Clare Short, the UK International Development secretary, said: "HIV/Aids is a death sentence for poor and marginaised people. Over 90% of all HIV/Aids cases are now in developing countries - it is overwhelmingly a disease of the global disadvantaged.
"It lays a crippling burden on societies already afflicted by gross inequalities and is sharply reducing life expectancy in many countries.
"HIV/Aids can only be tackled seriously if governments help people to take the virus seriously."
The DFID has made HIV/Aids a priority area of its health strategy and its main aim is to contain the spread of HIV and to minimise the impact of the disease on the health and livelihoods of people in poorer countries.
The UK government has already funded a number of HIV programmes in Africa which it says are making progress.
They include:
- Money for a six-year £35m sexual and reproductive health programme in Malawi. The UK cash covers support for the national HIV/Aids programme, condoms, contaceptives and drugs to treat sexually transmitted diseases
- £1.5m STD/HIV project and £500,000 for HIV testing kits in Nigeria
- More than £2.6m for a reproductive health services programme in southern Africa.
Wednesday, 12 May, 1999, 11:25 GMT 12:25 UK
Aids Africa's top killer
Aids is now the leading cause of death in Africa, overtaking malaria as the continent's main killer disease, the United Nations has said.
It said the epidemic was responsible for one in five of all deaths in Africa last year.
Worldwide, the UN said Aids is now a bigger killer than any other infectious disease - and the fourth overall cause of death, after heart disease, strokes and respiratory infections, which often affect people in old age.
Nowhere in the world has the impact of Aids been more devastating than in Africa, where the UN estimates that more than 11 million people have now died of the disease.
'Formidable threat'
Peter Piot, executive director of UNAids, the body responsible for co-ordinating the fight against Aids, says it is the most formidable disease to confront modern medicine, with the potential to undermine the massive improvements made this century in global health and well-being.
He said HIV was catastrophic for two reasons: "Aids targets young adults and the number of deaths are accelerating quickly.
"Even if we stopped HIV today, because of the millions of people now living with the infection, the burden of Aids will continue to be severely felt.
"This is only the tip of the iceberg," he said.
Millions died
The UN estimates that two million Africans died of Aids last year. This is well over 80% of the world-wide death toll.
Malaria, which used to be Africa's main killer, accounted for about a million deaths.
Part of the explanation behind the jump in the UN's Aids figures is statitistical - many deaths previously attributed to tuberculosis are now known to have been actually caused by Aids.
Life expectancies in many countries are now plummeting as a result of, and national health systems have been overwhelmed.
Earlier this year, the Burundian government had to send Aids patients home from hospital because, it said, there were almost no beds for anyone else.
Aids cases continue to rise
The report - prepared in association with the World Health Organisation - said that while only small fluctuations in impact have been seen over the years with other causes of death, the Aids curve was rising sharply.
"These new findings challenge the world to make better use of the tools we have to reduce the impact of Aids, including prevention and care, and to speed up the search for an Aids vaccine," Mr Piot added.
Another finding of the report is that depression and other disorders which affect the brain have a major impact on a person's physical health.
The WHO measured how disability and other conditions affected ill health.
They found neuropsychiatric conditions, including depression, dementia and alcohol and drug abuse, accounted for 23% of the disease burden in Europe and the USA.
The report said: "Neuropsychiatric conditions have been ignored for a long time as they are absent from cause of death lists.
"However, when disease burden measurement includes time lived with a disability, several of the neuropsychiatric disorders become leading causes of disease burden worldwide."
The WHO estimates that major depression shortens healthy active life by four years.
UN to forecast HIV rise
Estimates of the number of HIV infections worldwide are expected to show an increasing numbers of victims in developing countries.
The AIDS Epidemic update, compiled jointly by the United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation, is to be released on Tuesday.
It is thought that while it will show a continuing low rate of new infections in the developed world, it will confirm the enormous toll the disease is taking on developing nations, particularly in Africa, and more recently, Asia.
Figures for 1998 showed that an estimated 2.2 million people died from Aids related illnesses worldwide.
The disease is now the fourth leading cause of death in the world, and is thought to have infected more than 47 million people.
More than 19 out of 20 HIV cases, and Aids deaths happen in the developing world.
Rise in infections
Last year's Aids Epidemic Update suggested that more than 30m were living with the HIV virus worldwide - a rise of 10% over the previous year.
This means than 11 men, women or children were infected per minute.
Sub Saharan Africa is still the worst affected region in the world, with more than 70% of HIV infections taking place there.
Countries such as Botswana, Namibia, and Zimbabwe are particularly hard hit.
However, experts are warning that the biggest rate of increase is in Asia.
India and China are thought to be two of the nations most vulnerable to the spread of the disease, even though infections are relatively low at the moment.
In contrast to sub-Saharan Africa's 22 million plus HIV cases, there are approximately 500,000 infected men, women and children in Western Europe.
The easier access to modern drugs, and huge sex education drives have limited sexual transmission, and mothers passing the virus on to their babies
Aids row in South Africa
Demonstrators in Johannesburg are demanding access to the latest treatment for pregnant women infected with HIV - the AIDS virus.
The hard-pressed South African Health Ministry say they cannot afford the drug AZT, even though the makers of the drug, Glaxo Wellcome, are reported to have offered them a substantial discount.
Western countries have been promoting the use of AZT to pregnant women as a way of reducing HIV transmission.
UK Aids organisations say research shows the number of babies born to HIV positive mothers who themselves become infected falls by two-thirds if the mother takes AZT and does not breastfeed.
However, the drug is very expensive.
An estimated one in five pregnant women treated in public hospitals is HIV-positive and the cost of private treatment at about $500 is way beyond the reach of most South Africans.
