My thoughts about natural disasters led me to consider the worst natural disaster of all – plague.

So, AIDS/HIV has dropped off the news reports, but how are we actually doing?

On the plus side, the worldwide number of new cases of HIV is estimated to be on the decline since before 2001 (perhaps as early as 1994).
Also on the plus side, the worldwide number of deaths from AIDS peaked in 2005 and has been declining slowly ever since.

On the minus side, the number of new cases of HIV and deaths from AIDS is still obscenely high, estimated at 2.1 and 1.5 million people per year respectively.
Also on the minus side, the number of people with HIV is at an all-time high, most recently estimated at 35 million people.

Worryingly, many countries still do not report HIV/AIDS to the World Health Organisation, and this includes both China and Russia! That’s just one reason why world HIV/AIDS statistics are wildly uncertain.
Another worry is that the WHO has changed its mind retrospectively about the number of people with HIV. The 2004 report from WHO gave the number of people in 2003 with HIV as 37 million. The 2014 report from WHO gave the number of people in 2003 with HIV as 31.7 million, a difference of 6.3 million.

My personal opinion is that deaths per year of 1.5 million from AIDS is obscenely high. We are winning the fight against HIV/AIDS but not nearly fast enough.

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Considering it’s a preventable disease all those new cases every year is terrible, safe sex, clean needles, etc.

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

I realise this is probably not the response you’re looking for, but we’re certainly ‘winning’ at stopping it with post-exposure prophylaxis in rich countries.

If you don’t know about PEP yet, there’s some information about it here

Cymek said:

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

BACs get the drugs free.

Cymek said:

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

production of many drugs is protected by patents and as a consequence it’s unlikely that low cost mass production will be possible any time soon.

Cymek said:

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

Sure

poikilotherm said:

Cymek said:

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

BACs get the drugs free.

They who now?

Dropbear said:

poikilotherm said:

Cymek said:

Could the drug regime for keeping HIV at bay work in poor nations even if the money existed for the drugs themselves.

BACs get the drugs free.

They who now?

busted arse countries get the drugs for HIV Tx and PEP for free.

poikilotherm said:

Dropbear said:

poikilotherm said:

BACs get the drugs free.

They who now?

busted arse countries get the drugs for HIV Tx and PEP for free.

Sweet. I guess Africa will be free of AIDS by November

Dropbear said:

poikilotherm said:

Dropbear said:

They who now?

busted arse countries get the drugs for HIV Tx and PEP for free.

Sweet. I guess Africa will be free of AIDS by November

yep, like Pakistan will be free of polio soon too…

Dropbear said:

In western countries today, HIV is a condition you live with.

In BACs it still kills you pretty quick.

One of these days, poor people are going to get fed up with this inequality shit

I still hate the Nigerian and Indian governments for their refusal to lift a finger to help in ridding their countries of deadly communicable diseases.

Finding the South Africa is the major hotbed for AIDS came as a surprise to me. In 2003, 5.3 million people in South Africa had HIV. In 2012, it had risen to 6.1 million. That is much more than any other African country, even Nigeria with 3.4 million HIV sufferers in 2011. South Africa is not particularly poor by African standards. In Nigeria, only 3.4% of the population has HIV; in South Africa in 2012 that’s a massive 17.9%.

The non-cooperation of China and Russia with the WHO is also a worry.

This is interesting, the lower prevalence of HIV in India than expected is a significant part of the revision of AIDS/HIV statistics downwards. Adult HIV prevalence in India is only 0.31%. “Previously it was thought that around 5 million people were living with HIV in India – more than in any other country. Better data, including the results of a national household survey conducted in 2005-2006, led to a major revision of the prevalence estimate in July 2007. It is now thought that around 2.39 million people in India are living with HIV.” – from: http://www.avert.org/india-hiv-aids-statistics.htm

> One of these days, poor people are going to get fed up with this inequality shit
Unlikely that they’re going to do that, it would mean cutting off their major source of income – charity.

The AVERT country summaries are all informative and useful. The one on China http://www.avert.org/hiv-aids-china.htm

says this

“China’s HIV epidemic remains one of low prevalence overall (less than 0.1 percent among adults … Initially characterised by denial and inaction, the Chinese government has recently realised the danger of ignoring HIV and AIDS and has initiated a broad programme to tackle the epidemic. … In 2004, a State Council document recommended conducting a mass education campaign among the general population … Partly because of the national failure to educate Chinese citizens about AIDS in the 1980s and 1990s, stigma and discrimination towards those living with HIV in China is still a major problem. Stigma, fear and discrimination constitute a vicious circle which fuels a hidden epidemic.”

http://www.avert.org/hiv-aids-russia-eastern-europe-central-asia.htm

says this

“Around 1.4 million people in Russia, Eastern Europe and Central Asia were living with HIV at the end of 2011, representing an HIV prevalence of 1 percent. Around 140,000 became infected in 2011 and 92,000 died from AIDS-related illnesses; there was a 21 percent increase in AIDS-related deaths between 2005 and 2011.

