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Friday, 1 December, 2000, 14:09 GMT
Quiz Kathleen Cravero, from UNAIDS
Thirty six million people around the world are now living with HIV or Aids, according to the latest report from the UN Aids programme.

This year UNAIDS singled out Eastern Europe as a region of major concern. In Russia alone more than a million people will be infected in the next two years.

Yet Africa remains the hardest-hit region. There, some 3.8 million people were infected in the last year alone.

Are these statistics as grim as they sound? What is UNAIDS doing? What works, what doesn't? Do you have any questions about your own country or region?

UNAIDS deputy director Kathleen Cravero answered your questions in a live Forum from Geneva. Click below to listen.




Today is World Aids day and joining us from our Geneva studio is Kathleen Cravero who is a deputy director of UNAIDs the United Nations Aids agency.

We have had a great number of e-mails with questions for you from all over the world but before we go onto them, I just wanted to ask you about World Aids day and how you think it contributes to the fight against the disease?

Kathleen Cravero:

As you know it is not only World Aids Day but the World Aids campaign. Each year this campaign, which culminates on the 1st December, has served to galvanise people, communities, organisations and nations across the world on a specific issue of particular importance to the epidemic.

We have had World Aids campaigns focusing on young people and a variety of other subjects and this year the theme of the World Aids campaign and the World Aids day, is that men make a difference. The idea of the campaign is not only to point out harmful cultural practices, practised among men, but to emphasise the positive contribution that men can make to stemming the tide of the epidemic in their own communities and indeed across their nations.

Dennis Amos Mwalongo, Arusha-Tanzania, East Africa:

In Africa and my motherland Tanzania the cultures and customs of various tribes do not allow parents to speak about sex and their related issues. How can we eliminate this gap so that the young generation can learn more?

Kathleen Cravero:

At UN Aids and among our co-sponsoring agencies, we have been doing a lot of work in the area of trying to make sure that children - especially children - but all people, have the information they need to make informed choices about their sexual behaviour.

There are cultures throughout the world, not only in Africa, where it is difficult for parents to pass this information to their children. This is one of the things we would like to change, to have parents to be able to speak more openly to their children. In addition we are working to get more accurate information presented through schools and through peer education by children sharing information.

Questioner from Canada:

Is having sex with condoms a 100 per cent safe way of preventing transmission of HIV?

Kathleen Cravero:

Nothing but abstinence is 100 per cent safe but use of condoms is one of the best ways for people to prevent transmission of the disease. We 100 per cent recommend the use of condoms and think that it is probably the most practical effective way for many people across the globe to be able to prevent transmission of the disease.

Ronan McNamara, London, UK:

Do you think the UN should be promoting abstinence rather than the use of condoms?

Kathleen Cravero:

We believe that the United Nations governments and organisations concerned about the future of their countries and communities should be promoting a range of choices. We do not feel it is necessarily the role of the UN to say that everyone should abstain but that there are several safe choices for people to make regarding their sexuality. Abstinence is certainly one of them but it is not the only one.

Simsandi, Phnom Penh, Cambodia:

How far do you believe scientists are from finding a cure for either HIV or Aids?

Kathleen Cravero:

UN AIDS is supporting research to find a vaccine for HIV Aids. We have been doing that for several years and we will certainly continue to do that. There has been substantial progress made in that direction but the science is complicated. The virus is difficult against which to develop a vaccine, therefore we believe very strongly that while we work to develop a vaccine, we should also continue to promote safer sexual behaviour and a wide range of interventions to face the challenge of the epidemic at country level.


How far do you see vaccine technology developing over the next few years, or is it still going to be in clinical trials?

Kathleen Cravero:

I think it is hard to say because we have to see what the results of the current clinical trials are. I don't think we are going to see vaccine in the next one, two or three years, but whether it will be five years or ten years is difficult to say right now. While we certainly could more, there is substantial effort going into vaccine research.

Andrew Hill, Lincoln, UK:

How do you see Aids affecting the UK in the next 5 years and how many cases do you think go unreported and whether that is a significant problem?

