Stephen Lewis damns UNAIDS over statistics revision; diverts from the

Rob Dawson, Thursday, November 29, 2007

In a passionate speech at the World Health Editors Network in London,
a former United Nations Special Envoy for AIDS in Africa and
Co-Director of AIDS-Free World, Stephen Lewis, warned that a recent
UNAIDS document reporting decreased HIV infections has "undermined
public confidence in the reliability of the figures, introducing
completely unnecessary levels of doubt, contention and confusion".
Describing the UN as "stubborn and sloppy", he expressed concern that
the report does nothing to convince the world that we are "billions
and billions of dollars behind, when it comes to funding all the
components of the pandemic, from orphans to second line drugs."

In its latest report, UNAIDS cut the number of infections worldwide to
about 32.7 million, down from its estimated 39.5 million in 2006.
Rather than a reduction based on decreased rates of infection, the new
figure was mainly due to fixing flawed statistics from previous reports.
The former data collection methods relied heavily on "sentinel-site
surveillance" which extrapolates data gathered at prenatal clinics.
An assumption was made that the rate of HIV in the general population
would be similar to the rate among pregnant women in urban clinics.
This year the UN attributed more of their calculations to national surveys
and blood-testing.

While it's good news that fewer people are infected than previously
thought, there was concern that the dramatic re-representation of the
figures would result in diverted resources from an epidemic still in
desperate need of funds.

"For years, knowledgeable epidemiologists have been telling the UN
that the figures were too high. They didn't whisper their criticisms:
they wrote books and articles," Lewis said. "But the UN chose a course
of delay and dithering. It can never admit that it's wrong. So finally,
and predictably, came the moment of truth: the result is an overall
prevalence rate that is lower by almost seven million than last year's
estimate."

Lewis also expressed anger that the report did not address the human
tragedy and focused too much on statistics.

"The new estimates confirm a continuing apocalypse for sub-Saharan
Africa: 22.5 million infections, 61% of them women, 68% of world-wide
infections, 76% of all deaths, 11.4 million orphans. This is where the
focus must be, this is where it should always have been; not a report
cluttered by mathematical adjustments so that virtually every story
that's written begins with the news of a statistical volte-face. If the
recording of data had been more scrupulous all along, we could have
welcomed this report," he said. "Instead, all of us have to run to the
trenches to remind the world that more money is still desperately needed."

Lewis also highlighted several flaws in the data which could lead to
yet another recalculation. For example, the narrative evidence of the
report states repeatedly that Mozambique has shown no decrease in
infection rates yet later asserts that Mozambique is one of the six
countries in the world that has most significantly contributed to the
reduced numbers seen in the report. No data on Mozambique is set out
conclusively in the report.

In conclusion, Lewis stressed that more should be done no matter what
statistical calculation is applied to the figures.

"Whether it's 40 million or 33 million, this plague continues to
ravage humankind. I simply do not believe that the United Nations has
done everything it can possibly do to turn the tide," he said.