Making AIDS prevention a national priority.

During the period from August 1993 through August 1994, it was estimated that another 3 million persons had been infected with HIV, with the global total exceeding 17 million then. In Asia infections increased from 12% to 16% with a corresponding decrease in North America and Europe. Over 60% of all infections had occurred in Sub-Saharan Africa. In south and southeast Asia, HIV infections were estimated at over 2.5 million in mid-1994. Estimated infections in Thailand had risen 10-fold since early 1990, with rates of 4% among young men and 1.5% among pregnant women. Yet in Thailand reported cases of sexually transmitted diseases (STDs) fell by 77% between 1986 and 1993, which was attributed to media promotion of condom use. In east Asia and the Pacific, the estimated number of infections had reached 50,000 in mid-1994, a doubling in one year. There had been a steep rise in the rate of reported STDs in China. The countries of eastern Europe and central Asia in mid-1994 had over 50,000 infections, but many of the factors associated with rapid HIV spread were present: economic crisis, rising unemployment, armed conflicts, and major population movements. To date (mid-1994), there have been an estimated 100,000 infections in north Africa and the Middle East. As of mid-1994, 190 countries worldwide had reported close to 1 million AIDS cases to the World Health Organization. But an estimated 4 million adults and children had developed AIDS since the start of the pandemic. By 2000, the cumulative case total is projected to reach nearly 10 million. A retrospective analysis of the epidemic in Uganda, Tanzania, Rwanda, and Zambia showed that by the 12th year of the epidemic, youth under 25 accounted for up to 3/4 of all new infections. Implementing basic prevention programs in Asia would cost between 0.75 and 1.5 billion US dollars a year to avert an estimated 5 million infections by the year 2000 alone.