World AIDS Day

Twenty years ago I was reading And the Band Played On: Politics, People, and the AIDS Epidemic by Randy Shilts and alarm bells were ringing. I wasn’t fearful for myself, but ticked that my government wasn’t doing things that, to me, seemed obvious about protecting people from harm. I had a sense that many people considered people with AIDS expendable.

Now it’s 2007 and things are marginally better in some ways (see comments by Margaret Chan, Director-General of the World Health Organization, that follow this paragraph), but only in some ways. There is still a lot to do, not the least of which is to drop the stigma and disdain that still seems to me to be pandemic. So, I’m only sorta celebrating World AIDS Day.

The first World AIDS Day was staged by WHO in 1988, at a time when the world was waking up to this disease and its multiple catastrophic impact. Since then, the face of the epidemic has changed in significant ways, and we are gaining better insight every day.

Some trends have been positive. Leaders in most countries are fully awake to the threat. Awareness has brought commitment, and resources continue to increase, including for the development of new tools.

This year’s report on the epidemic, jointly prepared by UNAIDS and WHO, indicates that HIV incidence peaked in the late 1990s and prevalence has been level since 2001. Data set out in this report further suggest that prevention efforts are leading to fewer new infections, especially in young people, and that greater access to treatment is contributing to fewer HIV-associated deaths.

These positive trends mask some alarming changes in the epidemic. My main message today is straightforward: do not forget Africa, and do not forget women.

Link to the WHO statement.


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