UN warns that AIDS deaths are set to reach record level

BMJ 1999; 319 doi: (Published 27 November 1999) Cite this as: BMJ 1999;319:1387
  1. Richard Woodman
  1. London

    A record number of people will die from AIDS this year despite the improvement in survival achieved with antiretroviral therapies in wealthier countries, a report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) warned this week.

    UNAIDS estimated that 2.6 million people will die from diseases related to HIV and AIDS during 1999—a higher global total than in any year since the beginning of the epidemic. With the HIV positive population still expanding—there were 5.6 million new infections during this year alone—the annual number of deaths was expected to continue to increase for many years.

    The report estimated that 32.4 million adults and 1.2 million children would be living with HIV infection by the end of 1999. About 95% of those infected live in the developing world, and this proportion was predicted to rise even further as infection rates continued to rise in countries where poverty, poor health systems, and limited resources for prevention and care fuelled the spread of the virus.

    Sub-Saharan Africa continues to bear the brunt of HIV and AIDS, with close to 70% of the global total of HIV-positive people. Most will die in the next 10 years, joining the 13.7 million Africans already claimed by the epidemic. Figures suggest that 55% of infected adults in Sub-Saharan Africa are women. UNAIDS director Dr Peter Piot said: “Today we see the evidence of the terrible burden women now carry in the African epidemic.”

    UNAIDS pointed out that HIV also remains a challenge in industrialised countries. Dr Piot said: “There is evidence that safe sexual behaviour is being eroded among gay men in some western countries, perhaps because of complacency now that life-prolonging therapy is available.” If this was the case, the report warned that the complacency was misplaced: “The disease remains fatal, and information from North America and Europe suggests that the decline in number of deaths due to antiretroviral therapy is tapering off.”

    The report added that HIV infections in the former Soviet Union have doubled in just two years, and that injecting drug use gave eastern Europe and Central Asia the world's steepest increase in HIV infection in 1999. Half of all people infected with the virus were infected before they reached the age of 25 and typically died by 35.

    AIDS Epidemic Update: December 1999 is available free from UNAIDS, 20 Avenue Appia, 1211 Geneva 27, Switzerland, or on the internet at

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    The number of adults and children estimated to be living with HIV/AIDS at the end of 1999

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