How AIDS in Africa Was Overstated

The Washingtom Post has a piece on How AIDS in Africa Was [exagerated] Overstated.

Selected excerpts:

But AIDS deaths on the predicted scale never arrived here, government health officials say. A new national study illustrates why: The rate of HIV infection among Rwandans ages 15 to 49 is 3 percent, according to the study, enough to qualify as a major health problem but not nearly the national catastrophe once predicted. The new data suggest the rate never reached the 30 percent estimated by some early researchers, nor the nearly 13 percent given by the United Nations in 1998.

Taken together, they raise questions about monitoring by the U.N. AIDS agency, which for years overestimated the extent of HIV/AIDS in East and West Africa and, by a smaller margin, in southern Africa, according to independent researchers and U.N. officials. "What we had before, we cannot trust it," said Agnes Binagwaho, a senior Rwandan health official.

Such disparities, independent researchers say, skewed years of policy judgments and decisions on where to spend precious health-care dollars. "From a research point of view, they've done a pathetic job," said Paul Bennell, a British economist whose studies of the impact of AIDS on African school systems have shown mortality far below what UNAIDS had predicted. "They were not predisposed, let's put it that way, to weigh the counterevidence. They were looking to generate big bucks."

On its Web site, UNAIDS describes itself as "the chief advocate for worldwide action against AIDS." And many researchers say the United Nations' reliance on rigorous science waned after it created the separate AIDS agency in 1995 -- the first time the world body had taken this approach to tackle a single disease.

"It's pure advocacy, really," said Jim Chin, a former U.N. official who made some of the first global HIV prevalence estimates while working for WHO in the late 1980s and early 1990s. "Once you get a high number, it's really hard once the data comes in to say, 'Whoops! It's not 100,000. It's 60,000.' " Chin, speaking from Stockton, Calif., added, "They keep cranking out numbers that, when I look at them, you can't defend them."