PARIS--AIDS is now the fourth leading cause of death in the world, and the number one killer in Africa, according to figures released this week by the World Health Organization (WHO). The disease has moved up several notches from last year's ranking as seventh leading killer worldwide, according to WHO's latest World Health Report.
Only ischemic heart disease, cerebrovascular disease, and acute lower respiratory infections outrank AIDS on the international death list. In Africa, AIDS caused an estimated 1,830,000 mortalities in 1998, twice as many as due to malaria, which is now relegated to the number two spot on the continent's roster of lethal diseases.
Bernhard Schwartländer, senior epidemiologist for UNAIDS, the United Nations AIDS program, says that some of the change in disease ranking is due to new and improved methodologies for estimating disease mortality, which have revised estimates of some diseases downward while AIDS cases have been skyrocketing. Nevertheless, the new figures dramatically vindicate warnings late last year by UNAIDS that the epidemic is still raging out of control (Science, 4 December 1998, p. 1790). UNAIDS estimates that new infections by HIV, the virus that causes the disease, are increasing by at least 6 million each year. But a UNAIDS study released last month indicated that donations to international AIDS programs have failed to keep up with the growth of the epidemic.
"AIDS is now the [single] leading infectious disease killer in the world, and the number one killer of Africans," Peter Piot, UNAIDS's executive director, told Science. "It's an outrage that the international community is only investing $150 million each year to stem the spread of HIV in Africa."