World AIDS Day: HIV Pandemic Surging
Despite Advances, Record Numbers Dying of AIDS
U.S.: Sick Patients Fill City AIDS Wards continued...
Other inner-city hospitals see the same thing. Michael Kolber, MD, PhD, is
director of adult HIV services in the University of Miami department of
medicine. The vast majority of patients he sees are poor. And most are black
"I am not optimistic," Kolber says of the U.S. AIDS epidemic.
"The HIV infection rate keeps rising without an infusion of new money.
We've had the same dollars for four or five years being spread out among
increasing numbers of individuals. Our outreach program has diminished. And the
population we treat has other social needs -- housing, child care, mental
health, food. HIV -- when they have it -- they don't worry about it because of
all these other things."
The irony, del Rio says, is that he's optimistic about the world AIDS
situation but pessimistic about AIDS in America.
"The news about U.S. AIDS may be more negative than positive," he
says. "More people are living with HIV than ever before. The number of new
infections has not decreased. It has stayed about the same -- 40,000 a year.
Maybe that is where it is always going to be, but to me that is an unacceptable
level. More needs to be done."
The central problem, del Rio and Kolber agree, is twofold. Prevention
messages somehow must find their way to the most disenfranchised people in the
nation. And people who already have limited access to health care must somehow
get tested for HIV, and, if infected, get treated.
"In the US, the cost of AIDS drugs is on the order of $15,000 a
year," Kolber says. "They are still very expensive. I understand the
need for paying these companies for their research and development. But this
cost is a dramatic cost, and in parts of the U.S., people are not getting
medications they need."
Forward, Step by Step
It's easy to get discouraged by the huge numbers needed to describe the
global AIDS situation. It's discouraging that AIDS appears ready to boil over
in populous places such as Pakistan and Indonesia. It's scary to think about
what might happen if AIDS expands its foothold in China. And it's horrible to
count the number of AIDS deaths that cannot be avoided in the coming years.
Yet progress is being made, even if it's of the one-step-forward
Thanks to a huge five-year effort, 1 million of the world's 6 million
desperately ill people now get lifesaving treatments. True, the World Health
Organization's plan to treat 3 million people by 2005 fell 2 million people
short. But this year there were 300,000 fewer AIDS deaths than there would have
been. And next year the impact should be even greater.