In the words of René Dubos: “It’s easy to think you are emptying the ocean with a bucket when the tide is going out.”
Perhaps I paraphrase. The quote is derived from Dubos’ book, Mirage of Health. His writing is focused on the history of science and a wonderful discourse on the cyclic and repetitive nature of social thought and concepts of health and disease. To quote an Amazon.com reviewer: “extremely interesting reading for anyone interested in humanity, disease, science and history.”
Such a situation could exist with HIV/AIDS, relative to the success achieved in global HIV/AIDS interventions. New York Times, among others, reported the global number of HIV/AIDS deaths has declined consistently over the past 3 years despite the challenge, in tough times . . . to find enough resources.”
The NY Times was citing the UNAIDS World AIDS Day Report which stated that anti-HIV/AIDS interventions had reduced annual new infections globally by 21% between 1997 and 2010.
(All this despite a 250% increase from 2001 to 2010 in Eastern Europe and Central Asia. The Russian Federation and Ukraine account for almost 90% of the Eastern Europe and Central Asia region’s epidemic with IV drug use the leading HIV transmission vector, same report.)
Is the epidemic receding? Or are the modeled of HIV/AIDS prevalences simply fluctuating? For example, between 1993 and 2007, WHO estimates for PLWH in Africa were consistently 25 to 30 times greater than the cumulative number of HIV/AIDS cases reported by the internal surveillance systems of participating African countries, combined.
India recognized – to some extent – that its internal HIV/AIDS estimates were over inflated. As a result, India reduced its HIV/AIDS estimates by almost by half in one step in 2007 (from an estimated 5.7 million to an estimated 2.5 million). “Part of wider trend” said National Public Radio.
So is the epidemic retreating? Or is the tide of estimates on the ebb?
UNAIDS World AIDS Day Report (Free PDF)