World Aids Day: AIDS emerges as the leading cause of death in WHO updated projections of global mortality

By Syed Akbar
As the world observes the AIDS Day on December 1, the World Health Organisation projects AIDS as the leading cause of death, followed by depression, heart diseases and road accidents.
The WHO’s  updated ‘burden of disease’ projections released this month gain significance in the backdrop of India emerging as one of the few countries with projected large population suffering from AIDS/HIV infection. India at present has 3.5 million people afflicted with the disease and the number is fast increasing. Andhra Pradesh leads the States in the country.
The WHO’s projections also assume importance as India accounts for 16 per cent of the world’s population and 21 per cent f the world’s global burden of disease, including AIDS. The WHO’s projection is for the year 2030 and its statistics are based on the 2002 figures.
The WHO revised this November its projection on global burden of diseases giving AIDS the status of the Killer No. 1. With fast paced life, depression, particularly of the unipolar (single mood) variety has emerged as the second leading cause of death. Depression includes trouble sleeping, loss of weight and agitated and irritable behaviour. One of the characteristic features of unipolar depression is that people who suffer from it put on a "happy face" in front of others, while deep down they feel quite depressed and disinterested in life.
Cardiac diseases particularly of the ischaemic type and road accidents occupy the third and the fourth slot in the updated projections of global mortality and burden of diseases, 2002-2030 released by the WHO a few days ago.
According to the WHO report, global HIV/AIDS deaths may rise from 2.8 million in 2002 to 6.5 million in 2030 if the anti-retroviral drugs reach 80 per cent of people by 2012. In the most optimistic scenario with increased prevention activity, HIV/AIDS deaths may drop to 3.7 million by the projected year. 
Another disturbing factor is the emergence of tobacco-related deaths. The WHO projects total tobacco-attributable deaths to 6.4 million in 2015 and 8.3 million in 2030 from the present 5.4 million. Tobacco is projected to kill 50 per cent more people in 2015 than HIV/AIDS, and to be responsible for 10 per cent of all deaths worldwide.
Eminent sexologist Dr K Swayam Prakash says that the regulatory mechanism has to be strengthened to a great extent to detect and stop malpractices in blood banking. “Greater coordination between national/ state blood transfusion councils and drug control authorities is needed. Training and orientation of drug inspection in the field needs to be speeded up and made more effective in fulfilling their regularly functions,” he pointed out. 
The latest UNAIDS report on the global AIDS epidemic estimates that 65 million people have been infected with HIV, of whom some 25 million have died since the start of the epidemic 25 years ago. The rate of new HIV infections continues to climb every year, with an estimated 4.1 million people having been infected in the twelve months ending December 2005. Globally, the total number of people living with the virus also continues to grow, reaching 38.6 million at the end of 2005 and trends indicate that left unchecked the epidemic will continue to increase. 
In other words, at this stage of the global AIDS epidemic there are more HIV infections every year than AIDS-related deaths.
With the WHO projecting an alarming scenario for AIDS, the National AIDS Control Organisation has increased its efforts to move towards centralizing blood transfusion services and to reduce fragmentation in management, especially in urban areas. In rural and difficult to access areas, stand alone or small blood banks will be encouraged. It will also continue to have quality management in blood banking.
“All aspects like processes, products, equipment, consumables etc. would increasingly be subjected to quality assurance procedures, so that a safe and reliable transfusion services can be provided,” says a NACO strategy report.