The head of the United Nations’ AIDS program warned on Tuesday that India, China and Russia are ‘‘perilously close to a tipping point’’ that could turn their small, localized AIDS epidemics into gigantic ones capable of disrupting the whole world’s response to the disease. The situation in those three countries ‘‘bears alarming similarities to the situation we faced 20 years ago in Africa,’’ the Belgian physician and epidemiologist Peter Piot told policymakers here. It could transform ‘‘from a series of concentrated outbreaks and hot spots into a generalized explosion across the entire population—spreading like a wildfire from there.’’ If that happens, affecting both the global economy and international security, ‘‘no country on Earth will escape the impact,’’ said Piot, who heads UNAIDS, a program run by UN agencies, the World Bank, and the World Health Organization. While many experts in recent years have publicly worried about the emerging AIDS epidemics in China and India, Piot’s warning was unusually ominous and concrete. He also drew a connection between AIDS prevention efforts in Asia and AIDS treatment efforts in Africa, which have sometimes been viewed as potential competitors for scarce resources. Specifically, he argued, the laborious, expensive and overdue effort to bring antiretroviral therapy to millions on the continent where AIDS began could unravel if Africa-scale epidemics India and China steal the world’s attention. Piot, who spoke at the Woodrow Wilson International Center on Tuesday on the eve of World AIDS Day, has observed the AIDS epidemic first-hand virtually from its start. In the early 1980s, he helped lead an international team of researchers in Zaire (now the Democratic Republic of Congo) that figured out —— even before the AIDS virus was discovered —— that the disease could be spread by heterosexual intercourse. He warned: ‘‘If the epidemic gains a foothold in even a few states or provinces in China and India, and spreads there as it has in some African countries, the global resources now available for Africa could easily diminish, perhaps even vanish. If we hope to have the resources to treat the epidemic in the hardest hit countries, we must prevent major epidemics in the most populous countries.’’ —LAT-WP China heeds warnings
