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 THE
EXPLODING
GLOBAL HIV/AIDS
PANDEMIC

THE POTENTIAL ENORMITY OF THE
HIV/AIDS PANDEMIC IS PROFOUND
Three-year-old Emmanuel stands outside his house in Kampala,
Uganda. Emmanuel has been infected with HIV since his birth, and
lives now with some relatives as his parents, both are HIV positive,
are unable to take care of him.
AIDS awareness billboard
in Lundazi, Zambia


A DEADLY SITUATION
“UNLESS METHODS OF
PREVENTION, WITH OR WITHOUT A
VACCINE, ARE SUCCESSFUL, THE
WORST OF THE GLOBAL PANDEMIC
WILL OCCUR IN THE 21ST
CENTURY”

New England Journal of Medicine

HIV HAS INFECTED MORE THAN
60 MILLION PEOPLE AROUND
THE WORLD.

AIDS HAS ALREADY KILLED MORE
THAN 25 MILLION PEOPLE,
SURPASSING TUBERCULOSIS AND
MALARIA AS THE LEADING
INFECTIOUS CAUSE OF DEATH
WORLDSIDE.

World Health Organization


IN 2007 ALONE, A RECORD 2.61
MILLION PEOPLE HAVE DIED –
INCLUDING 330,000 CHILDREN.
IN 2007 33.2 MILLION PEOPLE LIVED
WITH THE DISEASE.

IN AFRICA, FOR THE FIRST TIME,
HIV-INFECTED WOMEN AGED 15-49
OUTNUMBER INFECTED MEN.

THE IMPACT ON DEVELOPING
NATIONS IS STAGGERING, WITH
EVEN GREATER POTENTIAL
DISASTER TO COME.


Over 19 million women are living
with HIV/AIDS.
By the year 2010, five countries
(Ethiopia, Nigeria, China, India, and
Russia) with 40 percent of the
world's population will add 50 to 75
million infected people to the
worldwide pool of HIV disease.

There are 14,000 new infections
every day (95 percent in
developing countries). HIV/AIDS
is a "disease of young people"
with half of the 5 million new
infections each year occurring
among people ages 15 to 24.

The UN estimates that,
currently, there are 14 million
AIDS orphans and that by 2010
there will be 25 million.

AFRICA HAS BEEN THE EPICENTR
OF HIV/AIDS GLOBALLY AND
CONTINUES TO CARRY THE
LARGEST DISEASE BURDEN, WITH
70% OF PEOPLE LIVING WITH AIDS
WORLDWIDE, 83% OF GLOBAL AIDS
DEATHS, AND 95% OF THE WORLD’S
AIDS ORPHANS.

AIDS HAS REVERSED DECADES OF
PROGRESS FROM IMPORTANT
PUBLIC HEALTH EFFORTS TO
IMMUNIZE CHILDREN, CONTROL
DISEASES, AND IMPROVE
NUTRITION.

AIDS IS LOWERING LIFE
EXPECTANCY AND SIGNIFICANTLY
AFFECTING INTERNATIONAL
BUSINESS.

IF THE GLOBAL SPREAD OF
HIV/AIDS CONTINUES UNCHECKED,
SOUTH AND SOUTHEAST ASIA, AND
PERHAPS CHINA WILL FOLLOW THE
DISASTEROUS COURSE OF SUBSARAHAN AFRICA.

CURRENTLY, THERE ARE AN
ESTIMATED 6.7 MILLION HIVINFECTED PEOPLE IN SOUTH AND
SOUTHEAST ASIA.

IN INDIA ALONE, UNAIDS
ESTIMATES THAT BETWEEN 3 AND
5 MILLION OF ITS NEARLY 1
BILLION POPULATION ARE
INFECTED, AND THE NUMBER OF
NEW INFECTIONS IS CONTINUING
TO DOUBLE EVERY MONTH.

