Revelation, beat-up or “I told you so” moment?

The WHO has declared an end to heterosexual AIDS outside of Africa, according to Jeremy Laurance, writing in The Independent.

Laurance quotes Kevin de Cock, a thoughtful and honest scientist who happens also to head up WHO’s HIV division, as saying “It is very unlikely there will be a heterosexual epidemic in other countries [outside Africa]. Ten years ago a lot of people were saying there would be a generalised epidemic in Asia – China was the big worry with its huge population. That doesn’t look likely.”

While it’s not clear in what context de Cock made the comments, Laurance describes them as “the first official admission that the universal prevention strategy promoted by the major Aids organisations may have been misdirected”.

Regular readers know that I specialise in railing against spending HIV prevention money on populations that were never at risk in the first place. And I believe that the UN organisations have been at fault for “beating up” the epidemic to make it look as though everyone is at risk. So I could just claim that this is a vindication of what I’ve been saying all along. But to be fair, the story is itself a little bit of a beat-up. Careful readers of the epidemiological sections of WHO/UNAIDS reports will see that they have for some time now tried to draw a distinction between the epidemic in sub-Saharan Africa and that in the rest of the world. It is the other UN organisations that are “co-sponsors” of UNAIDS that gain more from the “everyone is at risk” mantra. The agencies that deal with young people and education and migration and labour and whatnot, the ones that want to get their snouts in the AIDS funding trough without really getting down and dirty with sex and drugs.

Is de Cock saying anything we didn’t already know? No (although his comments continue to excite a bit of comment in the blogosphere, at the WSJ online for example, Slog, and Sweetness and Light. Is his admission a big reversal of WHO policy? Not really. Does it allow me (and many others who have been banging the same drum) to say “I told you so”? Absolutely!

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This post was published on 09/06/08 in Science.

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