A quarter of a century after the outbreak of Aids, the World Health Organisation (WHO) has accepted that the threat of a global heterosexual pandemic has disappeared.
-- From "Threat of world Aids pandemic among heterosexuals is over, report admits" by Jeremy Laurance in The Independent 6/8/08
In the first official admission that the universal prevention strategy promoted by the major Aids organisations may have been misdirected, Kevin de Cock, the head of the WHO's department of HIV/Aids said there will be no generalised epidemic of Aids in the heterosexual population outside Africa.
Dr De Cock, an epidemiologist who has spent much of his career leading the battle against the disease, said understanding of the threat posed by the virus had changed. Whereas once it was seen as a risk to populations everywhere, it was now recognised that, outside sub-Saharan Africa, it was confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients.
Aids organisations, including the WHO, UN Aids and the Global Fund, have come under attack for inflating estimates of the number of people infected, diverting funds from other health needs such as malaria, spending it on the wrong measures such as abstinence programmes rather than condoms, and failing to build up health systems.
Critics of the global Aids strategy complain that vast sums are being spent educating people about the disease who are not at risk, when a far bigger impact could be achieved by targeting high-risk groups and focusing on interventions known to work, such as circumcision, which cuts the risk of infection by 60 per cent, and reducing the number of sexual partners.
There were "elements of truth" in the criticism, Dr De Cock said. "You will not do much about Aids in London by spending the funds in schools. You need to go where transmission is occurring. It is true that countries have not always been good at that."
One of the danger areas for the Aids strategy was among men who had sex with men. He said: "We face a bit of a crisis [in this area]. In the industrialised world transmission of HIV among men who have sex with men is not declining and in some places has increased.
"It is astonishing how badly we have done with men who have sex with men. It is something that is going to have to be discussed much more rigorously."
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