An Interview with Dr. Peter Piot, Executive Director of UNAIDS (1)

By Chatterjee, Shoma | Journal of International Affairs, Fall 2001 | Go to article overview

An Interview with Dr. Peter Piot, Executive Director of UNAIDS (1)


Chatterjee, Shoma, Journal of International Affairs


Journal: The upcoming UN Special Session on Children has identified HIV/AIDS as one of the primary issues that impacts children around the world. Could you give us a sense of the magnitude of the problem that children face with regard to HIV/AIDS? How many are affected with having the disease and how many are affected by the disease because they have either been orphaned or have ill parent(s)?

Dr. Piot: AIDS first came to public light only 20 years ago, in a June 1991 report from the US Centers for Disease Control, but since that time, the impact of the disease has been vast. Around 60 million people have become infected with HIV around the world, and some 22 million of them have died.

What is most striking -- and most devastating -- is that the global AIDS epidemic overwhelmingly affects young people. Fifty percent of the 15 thousand people who are infected with HIV every day are aged between 15 and 24, a global total of 2.5 million new annual infections in this age group. Thirty percent of the total global population currently living with HIV is under the age of 24.

Because HIV is mainly transmitted sexually, adolescents and young adults risk exposure to HIV as they become sexually active. Injecting drug use is responsible for around 10 percent of AIDS cases worldwide, and in a number of countries outside Africa it is either the predominant or the second major route of transmission. In particular, in developing countries and countries in transition (especially Central and Eastern Europe) injecting drug use and attendant risks of HIV exposure particularly affect adolescents and young adults.

Young adults not only bear the brunt of the HIV epidemic, they are also in the prime of their reproductive lives. Transmission of HIV from mother to child results in a further HIV epidemic among infants and young children. UNAIDS has estimated that in the year 2000, 600 thousand children under the age of 15 became infected with HIV, and in more than 90 percent of these cases transmission was from mother to child. There are currently an estimated 1.3 million children under 15 living with HIV globally, the great majority in sub-Saharan Africa.

Since the beginning of the epidemic, over 5 million infants have been infected with HIV and most of them have died. In 2000 alone, half-a-million children under 15 died as a result of AIDS. In the worst affected countries, AIDS is reversing decades of progress in reducing infant and child mortality. Many HIV-infected children survive their first birthdays, only to die before the age of 5. In Zimbabwe, 70 percent of all deaths among children less than 5 are due to AIDS. In South Africa, that percentage is 45. In The Bahamas, 60 percent of deaths among children less than 5 are due to AIDS. In Myanmar, Cambodia and Thailand, 1 percent of deaths among children are due to AIDS.

The third group of young people most affected by the HIV/AIDS epidemic is the children left behind when their parents die. Already, 13 million children have been orphaned by AIDS, losing either their mother or both parents before the age of 15. AIDS has had a dramatic affect on the global number of orphans, especially in Africa which accounts for 90 percent of the total number of AIDS orphans.

Journal: What are your projections for the rate of growth in the number of children affected by the disease?

Dr. Piot: Globally, the HIV epidemic is continuing to grow. In coming years, the impact of the epidemic will inevitably become worse before it becomes better, as larger numbers of those already infected with HIV become sick or die. In many parts of the world, the epidemic is becoming entrenched, and showing no signs of reducing -- for example, most of Europe, North America and Latin America. In some regions, the epidemic is on a steep upward curve, notably in Eastern Europe, particularly the Russian Federation, parts of Central America and the Caribbean, and within some countries in Asia. …

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