“It is estimated that over two-thirds of the area’s infected people live in Russia, and combined with Ukraine, these two countries account for almost 90 percent of the region’s newly reported HIV diagnoses. Both countries also have the highest number of people living with HIV relative to the general population; adult HIV prevalence is 0.8 percent in Ukraine and between 0.8 and 1.4 percent in Russia. Significant numbers of people infected with HIV live in Belarus (20,000) and Kazakhstan (19,000).

“Since 2001, HIV prevalence in Russia, Eastern Europe and Central Asia has increased by 250 percent, making the region home to the world’s most rapidly expanding epidemic. In contrast, over the same period, prevalence in sub-Saharan Africa fell from 5.8 percent to 5 percent, and stabilised in South and Southeast Asia at 0.3 percent”.

mollwollfumble said:

“Since 2001, HIV prevalence in Russia, Eastern Europe and Central Asia has increased by 250 percent, making the region home to the world’s most rapidly expanding epidemic. In contrast, over the same period, prevalence in sub-Saharan Africa fell from 5.8 percent to 5 percent, and stabilised in South and Southeast Asia at 0.3 percent”.

I’m afraid that doesn’t surprise me. On a trip to Estonia the local parks were littered with discarded needle cases. It seemed that intravenous drug use was very common.

Re the OP and natural disasters and the plague the great fear seems to be a flu like disease whose latent period allows it to be transported around the world via air travel before it actually breaks out.

This chart comes from UNAIDS_Global_Report_2012

So, we’re winning the war against HIV/AIDS in Sub-Saharan Africa and the Caribbean, but not necessarily anywhere else.

Other information from that link is enlightening also. It tells you which countries to avoid having sex with sex workers (notably Indonesia, Papua New Guinea and throughout Africa), and which countries to avoid having homosexual male sex (almost everywhere other than Bangladesh). A major push is for distribution of anti-retrovirals to 15 million people by 2015 (nearly half of all HIV positive people). By end 2011 it was up to 8 million.

AwesomeO said:

Re the OP and natural disasters and the plague the great fear seems to be a flu like disease whose latent period allows it to be transported around the world via air travel before it actually breaks out.

I agree. I once calculated that a highly infectious disease with long latency period could be transported to every major location in the world by air travel in about six weeks.

HIV/AIDS has a much longer “clinical latency period” than even that. Luckily it’s not highly infectious.

mollwollfumble said:

AwesomeO said:

Re the OP and natural disasters and the plague the great fear seems to be a flu like disease whose latent period allows it to be transported around the world via air travel before it actually breaks out.

I agree. I once calculated that a highly infectious disease with long latency period could be transported to every major location in the world by air travel in about six weeks.

HIV/AIDS has a much longer “clinical latency period” than even that. Luckily it’s not highly infectious.

It probably wouldn’t take much to overwhelm the medical systems, especially as doctors and nurses would be among the early infected. Governments could do little other than attempt to impose quarantines, supply systems would break down, in the west it would be a thoroughly miserable time.

> A major push is for distribution of anti-retrovirals to 15 million people by end 2015 (nearly half of all HIV positive people). By end 2011 it was up to 8 million.

That push was proposed by the United Nations (UNAIDS) in 2011, and as of 4 Mar 2014 is supported by the “International Federation of Red Cross and Red Crescent Societies”.

As “only half of all people living with HIV are aware of their HIV status” and the number of people with HIV is about 35 million, it is clear that there is an “urgent need to expand access to HIV testing services. Voluntary and confidential HIV testing is central to UNAIDS’ Treatment 2015 initiative.”

AwesomeO said:

Re the OP and natural disasters and the plague the great fear seems to be a flu like disease whose latent period allows it to be transported around the world via air travel before it actually breaks out.

I think there was someone that postulated that flu and colds etc might actually travel on the wind

a flu breaking out in east asia ends up in America X weeks later carried on trade winds

then you’ve got birds that carry disease

One problem is that the formerly rich western states are running out of money, governments are less keen to send aid to BAC.

wookiemeister said:

AwesomeO said:

Re the OP and natural disasters and the plague the great fear seems to be a flu like disease whose latent period allows it to be transported around the world via air travel before it actually breaks out.

I think there was someone that postulated that flu and colds etc might actually travel on the wind
a flu breaking out in east asia ends up in America X weeks later carried on trade winds
then you’ve got birds that carry disease

Flu can’t travel on the wind. There was a study about how flu travels in the air inside aeroplanes. Normal flu can travel about two metres. SARS was exceptional in being able to travel about 4 metres.

As for birds, some flus can move between birds and humans, pigs seem to be another big one. But birds and humans are sufficiently different that a strain that is mild for one will be deadly for the other. Also, not too many people (or domestic birds) come into direct contact with migrating birds. Human-human contact will always the be biggest concern.

I personally think that today’s hospitals are no better than they were at (perhaps) the start of World War I, in the sense of isolating contagious diseases and avoiding hospital-acquired diseases. My daughter died from a pneumonia she picked up while visiting hospital for a minor eye operation.