RAPID INCREASES ARE OCCURRING
IN EASTERN EUROPE AND CENTRAL
ASIA, AND AIDS REMAIN A SERIOUS
THREAT IN LATIN AMERICA AND
THE CARIBBEAN.

HIV INFECTIONS IN THE FORMER
SOVIET UNION HAVE DOUBLED IN
JUST TWO YEARS.

THE SECRETARY-GENERAL OF THE
UNITED NATIONS HAS STATED
THAT AIDS IS HAVING AN IMPACT
ON GROSS DOMESTIC PRODUCT IN
SOME COUNTRIES.

THE MICRO-ECONOMIC EFFECTS OF
ABSENTEEISM, DECLINE IN A
SKILLED WORKFORCE, AND
PAYMENTS FOR SICKNESS AND
DEATH BENEFITS IN THE
DEVELOPING WORLD WILL LEAD TO
MACRO-ECONOMIC EFFECTS
WORLDWIDE.

THERE IS A PARALLEL EPIDEMIC OF
TUBERCULOSIS IN THE
DEVELOPING WORLD.

THE HIV/AIDS EPIDEMIC IN THE
UNITED STATES

An estimated one million people
are currently living with HIV in
the United States, with
approximately 40,000 new
infections occurring each year.

By race, 54 percent of the new
infections in the United States
occur among African
Americans, and 64 percent of
the new infections in women
occur in African American
women.


75 percent of the new infections
in women are heterosexually
transmitted.
Half of all new infections in the
United States occur in people
25 years of age or younger.

IN THE UNITED STATES THE
EPIDEMIC CONTINUES TO EVOLVE.


ALTHOUGH THE INCIDENCE OF NEW
AIDS CASES HAS DECLINED*, THE
DECLINE IN DEATH RATES HAS
LEVELED OFF.
*NEW DRUG THERAPIES THAT
PREVENT PROGRESSION FROM HIV
INFECTION TO AIDS.

ACCORDING TO THE CDC, THE RATE
OF NEW HIV INFECTIONS HAS BEEN
CONSTANT SINCE 1990 WITH NO
DECLINE, MEANING THAT THE
OVERALL EPIDEMIC IS CONTINUING
TO EXPAND.

HIV INFECTION RATES ARE
CONTINUING TO CLIMB IN A
NUMBER OF SUBPOPULATION
GROUPS, SUCH AS WOMEN, RACIAL
AND ETHNIC MINORITIES, YOUNG
HOMOSEXUAL MEN, PEOPLE OVER
50 YEARS OF AGE, AND
INDIVIDUALS WITH ADDICTIVE
DISORDERS.

THE RECENT APPEARANCE OF
MULTI-DRUG RESISTANT STRAINS
OF HIV PRESENT A SERIOUS PUBLIC
HEALTH CONCERN.

THESE DATA FOREBODE AN
EPIDEMIC OF EVEN GREATER
MAGNITUDE AHEAD.

CDC ESTIMATES THAT ABOUT ONE
MILLION AMERICANS ARE
CURRENTLY INFECTED WITH HIV.

PREVALENCE OF AIDS IS HIGHER
AMONG AFRICAN AMERICANS AND
HISPANICS, WHO ACCOUNT FOR
45% AND 20% RESPECTIVELY.

OF WOMEN WITH AIDS, MINORITIES
ACCOUNT FOR 80% OF CASES;
AMONG MEN, MINORITIES ACCOUNT
FOR 61% OF CASES.


AIDS RESEARCH
NIH HAS DEVELOPED A COMPREHENSIVE
BIOMEDICAL AND BEHAVIORAL
RESEARCH PROGRAM TO BETTER
UNDERSTAND THE BASIC BIOLOGY OF
HIV, DEVELOP EFFECTIVE THERAPIES TO
TREAT IT, AND DESIGN INTERVENTIONS
TO PREVENT NEW INFECTIONS FROM
OCCURING.