Zackie Achmad, spokesman for the National Association of People Living With Aids, said the planned demonstration outside Glaxo Wellcome was demanding drugs be sold at cost price to assist in treating pregnant women.
"The cost of treating babies with HIV or AIDS is much higher than preventing transmission from mother to child," he said.
Not cost-effective
The Health Ministry says the cost of providing treatment would be nearly £1m and with the benefits of AZT still far from clear it was not cost-effective.
Health Ministry spokesman Vincent Hlongwane said the government was concentrating its budget on information and awareness campaigns.
"We can't throw all our money - the limited resources - on just one intervention which is not 100% foolproof," he said.
Rape concern
Women's groups also say the drugs can reduce the chances of contracting HIV if administered within 24 hours of sexual intercourse.
Concern is being expressed at the increased danger women face of infection from rape.
People Opposing Women Abuse, Powa, says police statistics grossly under-estimate the true extent of rape in South Africa.
They say that for every reported rape, 35 victims stay silent - resulting in a rape occurring every half-minute in South Africa.
South Africa is among the most crime-plagued countries in the world with 116 rapes per 100,000 - nearly double the annual murder rate of 59 per 100,000 in 1998.
More than 1,500 new infections are taking place every day, and by the end of the first decade of the new millennium more than a quarter of the population is expected to have contracted HIV.
New treatment
Meanwhile, scientists in southern Africa have shown that a treatment used for leukaemia and sickle cell anaemia could be a cheap alternative to expensive cocktails of Aids drugs, including AZT.
They claim hydroxyurea, used in combination with a low dose of ddI, an existing HIV drug, can reduce the virus to undetectable levels within six months.
According to the New Scientist, the drug combination was tested on 127 Aids patients at an HIV clinic in South Africa.
Sixty-eight per cent of the people had undetectable levels of HIV within six months and the virus was kept at bay.
The results were replicated in a study in Botswana.
The combination does have side effects in some patients, such as darkened skin and nails, but only a small amount of patients are affected.
Hydroxyurea costs around $100 a year. Combined with ddI, the annual cost is $1,200 - a tenth the cost of triple combination therapy favoured in the west.
This is still too high for most developing countries and Aids campaigners are trying to get Bristol Myers Squibb, who manufacture ddI, to reduce the price in Africa.
Aids worldwide
The Aids pandemic is growing despite years of prevention work. UNAIDS, the United Nations' programme on Aids, says it manages to bring down HIV rates in some countries only to find them rising in others. Aids has now become the leading cause of death in Africa, overtaking malaria.
Asia
Asia is now set to see the biggest Aids explosion with numbers of HIV cases expected to double by the year 2000.
Cambodia is the most affected country in the region. Its health ministry estimates that 150,000 of the 11m population have HIV. Around 90% of these are thought to have caught the virus through heterosexual intercourse.
UNAIDS fear these figures are grossly underestimated.
It recently warned that one of the key contributors to the disease's spread in Asia was the prevalence of sexually transmitted disease (STDs).
People with STDs are more likely to contract the virus.
However, in different parts of the continent, as in different parts of the world, there are variations in the pattern of HIV spread.
For example, in China and Vietnam, intravenous drug use is a prime route for infection.
Americas
In Latin America, as in the USA and Western Europe, the main communities affected by HIV are gay men and intravenous drug users.
The number of cases of people being infected through heterosexual sex is rising fast.
In the US, the number of Aids deaths has declined for two consecutive years, but the disease remains the leading killer of African American men aged 25-44 and the second leading killer of African American women in the same age group.
African Americans, who comprise only 13% of the U.S. population, accounted for 43% of new Aids cases in 1997 and 36% of all Aids cases.
The main routes of infection are heterosexual sex and IV drugs.
Research shows African Americans are more likely to be diagnosed at a later stage than whites and to receive poorer healthcare because of economic disadvantages.
Hispanic Americans represent just 10% of the US population, but they account for more than 20% of new Aids cases.
Approximately half of all new HIV infections in the United States occur in people under age 25. A quarter occur in people under age 22.
Africa
More than 80% of people with Aids come from Africa.
The World Health Organisation says the disease is now the leading cause of death, and is the cause of a fifth of all deaths in the continent. The UN estimates that two million Africans died of Aids in 1998. The numbers may be rising because many deaths were previously attributed to other conditions, such as tuberculosis.
Aids rates vary according to country with some having relatively low levels of infection, while others, such as Kenya, Tanzania, Zimbabwe and Uganda have suffered greatly.
In Zimbabwe, which with Botswana has the highest incidence of Aids, life expectancy is likely to fall from 61 to 39 by the year 2010 because of Aids.
One in four people in the country is HIV positive.
Southern Africa, which is expected to see similar levels of HIV as were seen earlier in Eastern Africa, is only just beginning to tackle the problem.
It has a relatively well developed road system as well as a high level of migrant workers, allowing the disease to spread rapidly.
Many men working in the mines have to live most of the year away from home and there is a high use of prostitutes.
The end of apartheid may help the spread of HIV because it allows freer movement around the country.
The Aids epidemic in South Africa has also prompted protests about access to drug treatments, such as AZT, which are available in the West.
The government argues that it cannot afford the drug, even though the manufacturers are reported to have offered it at a reduced price.
But UNAIDS says education and prevention has reduced the Aids toll in some countries.
Uganda was hit early on in the pandemic and has organised huge health campaigns. As a result, the numbers of people infected are beginning to fall.
Europe
Aids also shows graphically the inequalities in world health.
While in the West, the presence of strong drug combinations has led to HIV becoming virtually a manageable disease, the situation is totally different in developing countries where drug treatments are too expensive and access to HIV tests is restricted.
In Europe, the number of people dying from Aids has fallen by 80% since 1995 because of the introduction of drug treatments which keep the virus at bay.
