U.N. Revises Global HIV Infection Estimate The U.N. is revising downward its estimate of worldwide HIV infections. There are 33 million people living with HIV, down from 39 million last year, according to U.N. AIDS. The revision comes as better surveys and methods for accounting for the infected have led to lower estimates of HIV.

U.N. Revises Global HIV Infection Estimate

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MELISSA BLOCK, Host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

MICHELE NORRIS, Host:

And I'm Michele Norris.

The United Nations and the World Health Organization have dramatically reduced the estimated number of people infected with HIV around the world by six million in just a year. The lower number does not reflect major advances in prevention or treatment. Instead, it's mainly a change in the way people are counted. And critics say the revision is long overdue.

NPR's Brenda Wilson reports.

BRENDA WILSON: Experts at the World Health Organization say the global AIDS epidemic has stabilized, declining in some areas, and still increasing in others. But that news is being overshadowed by the revision downward to 33 million and the estimated number of people infected with HIV.

As recently as 2001, the estimate was 40 million, which is when the U.N. started lowering the number.

According to Paul De Lay at UNAIDS, nearly all of the decline was due to methodology.

PAUL DE LAY: The biggest single reason for the reduction - the six million - were the revision in the estimates in India. And better data, better analysis and a better understanding in survival are part of the reason that the numbers in India dropped over 3 million.

WILSON: Dramatic reductions were also found in five other countries: Angola, Kenya, Mozambique, Nigeria and Zimbabwe. In Kenya and Zimbabwe, they were due to true declines from people changing their behavior. But the main difference can be explained by lower estimates provided by national household surveys that have been conducted in 30 African, Caribbean and Asian countries.

In the past, most of the data came from testing pregnant women who sought care at antenatal centers from tuberculosis patients, and people who sought treatment for sexually transmitted infections.

James Chin, professor emeritus at the University of California, Berkeley, says that he tried to tell UNAIDS not to rely on data from these selected populations.

JAMES CHIN: In Africa, at the beginning, when we found whatever HIV prevalence was present in, say, the city, in the rural areas whose generally at least 10 times lower. So, this was something that I knew from the beginning we had to pay a lot of attention to and I kept banging away at this major point.

WILSON: UNAIDS did make adjustments to accommodate the difference between urban and rural areas, but says it didn't count on unexpected differences and lower rates even within urban areas. At about the same time at the beginning of this decade, money had begun to pour in to fight AIDS, which raised suspicions that the numbers were kept high to keep support flowing.

Chin doesn't go that far.

CHIN: All I'm saying is that they have been very, very reluctant to come up with and accept the more- what I considered to be the more accurate method.

WILSON: The director of the AIDS division at WHO, Kevin De Cock, says the numbers were changed over time as they got a better understanding of the information they were seeing in the household surveys. And it's true, he says, that the changes can have an impact on the assistance countries receive.

KEVIN DE COCK: That's true of all of public health and it's true of the funding for other diseases and the high level discussions that go on in relation to the global fund to fight AIDS, TB and malaria. But I think we just want to emphasize that, you know, there really is no evidence. There is no evidence that data have been manipulated or changed for political consideration.

WILSON: Even with the revised estimates, trend show a decline in new infections and deaths, but not the number of people who need treatment for HIV.

Brenda Wilson, NPR News.

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