ON THE plus side, drug treatment for HIV is being refined, AIDS-related
deaths in Britain and the US are falling, and a few months ago doctors started
clinical tests of the much-vaunted Oxford/Nairobi HIV vaccine. So why does so
much gloom still surround HIV? In a nutshell, the worst-affected countries
can鈥檛 afford the drugs鈥攁nd the vaccine is unlikely to work.
In the hardest-hit countries, infection rates have hit catastrophic levels.
In sub-Saharan Africa an estimated 3.8 million people contracted the virus in
2000, bringing the total to more than 25 million.
In South Africa alone, the UN鈥檚 joint programme on HIV and AIDS predicts that
half of all teenage boys will die from AIDS. Belatedly, the ruling African
Nation Congress is producing health education material. But it is still failing
to publicise how cheap drug treatment can prevent infected mothers passing HIV
to their babies.
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In India the horse may already have bolted. And in China it鈥檚 not clear if
anyone鈥檚 even bothering to close the stable door. In the mid-1990s, New
Scientist reported that massive under-reporting of HIV in China disguised a
huge health problem. In 1995, an estimated 100,000 Chinese had HIV. Today, the
number stands at 1 million.
News is no better on the immunisation front. The vaccine developed by the
Universities of Oxford and Nairobi is based on the immune responses of six
former Kenyan prostitutes who seemed to be resistant to HIV. But early this year
came news that the women are now infected, casting doubt on the entire project.
And the discovery this year that a Canadian man infected with a 鈥渕ild鈥� strain of
HIV had also contracted a more aggressive form, cast an even deeper pall over
vaccine research.
In the developed world, insights into clinical pharmacology are gradually
making courses of treatment simpler. One blot on the landscape is that treatment
guidelines in the US are likely to change because anti-HIV drugs are turning out
to be more toxic than was thought. But at least patients in rich countries have
hope. Very few do in the developing world. For most of the planet, the worst is
yet to come.
