Threat of global AIDS epidemic over, says WHO

A quarter of a century after AIDS first appeared, the World Health Organisation has for the first time said the threat of a global heterosexual pandemic outside Africa might have passed.

According to Dr Kevin de Cock, one of the world's leading epidemiologists and head of the organisation's HIV/ AIDS department, there has been a shift in the understanding of the risks posed by the virus.

HIV was earlier regarded as a risk to populations everywhere, irrespective of the percentages that practised unsafe sexual behaviour. But experts now believe that outside of sub-Saharan Africa, the disease is largely confined to high-risk groups like men having sex with men, sex workers and their clients.

Speaking to TOI from New York, Dr de Cock said, "If the virus had to cause an epidemic among the general population in India and China, as originally feared, why hasn't it happened till now? It doesn't look likely anymore."

Dr de Cock, who expressed doubts about predictions of an Africa-type situation developing in India, said prevention strategies need to be focused where HIV transmission is occurring. "India needs to look at who are getting infected more often and then target that section of society," he said. He called for massive investments in educating those most at risk rather than focus on a school AIDS programme. "Countries need to go where transmission is occurring, which they have not always been good at," he said.

The WHO expert said that unlike Africa, specially in its southern and eastern parts, where the virus has been found to be "self-sustaining" in the general population, a similar trend has not emerged in Asian countries. In these nations, the prevalence is mostly concentrated in groups at risk and their partners. "It is very unlikely that there will be a heterosexual epidemic in other countries outside Africa," Dr de Cock said, while emphasising that this should not breed complacency.

UNAIDS chief Dr Dennis Broun, too, agreed with Dr de Cock. He told TOI, "We made a mistake with our predictions.

However, the gloomy predictions were made seeing evidence that was available to us 10 years ago, which was minimal. Today, with all the accumulated information, it is unlikely that Asian countries will see a generalised epidemic."
Nearly 2.45 million Indians live with HIV with prevalence rate in the general population of 0.36%.