History
In January Brazil's government reached a deal with pharmaceutical companies to reduce the price of HIV/AIDS drugs by around a third. It was believed that the deal saved the government about $100 million in 2004 and cut the average treatment cost per patient to a new low of $1,200.38 Also, 10 million free condoms were given out to people in Brazil during the carnival season as part of an AIDS-prevention campaign.39
In parts of Russia and Eastern Europe, HIV was spreading faster than anywhere else in the world.
In February, President Bakili Muluzi of Malawi announced that his brother had died from AIDS. This was intended to highlight issues of stigma and discrimination related to HIV/AIDS. President Muluzi made the announcement as he launched the first AIDS policy in a country where an estimated 15% of the 15 million population were HIV-positive.40
The Global Fund to Fight AIDS, Tuberculosis and Malaria suspended payments to three HIV/AIDS programmes in Ukraine, citing concerns over slow progress and management problems. It was the first time in its history that the Global Fund had stopped funding to a scheme that it had supported.41
In parts of Russia and Eastern Europe, HIV was spreading faster than anywhere else in the world. A survey by the United Nations Development Programme estimated that almost one in 100 Russians were HIV-positive and that AIDS could claim up to 20.7 million lives by 2045.42 The head of the UN Development Programme, Mark Malloch Brown, criticised Russia's efforts to combat the virus:
"President Putin mentioned it last May, but one speech is not enough and one reference in a speech is not enough."43
Stephen Lewis, the UN special envoy for HIV/AIDS in Africa warned that the WHO's attempt to get three million people onto treatment by the end of 2005 was compromised by lack of financial support from the world's richest countries.
"There has never been a more determined plan of action… If 3 by 5 fails, as it surely will without the dollars, then there are no excuses left, no rationalizations to hide behind, no murky slanders to justify indifference. There will only be the mass graves of the betrayed."Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa -44
In March, the US Food and Drug Administration approved the first oral fluid rapid HIV test.45
South Africa began a programme to give out free HIV/AIDS drugs after years of confusion and delays. The program started in South Africa's richest province, Gauteng, where five major hospitals, including Chris Hani Baragwanath, the largest in Africa, were selected to administer the drugs.46
"To me, it means a lot," said the frail man, whose girlfriend and 2-year-old daughter have also tested positive for HIV. "I have a child to raise... I want to take her to her first day of school, and I can only do that if I am healthy."27-year-old HIV-positive South African man47
A study found that the HIV prevalence rate in Uganda had been reduced by 70% since the early 1990s. It was estimated that half a million Ugandans were HIV positive in 2004, compared with 1.5 million a decade before. It was believed that the reduction in HIV prevalence was due to people having fewer sexual partners as well as to effective prevention efforts in local communities.48
"In Uganda people became engaged with the epidemic at the community level. Local care groups, religious movements, non-governmental organisations and care networks all spread the message. Families, friends and neighbours began talking about HIV prevention and care, and sexually transmitted diseases stopped being a taboo subject."
A survey of US media coverage of the AIDS epidemic revealed that the number of AIDS-related stories peaked in 1987 and rapidly declined in the early 1990s, despite these being the peak years for AIDS deaths. The stories increased slightly in 1991, when Magic Johnson spoke publicly about his HIV status. The number of stories revived again in 1996-7 with the introduction of combination therapy.49
In May, five Bulgarian nurses and a Palestinian doctor accused of deliberately infecting children with HIV were sentenced to death by a Libyan court. The medical staff had been detained in 1998 and the trial had started in 2000.50
The US porn industry was hit by fears of HIV outbreak among its stars. By May, five porn actors had been found to be HIV-positive.51 52
President Bush's $15 billion initiative to combat the global AIDS pandemic, by now known as PEPFAR (President's Emergency Plan For AIDS Relief), began full implementation in June, having received its first funding in January. PEPFAR was to concentrate on fifteen focus countries, all of them in Africa except Guyana, Haiti and Vietnam (which was a late addition to the list). The initiative set a goal of providing AIDS treatment to 200,000 people living in the focus countries by June 2005.53
A new UNAIDS report estimated that 37.8 million people were living with HIV at the end of 2003, including 17 million women and 2.1 million children under 15 years old. It was estimated that there were nearly 8,000 AIDS deaths per day during 2003. These were slightly lower than previous estimates because improvements had been made to the estimation process, but without doubt the epidemic was still expanding. The number of AIDS orphans had risen to 15 million, of whom 12.1 million lived in sub-Saharan Africa.54
The WHO announced that, by the end of June, 440,000 people in developing and transitional countries were receiving antiretroviral treatment, an improvement of 40,000 since the end of 2003.55
The Bill and Melinda Gates Foundation announced that it would donate $50 million to the Global Fund, bringing its total Fund contributions so far to $150 million.56
The South African Treatment Action Campaign and its leader, Zackie Achmat, were jointly nominated for the 2004 Nobel Peace Prize, but were not chosen to win.57
In November the Global Fund said that it would delay launching its fifth round of grants for five months because of a funding shortfall. Some commentators said the US was not providing enough support for the Global Fund because it preferred its own PEPFAR initiative.58
Botswana's antiretroviral treatment programme, which had made dramatic progress during 2004, was providing medication to around 36,000 and 39,000 people by the end of the year - around half of the number who needed the drugs.59
Women, Girls, HIV and AIDS was chosen as the theme of World AIDS Day 2004. Events to mark the occasion took place around the world, including in China, where Premier Wen Jiabao called for "unremitting efforts" against the epidemic, and the Executive of the Global Fund warned of catastrophic consequences should such efforts fail.
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