TThe HIV/AIDS pandemic has become a human and
social disaster, particularly affecting the developing
countries of Africa, Southeast Asia, and Latin
America. By the end of 2004, about 40 million people
were estimated to be infected by HIV globally. The health
sectors in many affected countries are facing severe shortages
of human and financial resources, and are struggling to cope
with the growing impact of HIV/AIDS. In most developed
countries, the availability of antiretroviral treatment has
resulted in a dramatic reduction in HIV/AIDS-related
mortality and morbidity. In contrast, in the developing
countries, there is little access to treatment, and access to HIVprevention
services is poor. The ‘3 by 5’ initiative was launched
by the WHO and UNAIDS in 2003 with the aim of providing
antiretrovirals to three million people in developing countries
by the year 2005. HIV infection has a significant negative
impact on oral health, with approximately 40-50% of HIVpositive
persons developing oral fungal, bacterial, or viral
infections early in the course of the disease. Oral health
services and professionals can contribute effectively to the
control of HIV/AIDS through health education and health
promotion, patient care, effective infection control, and
surveillance. The WHO Global Oral Health Program has
strengthened its work for prevention of HIV/AIDS-related oral
disease. The WHO co-sponsored conference, Oral Health and
Disease in AIDS, held in Phuket, Thailand (2004), issued a
declaration calling for action by national and international
health authorities. The aim is to strengthen oral health
promotion and the care of HIV-infected persons, and to
encourage research on the impact of oral health on HIV/AIDS,
public health initiatives, and surveillance.
The HIV/AIDS Pandemic
The HIV/AIDS pandemic has become a human, social, and
economic disaster, with far-reaching implications for
individuals, communities, and countries. No other disease has
so dramatically highlighted the current disparities and
inequities in health-care access, economic opportunity, and the
protection of basic human rights. By the end of 2004, about 40
million people were estimated to be infected with HIV
(UNAIDS/WHO, 2004). During 2004, the HIV/AIDS
pandemic claimed more than three million lives, and five
million people became infected with HIV. Each day, there are
14,000 new HIV infections, more than half of these occurring
among young people under 25 years of age. Over three million
children are infected with HIV (UNAIDS/WHO, 2004).
Global data available on the HIV/AIDS pandemic are
illustrated in Figs. 1 and 2. Sub-Saharan Africa has been most
severely affected, with almost 10% of the adult population
being infected in 2004, and an estimated 25 million people
living with HIV (UNAIDS/WHO, 2004). Life expectancy has
fallen to below 50 years. Nearly 10% child mortality is HIVassociated,
with a negative impact on the progress in child
survival made during the past decades. In Southeast Asia,
there are more than seven million people infected, and further
spread could lead to millions more becoming infected in the
coming decade. The epidemic in Latin America is wellestablished,
with nearly two million people being infected,
while rapid growth has been observed in recent years in
Eastern Europe and Central Asia. Globally, the major mode of
HIV transmission is through sexual intercourse, intravenous
drug use, mother-to-child transmission, and contaminated
blood in the health-care setting. The relative importance of the
different modes of transmission varies between and within
regions of the world.
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