By Dr. Toby Thompson, HIV/AIDS Task Force

The HIV/AIDS epidemic is being highlighted on World HIV/AIDS Day today, Dec. 1. This epidemic is off the front pages in the United States, perhaps because anti-viral drugs are available and special treatment teams are available. The global impact in family and societal breakdown, economic loss and frightening projections of deaths in the millions is real.

Consider some of these news bytes reviewed in just the past month:

HIV/AIDS has forced complete overhauls of standard protocols for drawing blood transfusions and organ transplantation, not to mention surgery and dentistry. The virus can mutate; no vaccine has yet been developed. There are no secure national borders, the cost of testing, the cost of treatment, the denial of governments that their nation is not at risk, taboos about discussing sexual practices, shame and discrimination; all contribute to the difficulties in stemming the epidemic.

The panic over SARS finally caused the Chinese government to initiate control measures and now the government is offering free drug treatment to 150,000 HIV-infected patients (in a pilot project, only 30 percent stayed on the drug regimen; the side effects were not tolerated.

Inadequate treatment can lead to drug resistance in the virus). Malaria and tuberculosis deaths have increased in Africa, and HIV/AIDS patients often die of these infections.

Now there are an estimated 42 million HIV/AIDS infected people in the world. Twenty-three million people have died in the last 20 years.

AIDS strikes people in their most productive years. No cure is available, although treatment may attenuate the illness.

Fifty-eight percent of HIV/AIDS infected people in Sub Saharan Africa are women!

There are approximately 14 million orphans now, with one or both parents gone.

Newborn infants of HIV positive mothers will become infected during childbirth or with breast-feeding, but the transmission can be prevented by anti-viral drugs during and after birth. The problem is the cost and availability of this treatment.

HIV has been spread in China and Haiti by infected blood from donors. Needle sharing among drug addicts is a source of contagion.

Promiscuous and unprotected sexual contact spreads HIV.

Family dislocation, as when men are separated from their family while working in mines, or distant cities for long periods of time is a factor of spread of HIV, reported in Africa and India.

Some success in the prevention of HIV/AIDS has been noted in Uganda. Canada, Brazil, South Africa and India, where the countries are active in stimulating the production of lower cost anti-viral drugs.

(Drug treatment in the U.S. can cost $10,000 per year; this can be reduced markedly with changes in patent and production laws).

Funding is woefully inadequate for prevention, education, testing, control, and treatment

Billions of dollars are needed, some is promised, but actual funds distributed are inadequate. During his tour of Africa this year, President Bush promised up to $15 billion over five years to the international AIDS prevention and treatment programs.

So far $1.3 billion has been authorized, and only $400 million actually contributed.

We should do better.

Epidemics do not respect borders; we are linked globally, economically, in public health and in social stability.

Poverty and hopelessness also breed exploitation and yes, terrorism.

We cannot be complacent about the issues of the HIV/AIDS epidemic.

(Dr. Toby Thompson of Albert Lea, a retired surgeon, is a member of the Freeborn County HIV/AIDS Task Force.)