THE TRANSMISSIBLE NATURE OF
HIV MAKES IT RADICALLY
DIFFERENT FROM NONTRANSMISSIBLE DISEASES SUCH
AS HEART DISEASE AND CANCER.

THE TRANSMISSIBILITY OF HIV BETWEEN INDIVIDUALS AND
ACROSS BORDERS AND
POPULATIONS - IS WHAT DEFINES
THE GLOBAL PANDEMIC AND
MAKES IT IMPERATIVE THAT THE
U.S. HELP ADDRESS PREVENTION
AND TREATMENT WORLDWIDE.

THE TRANSMISSIBILITY OF THE
INFECTION MEANS THAT THERE IS
THE POTENTIAL FOR UNLIMITED
GLOBAL SPREAD.

IT ALSO MEANS THAT, WITH THE
DEVELOPMENT OF APPROPRIATE
BIOMEDICAL AND BEHAVIORAL
INTERVENTIONS, THERE IS THE
POSSIBILITY FOR DRAMATIC
REDUCTIONS IN NEW INFECTIONS AND ULTIMATE CONTROL OF THE
PANDEMIC - IN A WAY THAT WILL
NEVER BE POSSIBLE FOR
NONINFECTIOUS DISEASES.

NIH CONTINUES TO PLACE A HIGH
PRIORITY ON PRIMARY
PREVENTION OF NEW HIV
INFECTIONS AS THE MOST
EFFECTIVE MEANS OF
CONTROLLING THE SPREAD OF THE
EPIDEMIC IN THE UNITED STATES
AND GLOBALLY.

NATIONAL INSTITUTES OF HEALTH
RESEARCH PRIORITIES


PRIORITY: HEALTH DISPARITIES IN
THE UNITED STATES
AIDS REMAINS THE NUMBER ONE
CAUSE OF DEATH FOR YOUNG
AFRICAN AMERICAN MEN.

PRIORITY: BETTER THERAPIES

PRIORITY: BETTER THERAPIES

PRIORITY: HIV PREVENTION

PRIORITY: BETTER THERAPIES

PRIORITY: HIV PREVENTION

PRIORITY: VACCINES


PREVENTION:
NIH CONTINUES TO PLACE A HIGH
PRIORITY ON PRIMARY PREVENTION
OF NEW HIV INFECTIONS AS THE MOST
EFFECTIVE MEANS OF CONTROLLING
THE SPREAD OF THE EPIDEMIC IN THE
UNITED STATES AND GLOBALLY.


VACCINES
A SAFE AND EFFECTIVE HIV
PREVENTION VACCINE IS
ESSENTIAL FOR THE GLOBAL
CONTROL OF THE AIDS
PANDEMIC.

TREATMENTS: THERE ARE
TREATMENTS THAT HAVE
EXTENDED LIFE AND IMPROVED
THE QUALITY OF LIFE FOR MANY
HIV-INFECTED PEOPLE IN THE
UNITED STATES AND WESTERN
EUROPE.



TREATMENT FAILURE NOW
AFFECTS A GROWING PROPORTION
OF THOSE RECEIVING TREATMENT.
TREATMENT IS TOO ARDUOUS,
TOXICITIES DEVELOP, AND IT
COSTS TOO MUCH.
$15,00O PER YEAR FOR DRUGS.


THE NEED FOR SIMPLER, LESS TOXIC,
AND CHEAPER DRUGS AND DRUG
REGIMENS TO TREAT HIV INFECTION
CONTINUE TO BE ITEMS OF HIGH
PRIORITY FOR RESEARCHERS.
IMPROVED REGIMENS ARE NOW IN
CLINICAL TRIALS, AND SOME WILL BE
AVAILABLE IN THE NEXT FEW YEARS.

AS ALWAYS, IT IS VERY
EXPENSIVE...


END OF LECTURE FOR
NOVEMBER 2nd, 2011
QUESTIONS?