UNAIDS Accused Of Inflating HIV Prevalence Estimates To Increase Donor Funding

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UNAIDS in tworecently published books has "come under stinging attack" and beenaccused of "allowing politics to trump science in its efforts tocombat" HIV/AIDS, AFP/Yahoo! News reports. According to AFP/Yahoo! News, thebooks have "sparked a wide-ranging debate" among HIV/AIDS advocatesabout how to fight the spread of the disease and "raised questionsabout UNAIDS' leadership."

U.S. epidemiologist James Chin in hisbook, "The AIDS Pandemic," accused UNAIDS of inflating HIV prevalenceestimates to "dramatize the epidemic" and increase donor funding. Chin"appeared vindicated" earlier this year, when India reduced its HIV/AIDS caseload estimate to 2 million to 3.1 million people, AFP/Yahoo! News reports.UNAIDS previously estimated that the country had about 5.7 millionpeople living with HIV/AIDS. In addition, the organization estimatedthat 1.6% of adults in Cambodia were HIV-positive, but the estimatelater was reduced to 0.6% of adults, AFP/Yahoo! News reports.

PrasadaRao, UNAIDS regional director for Asia, said that the higher estimateswere based on data from clinics, which experts used to estimate thenumber of people in the general population living with the virus. Raoadded that the lower estimates were based on improved, random surveysamong households, which provided a better analysis of the generalpopulation. "I don't see any motive on the part of UNAIDS to inflatenumbers," Rao said, adding that he does not "think there is any axe togrind in this case."

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Most experts agree that HIV/AIDS caseload estimates "remain a guess best used to show trends in each country," according to AFP/Yahoo! News."There is a fine line between deliberately lying with the numbers orusing the upper range of estimates that are based on slim assumptionsand unrepresentative data," Chin said in an e-mail to Agence France Press.Both Chin and Rao agreed that the debate should focus more on how tospend resources than on the number of people living with HIV/AIDS.

Inanother recently published book, "The Invisible Cure," Helen Epstein,who studied HIV/AIDS in Africa, wrote that UNAIDS either misunderstoodor ignored data in the mid-1990s that showed the practice of havingmultiple, long-term sexual partners was common in Eastern and SouthernAfrica and allowed HIV to spread quickly through the region. Accordingto Epstein, rather than encouraging people to be faithful to onepartner, UNAIDS focused on condom use and abstinence, which she sayswas less effective but more politically appealing.

Epsteinadded that the organization "overblew the prospects" for an HIVepidemic in Asia, where the virus is spread mainly through high-riskgroups, whereas in Africa it is spread among the general population."They got it almost perfectly wrong in some places," she said. Epsteinadded that UNAIDS previously focused more on potential HIV/AIDSoutbreaks in other parts of the world rather than on addressing thedisease in the most affected African countries.

Rao said he isconcerned that if advocates believe UNAIDS is manipulating data, theagency's reputation and efforts to eradicate the disease could bedamaged. "UNAIDS is not saying the data is wrong. It is accepting thedata and trying to harmonize the facts," Rao said, adding, "That showsthe openness that the organization has got on this issue. And it isprepared to correct its data (and) revise its data based on othersources of information" (Shea, AFP/Yahoo! News, 8/29).
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