Re: How was the Aids situation in Africa so greatly overstated (Health Supplement, April 18th)
The article raises the hoary issue of the so-called exaggeration by UNAids/World Health Organisation (WHO) of statistics on HIV/AIDS in Africa. The central thesis is that Africa is not dying of Aids and that unsound estimates have blown the problem out of all proportion.
It is difficult to understand why reputable newspapers in the western world have set out to debunk the presentation of the Aids crisis in Third World countries, and notably in Africa, at a time when the worst pandemic since the Black Death in the 14th century is decimating much of the African continent and, indeed, is increasingly in evidence in Asia, India and eastern Europe.
Every year, UNAids/WHO produce estimates on the epidemic. These are based on information provided by countries' own public services and are intended to help guide the national and international responses to Aids. The estimates are compiled from the most recent available data and UNAids/WHO, together with national experts from national Aids programmes and research institutions, "regularly review and update the estimates as improved knowledge about the epidemic becomes available" - (2005 update).
The article makes no allowance for the caution shown by UNAids in presenting its figures. Fully aware of the fragility of the data, the published estimates present a range of infection rates; thus, the estimates for 2000 showed a range of worldwide infection of 34 -46 million and a mid-point of 40 million. The comparable figures for 2005 give a range of 36.7-45.3 million and a mid-point of 40.3 million.
South Africa, which is the epicentre of the pandemic, has gone to considerable lengths to improve its statistics.
Two methods are used. The first, by the Actuarial Society of South Africa, focuses on modelling of data drawn from testing pregnant women at antenatal clinics. This is the most usual method employed in countries with a generalised Aids epidemic.
The various interests, including the Department of Health, have now agreed that about 5 million South Africans, or one-ninth of the population, are infected with HIV.
Whatever statistics are taken, they all clearly show the scale of the HIV/Aids pandemic in developing countries, notably in Sub-Saharan Africa. Whether the figures for that region show infection rates of 9 per cent or 7.2 per cent is hardly the point - 7.2 per cent represents 25.8 million people.
The statistics, however, tell only part of the story. The rest emerges from the day-to-day experiences of professionals, religious and other non-governmental organisations, community groups, employers, insurance companies, political leaders - all witnessing the real impact of Aids on their communities.
All of these together with governments, the UN, the EU, philanthropic organisations and ordinary people are trying to meet the mammoth task of prevention, treatment and care of those affected by and infected with Aids.
Aids particularly targets young people. The history of Aids in Africa since the 1980s has been one of underestimating the extent of the problem and its impact - be it on business, on food security or on the increasing number of Aids orphans.
Whole societies are at risk and the countries involved lack the resources to deal quickly with the crisis.
In particular, they are short of the medical and nursing skills necessary to manage programmes of anti-retroviral drug treatment (ART) that can arrest the onset of Aids.
Many of their best skills are going to Western Europe and America where they enjoy higher standards of living and working conditions.
For our part, notwithstanding our undoubted generosity in funding worthwhile charities in the developing world, we would be better employed in seeking to contribute to the fight against Aids rather than attempting to diminish its significance.
One positive contribution would be to train our own medical and nursing personnel to meet our needs - and, hopefully, transfer some more of our skills to meet developing countries' needs - rather than poaching doctors and nurses from Third World countries.
Brendan McNamara
The author is a former European Commission official and head of a division which was responsible for financing EU aid to developing countries.