00002-E-1 – 1 December 2002 The AIDS Pandemic: an Update on the Numbers and Needs l What are the numbers for 2002? l What are the global and regional trends? l Where do all these numbers come from? l How are the estimates made? l Can we look into the future?

00002-E-2 – 1 December 2002 What are the numbers for 2002?

00002-E-3 – 1 December 2002 Global estimates for adults and children end 2002 l People living with HIV/AIDS l New HIV infections in 2002 l Deaths due to HIV/AIDS in million 5 million 3.1 million

00002-E-4 – 1 December 2002 Adults and children estimated to be living with HIV/AIDS as of end 2002 Total: 42 million (3.2 mln children) Western Europe North Africa & Middle East Sub-Saharan Africa 29.4 million Eastern Europe & Central Asia 1.2 million South & South-East Asia 6 million Australia & New Zealand North America Caribbean Latin America 1.5 million East Asia & Pacific 1.2 million

00002-E-5 – 1 December 2002 Global Distribution of 42 million People Living with HIV in 2002

00002-E-6 – 1 December 2002 HIV Prevalence (% of adults 15-49) by Sex and Region in 2002

00002-E-7 – 1 December 2002 Estimated number of adults and children newly infected with HIV during 2002 Total: 5 million (0.8 mln children) Western Europe North Africa & Middle East Sub-Saharan Africa 3.5 million Eastern Europe & Central Asia East Asia & Pacific South & South-East Asia Australia & New Zealand500 North America Caribbean Latin America

00002-E-8 – 1 December 2002 Global Distribution of 5 million Newly HIV Infected People in 2002

00002-E-9 – 1 December 2002 The Global Distribution of Prevalence (Old +New) is still very similar to the Global Distribution of Incidence (New) Prevalence Incidence

00002-E-10 – 1 December 2002 Estimated adult and child deaths from HIV/AIDS during 2002 Total: 3.1 million Western Europe North Africa & Middle East Sub-Saharan Africa 2.4 million Eastern Europe & Central Asia East Asia & Pacific South & South-East Asia Australia & New Zealand<100 North America Caribbean Latin America

00002-E-11 – 1 December 2002 Global Distribution of 3.1 million Adult and Child Deaths from HIV/AIDS in 2002

00002-E-12 – 1 December 2002 About new HIV infections a day in 2002 l More than 95% are in developing countries (70% are in Africa) l 2000 are in children under 15 years of age (9 out of 10 are in Africa) l About are in persons aged 15 to 49 years, of whom: — almost 50% are women — about 50% are 15–24 year olds

00002-E-13 – 1 December 2002 What are the global and regional trends?

00002-E-14 – 1 December 2002 Comparing 2001 and 2002 l Modest increase in people living with HIV from 40 to 42 million, new infections still about 5 million, deaths about 3 million –0.9 mln increase in Africa, –0.8 mln South, Southeast, East Asia –0.2 mln Eastern Europe and Central Asia

00002-E-15 – 1 December 2002 Trends in Number of People Living with HIV infection by WHO Region

00002-E-16 – 1 December 2002 Trends in Number of People Living with HIV infection by WHO Region

00002-E-17 – 1 December 2002 Trends in Number of People Living with HIV infection by WHO Region

00002-E-18 – 1 December 2002 Where do all these numbers come from?

00002-E-19 – 1 December 2002 UNAIDS/WHO Classification of epidemic states l LOW LEVEL: –HIV prevalence has not consistently exceeded 5% in any defined sub-population (surveillance: high risk group focus) l CONCENTRATED –HIV prevalence consistently over 5% in at least one defined sub-population but below one percent in pregnant women in urban areas (surveillance: high risk groups + bridgers) l GENERALISED –HIV prevalence consistently over 1% in pregnant women nation-wide (surveillance: general population + high risk groups)

00002-E-20 – 1 December 2002 HIV Prevalence among Women Attending Antenatal Clinics, Uganda

00002-E-21 – 1 December 2002 HIV prevalence in blood donations in Indonesia: Percentage HIV-positive – – – – – – – – – 2001 Source: National AIDS Programme, Indonesia

00002-E-22 – 1 December 2002 HIV Prevalence Among Pregnant Women, Male Conscripts, and Donated Blood Thailand % Month/Year Pregnant women Donated blood Source: Sentinel Serosurveillance, Division of Epidemiology, Ministry of Public Health. Remark: Switching from bi-annually (June and December) to annually in June since 1995 Conscript data in November of each year since 1995 were not shown here Conscripts (age 21)

00002-E-23 – 1 December 2002 HIV prevalence among sex workers in selected provinces in China: Source: National AIDS Programme, China ( ). Data compiled by the US Census Bureau % HIV-positive GuangxiGuangzhouYunnan

00002-E-24 – 1 December 2002 HIV prevalence among injecting drug users in selected sentinel sites in Myanmar: Mar 1992 – Mar 2001 Myitkyina Taunggyi THAILAND LAOS CHINA INDIA 100 Source: Myanmar National AIDS Programme

00002-E-25 – 1 December 2002 How are the estimates made?

00002-E-26 – 1 December 2002 Epidemic model New entrants Not at risk At risk (susceptible) Infected AIDS deaths Non-AIDS death

00002-E-27 – 1 December 2002 Epidemic model New entrants Not at risk At risk (susceptible) Infected AIDS deaths Non-AIDS death fofo r phi

00002-E-28 – 1 December 2002 Model epidemic curve t0t0 r phi f0f0

00002-E-29 – 1 December 2002

00002-E-30 – 1 December 2002 Can we look into the future?

00002-E-31 – 1 December 2002 Population distribution in 2005 (6.4 billion people)

00002-E-32 – 1 December 2002 How bad can the Asian epidemic become? l Growth in size of Risk groups - l IDU, MSM,sex workers l Chances of mixing with general population - people’s movement, socio-political and economic developments l Response: behaviour change, vaccine, STD control etc.

00002-E-33 – 1 December 2002 Trends - Asia: Lessons Learned l Asian epidemics spread through specific, identifiable behaviors & populations l Asian epidemics are vulnerable to focused prevention efforts l Prevention in Asia produces huge benefits ( Thailand averted over 5 million infections)

00002-E-34 – 1 December 2002 Global Prevention Focus: Young People (Percent of population aged in 2000 and 2010)

00002-E-35 – 1 December 2002 Care Projected Number of AIDS Deaths

00002-E-36 – 1 December 2002 Estimated Number of People Needing Treatment by 2005 Number depends on: - accuracy of the numbers of deaths projections - decisions on when to start treatment (clinical, lab) - how many people are already on treatment in preceding years - children Need 6-9 million by 2005

00002-E-37 – 1 December 2002

00002-E-38 – 1 December 2002 Global Goals: UNGASS and MDG l In terms of global numbers and needs the epidemic will be driven by Africa and Asia l UNGASS Target: 25% reduction globally by 2010 in prevalence among young people (15-24 years) (25% by 2005 in most severely affected countries) l MDG Target: turn around the epidemic by 2015