Kathleen Cravero:

The UK is like other western European and North American countries. There has been a lot of work done on prevention and there has been a reduction in transmission since the beginning of the epidemic. But there is no room for complacency in the UK or other western European countries. It is important to aggressively promote safer sexual behaviour and prevention interventions.

I am not sure how much under-reporting there is specifically in the UK. I think in most western European and North American countries the reporting is fairly good, while reporting is a problem is some other parts of the world. However, we know that the number of infections is continuing to rise, so we must remain vigilant and step up prevention efforts especially among young people.


Do you believe that western Europe and other parts of the developed world are now starting to get complacent about HIV and Aids?

Kathleen Cravero:

We believe that the danger is there. Because there was progress made in the early years against the epidemic and we saw a reduction in transmission, it seems that some people - especially young people, who may not have that direct experience that their older siblings or parents had - it just puts them a little off their guard which we believe could be very dangerous for the future of the epidemic in some of these countries.

Dmitry, Yekaterinburg, Russia:

How much money is currently spent on Aids treatment and HIV prevention world wide? Is it enough?

Kathleen Cravero:

Our best estimates, and I would say it is hard to get accurate estimates of the amounts of money spent, is that somewhere between $350 - $500 million flowed into Africa for example for HIV/Aids activities in 1999. We estimate that basic prevention and care, not including drugs, would cost approximately $3 billion over 12 months in Africa to really turn the tide of the epidemic. So you see there is a considerable gap between the amount of money currently flowing into Africa and the amount that we need.


How do you start making up that short-fall? Is it a question of persuading governments or is there another way of doing it?

Kathleen Cravero:

We are trying various ways. I think it is matter of governments in industrialised countries giving more to those countries that are most affected. It is a question of the countries who are affected putting more of their own resources into fighting the epidemic by getting the private sector to be involved in the struggle, both at country level and at global level.

We hope that by bringing together different constituencies, for example, the UN, governments, NGOs, the private sector and the community sector, in a more coherent effective way against the epidemic, we will be able to increase the amount of resources and also the way in which they are used.

Gavin Brown, London, UK:

To what extent are the debts owed by developing countries hampering the fight against Aids? Would lives be saved if there was cancellation of debt?

Kathleen Cravero:

Certainly we believe that a cancellation of debt and the use of that money to fight Aids within countries, especially African countries, would make an enormous difference and because of that we are putting considerable effort in that direction. For example, in Malawi, Uganda and Burkina Faso, there have been, or about to be, a major concentration of resources from debt into HIV/Aids activities at national level. We hope that that will happen in several other countries during the course of the next 12 to 18 months.

There has been considerable enthusiasm for debt cancellation if that money will be spent for the prevention and care of HIV/Aids in developing countries.

Albert Kariuki, Kenya:

Why can't UNAIDS lobby for the reduction of drug prices to affordable levels to save lives in Africa?

Kathleen Cravero:

The United Nations, led by UNAIDS, is making enormous efforts and considerable progress in getting drug prices reduced. We have been carrying on negotiations with drug companies at global level and in many countries bi-lateral negotiations are going on between governments and specific drug companies to make sure that the prices can come down.

However, the price of drugs is only one aspect of a much broader spectrum of care that is needed in developing countries. We need to concentrate on all aspects of care and we hope to make continued progress in that regard in the future.

Jamie Hunter, Melbourne, Australia:

To what extent should the developed world feel responsible for the Aids crisis in the developing world?

Kathleen Cravero:

If we have learnt anything over the past five to ten years it is that it is a small world. There is no way that people in the so-called industrialised world can look at this epidemic and say it is someone else's problem - it is the world's problem and the greatest development challenge of this century and will require the utmost dedication of all peoples, in all countries.

Therefore the solidarity is needed, not only in terms of finance flowing from industrialised countries to developing countries but working together to identify the best prevention and the most effective ways to provide care to people affected by the epidemic. We must, as a global community, turn this epidemic back.

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