Expert Sees Million New AIDS Cases : Strain Predicted on Medical Systems Throughout World

An apparently inevitable explosion of AIDS cases during the next five years will severely strain the capacity of national health systems to care for victims of the fatal disease, especially in developing countries, a leading AIDS expert warned here this week.

Dr. Jonathan Mann, director of the World Health Organization’s Global Program on AIDS, told an international conference that unless a preventive drug is developed, “1 million new AIDS cases (worldwide) must be expected in the next five years.” That is nearly three times the estimated 350,000 people who have contracted acquired immune deficiency syndrome since it began spreading about 10 years ago. The 1 million new cases will develop among at least 5 million people who are already infected with the virus but have yet to become sick, Mann said.

“Unfortunately, we don’t have anything that will stop (the disease’s progress),” he said in an interview after his speech. “At this point we are helpless. . . . What we need to do is show people clearly that we are facing a real challenge in our capacity to care for people” who have AIDS.

Care Called Inadequate

In many developing countries, care for AIDS patients is already inadequate, he said, adding that “AIDS has highlighted and exposed the weaknesses and inadequacies and inequities of our existing health-care systems.” Later he said, “I think it will be possible to cope, but it’s going to take a tremendous effort.”

Dr. Carlyle Guerra de Macedo, director of the Pan American Health Organization, said AIDS is only one of many ailments that cause 800,000 avoidable deaths a year in Latin America and the Caribbean. Macedo said 130 million people in the region “do not have regular access to the minimal health services they have a right to.”

Mann said that despite such obstacles, the countries of Latin America and other Third World regions are taking part in worldwide efforts to control the spread of AIDS. He called the efforts, spearheaded by the World Health Organization, a “global mobilization.”

Nearly every country has established a national AIDS committee, and 115 countries have developed initial plans of action, Mann said. He cited the Pan-American conference, where he spoke, as an example of international cooperation. The conference was transmitted by satellite television to health workers throughout the Western Hemisphere and some African countries.

One goal of such efforts is to change attitudes about AIDS, fighting the stigma and discrimination that often hound patients. By driving AIDS patients underground, those attitudes make it more difficult to detect carriers and prevent contagion, Mann said.