Untitled Overview . Since 1981, there were 60 million people worldwide who have been diagnosed to be infected with HIV or living with AIDS. By the end of year 2001, there are about 40 million people suffering from HIV/AIDS; more than 70% (28 million) of these are in Sub-Saharan Africa. South Africa alone has more 4.7 milion (almost 1 in 10 of the population) afflicted with HIV/AIDS. About 25 million people worldwide have already died of AIDS- related diseases and opportunistic infections.

Untitled Geographic (worldwide) incidence of HIV and AIDS. Darker red (mostly in Sub-Saharan Africa) signifies higher occurence of HIV/AIDS. View color code to estimate % occurence.
Untitled Click on figure for the latest pictographic image of the estimated annual number of new HIV infections worldwide (2003), and by region, 1988 to 2003 (pdf, 2 MB)

To date, there is still no vaccine nor any effective cure against HIV infection. What are available are antiretroviral and combination drug therapies that can slow the progression from HIV infection to AIDS status; while other available drugs combat complications from AIDS-related illnesses and other opportunistic infections. These arsenals of drugs, HIV screening and improved health care to contain AIDS- related illnesses and opportunistic infections have been instrumental in the significant decline of HIV infection and deaths in many of the Western countries, like the Untitled United States .

However, the drugs and health care to manage AIDS come at a terribly high price. The combination drug therapies alone cost about $10,000-12,000 per person annually in the United States. Thus, drug pharmaceutical companies were pressured to lower the price of these drugs for less developed countries (LDCs). Faced with a concerted well-publicized pressure from LDCs and AIDS activists alike, some of the giant pharmaceutical companies caved-in. They withdrew from fighting the South African law allowing local manufacture or importation of retroviral drugs still under patent. More recently, Brazil, which already has a thriving local generic AIDS drug industry, has entered into an agreement that lowered the price of some of antiretroviral drugs still under patent by 40%. The latter would bring down the annual drug cost to about $4,000-6,000, still way beyond the reach of most people from the less developed countries (LDCs).

Even if the price of the antiretroviral drugs alone could be reduced to about $36 a month (or $432 a year), the drug cost alone for each person would be beyond the reach of most of the poor people living with AIDS in less developed countries (LDCs). There are also other costs to consider, other than drugs, in the fight against AIDS -- HIV screening, health care, training of personnel, establishment of the health and distribution infrastructure, education and counselling of target groups and people living with HIV and AIDS, etc. [Visit " Untitled Estimated Cost of AIDS Drugs and Overall Costs " for a more quantitative analysis of the realistic costs for combating AIDS in less developed countries (LDCs).]

While some countries, like Brazil, have instituted a drug subsidy program, such an ambitious plan would be beyond the reach of most less developed countries (LDCs) that are already saddled with previous huge international debts, already crippling their economies and future development plans.

The fact is, there are no easy answers. Notwidthstanding the "", so far proposed, there is no bold "Marshall Plan" -- with adequate worldwide resources and political will -- to make the HIV/AIDS epidemic go away.

The tragic reality is that millions of people will continue to get infected with HIV and the worldwide population of those infected with HIV would go up even much higher than the 40 million people living with HIV/AIDS. With very limited resources in less developed countries, any solution to combat HIV/AIDS leads to choosing the few who are going to live longer but doom most of those infected with HIV/AIDS to slow agonizing death from AIDS- related illnesses and opportunistic infections.

This gloomy prognosis must not be perceived as fatalistic despair. Rather, it should become the foundation of more realistic approaches -- to aspire for solutions that are feasible -- given the limited resources and apparent worldwide apathy to the HIV/AIDS epidemic. Evolving these realistic approaches begins with understanding the current status of the epidemic -- the "root causes" of and contributory factors, the target groups, realistic estimate of international and national resources and manpower that could be reallocated to deal with the problem, creation of distribution and health infrastructure, education, screening & preventive measures to combat further escalation of the epidemic, etc.

Read part 2: Untitled Realistic Priorities