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A United Nations reports indicates that the AIDS epidemic appears to be slowing in some regions, but AIDS remains a crisis in Southern Africa and is also gaining momentum in Eastern Europe. Four million HIV infections occur worldwide each year and 38 million people are infected. Here's NPR's Brenda Wilson.
BRENDA WILSON reporting:
The United Nations held its first special assembly on AIDS in 2001. A lot has changed since then. Dr. Peter Piot, the director of AIDS Programs for the UN, says the main thing is that $8.5 billion was spent last year to fight AIDS, and in many countries you can see the results.
Dr. PETER PIOT (Director, UNAIDS PROGRAM): In Eastern Africa, countries like Kenya, of course Uganda that was known before, in some parts of west Africa, in southern India, in the Caribbean, in basically every continent; and we see at the same time a crisis that is deepening, with Eastern Europe expanding, South Africa and the countries around it having also more infections.
WILSON: In 2001, about 240,000 people in developing countries were on life saving anti-AIDS drugs. Now, 1.5 million people are. Among poorer countries, Uganda appears to have benefited most from being targeted by the U.S. and other international organizations.
Dr. PIOT: Today in Uganda, well over half of all people who need anti-retroviral therapy actually have access to anti-retroviral therapy; only Botswana has a much better result.
WILSON: But the epidemic in southern Africa has resisted efforts to prevent the spread of the disease. Piot says most AIDS program don't really get at the conditions driving the epidemic in South Africa and surrounding countries.
Dr. PIOT: It has to do, in the first place, with poverty, with the organization of labor. Men were imported from all over southern and eastern Africa to work in the mines without their family, living in compounds. That has been a major factor in the spread of HIV, because the sexual expression is often commercial sex, and you cannot change that overnight.
WILSON: If every family in South Africa were reunited and had a house, he says, the rates of HIV would come down. The epidemic in Russia and eastern Europe is an expanding epidemic made up almost entirely of young people who use drugs. Almost a million are infected. In recent months, President Vladimir Putin has met with provincial leaders to call attention to the problem. But Piot says tackling it will be difficult.
Dr. PIOT: There is enormous discrimination and stigma, and working on AIDS at the local level is still quite difficult because both injecting drugs users and gay men are really rejected.
WILSON: Recognizing these and other vulnerable groups is expected to be a source of controversy, as the UN Special Assembly on AIDS opens tomorrow. Dr. Mark Dybul, the acting U.S. Global AIDS Director, expressed hope that the declaration at the end of the meeting reflects U.S. views.
Dr. MARK DYBUL (Acting U.S. Global AIDS Director: We would like to see language that matches what we have advocated for, which is education of youth and education of adults. The fact that you need all three components A, B and C, that's sexual education; that's teaching people to abstain and be faithful to an HIV negative partner. If that isn't possible, then use a condom.
WILSON: The president's wife, Laura Bush, is leading the U.S. delegation, and she will highlight the compassion of the American people in contributing more than any other country to the fight against AIDS.
Brenda Wilson, NPR News.
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