

We exaggerate regional traits and turn them into jokes - and those on the receiving end are in on it too, says DJ Taylor