30 Nations to Chart First Global Strategy Against AIDS

Spurred by “a unique sense of urgency,” representatives of about 30 Western and Third World countries will meet at the World Health Organization in Geneva Saturday to chart the first global strategy against the AIDS virus.

The meeting will be the first devoted to AIDS to bring together government officials from the developed countries that are centers for AIDS research and treatment, developing states that face an expanding AIDS crisis and countries that are still apparently free of the problem.

“There is a unique sense of urgency . . . because there is nothing good you can say about infection with this virus,” said Dr. Jonathan M. Mann, the newly appointed coordinator of the organization’s control program on AIDS, in an interview Thursday.

“The more we learn, the worse it is,” he said. “We want to get this going as fast as possible, consistent with good planning. There are only about 100 things which need to be done right away.”

Participants in the Geneva meeting will review the first detailed outline of the organization’s global control program for AIDS, which was authorized in May by WHO member nations.

The plan emphasizes information exchange, widespread availability of inexpensive but accurate blood tests for AIDS antibodies and advice on how to prevent transmission of the virus by sexual contact, from mother to child or by contaminated blood, needles or traditional skin-piercing devices. WHO headquarters staff in Geneva would provide coordination and assist nations throughout the world in starting their own programs.

WHO is an affiliate of the United Nations, with about 150 members, that works to promote public health around the world but especially in developing nations.

Mann said Saturday’s meeting will attempt to build on an “inspirational” sense of international commitment and cooperation that emerged at the International Conference on AIDS, which was sponsored here this week by WHO and a number of public and private French health-care agencies.

At the international AIDS conference, “it was made clear that a vaccine and treatment are not for tomorrow,” Mann said.

“Everyone agreed that this is a global health problem and prevention is essential,” he said.

Experts at the conference estimated that about 100,000 cases of AIDS have developed in the world to date, that about 300,000 cases may be occuring each year by 1991 and that perhaps 5 million to 15 million people have already been infected with the acquired immune deficiency syndrome virus.

The situation is considered particularly acute in the United States, some Western European cities, Haiti and in many African nations, including Rwanda, Uganda, Zaire and Zambia. A minimum of 10,000 new AIDS cases are thought to be occuring annually in Africa and 1 million to 2 million, and perhaps more, people may be infected with the AIDS virus, according to Mann. On the other hand, only rare cases of the disease have been reported in Asia and in Latin America.

Meeting participants are scheduled to include representatives of the United States, Canada, Australia, Western Europe and about 15 developing states from Africa, Asia and South America.

“The timing (after the AIDS conference) gives us the opportunity to give them the most up-to-date information available,” Mann said.

In absence of an expected breakthrough in an AIDS vaccine, the meeting will focus on prevention, health education and research. The World Health Organization plan calls for establishment of national programs for AIDS control.

Key elements of such programs would include a system to identify cases of AIDS virus infection, laboratory support for blood testing, eliminating unnecessary blood transfusions and injections and training physicians and other health-care workers in fighting AIDS.

Mann and other WHO officials will also be seeking several million dollars in funds from the Western nations, in addition to about $1 million pledged by the U.S. Agency for International Development earlier this month.

International public health meetings often do not result in concerted action by governments. In the last year, however, there has been a trend toward open discussion and sharing of information about AIDS at such meetings, which Mann interprets as a helpful development.

Many African nations, which were previously reluctant to admit the existence and seriousness of the AIDS problem, have become active participants at such meetings. Mann said the participation of representatives of African states at the conference that ended here Wednesday was a marked difference from the meeting last year in Atlanta. Dr. Bila M. Kapita of the Mama Yemo Hospital in Kinshasa, Zaire, gave the plenary address on AIDS in Africa here.

Kapita told the conference the “hidden epidemic” reached “almost everywhere” in Africa, with the strongest concentration in Central Africa.

Many of the African nations have the greatest gap between the scope of the AIDS problem and the availability of resources to deal with it.

In Africa, a key turning point on AIDS appears to have been a WHO meeting on AIDS in Brazzaville, Congo, in March that was attended by 45 nations, according to Mann.

“After an open discussion, there was a unanimous request that the WHO provide assistance and then a sigh of relief (at the recognition of the problem),” Mann said.

Before becoming the organization’s first AIDS control coordinator on June 16, Mann directed the U.S. Centers for Disease Control AIDS research program in Zaire and helped the Zaire government document the extent of the AIDS epidemic there. About 6.5% of the population of Kinshasa, the capital, is estimated to carry the virus.

The major means of transmitting the AIDS virus in Africa is through sexual activity of heterosexuals, according to many reports here this week. Blood transfusions, contaminated needles and ritual instruments also play important roles.

Meanwhile, there is increasing evidence that the methods of transmission of the disease and the infectiousness of the virus in Africa are no different than elsewhere, as had been thought in some medical circles as recently as six months ago.