BOB GARFIELD:
This is On the Media. I'm Bob Garfield. December 1st marks World AIDS Day, and events worldwide will remember the 25 million people who have succumbed to the disease and focus renewed attention on HIV prevention and treatment.

But on November 20th, the United Nations AIDS organization, UNAIDS, and the World Health Organization released a report that scaled down the official number of people infected with HIV worldwide, scaled down, that is, by over six million people. That still leaves 33.2 million suffering from a devastating disease, but it raises questions about official data and journalistic responsibility when reporting on numbers of this scale.

Daniel Halperin is a senior research scientist at the Harvard School of Public Health. He says that his research has shown that even this latest revision of the numbers may still be an overstatement.
DANIEL HALPERIN:
We actually had a paper over three years ago in the medical journal The Lancet where we estimated that the total number of people living with HIV or AIDS was probably roughly in the neighborhood of 25 to 30 million. And I would say that's probably still the case. So even the current 33 million estimate is probably a bit on the high side.

But the actually larger adjustment last week from UNAIDS and WHO is not in the total number of people with HIV, but it's the estimate of the number of people becoming newly infected each year. That had been about 4.3 million last year, and that estimate has now been revised to 2.5 million. So that's a discrepancy of over 40 percent. That's, actually, a much larger correction.

Furthermore, in the new data, they are saying now the rate of new infections - what we call HIV incidence - has actually been declining since the late 1990s.
BOB GARFIELD:
The media are often criticized for being credulous, especially from governmental sources, but I suppose there is the tendency to assume that statistics that they're getting from the World Health Organization, for example, would be reliable. For crying out loud, it's the World Health Organization. Is there anything that news organizations can do to make sure that the numbers they get, you know, have some relationship to reality?
DANIEL HALPERIN:
One of the lessons of this situation and some others is that just as reporters have learned over the years to be skeptical about numbers and about reports that are issued by, you know, for example, our own government, I think they have to have the same approach when dealing with international bodies, like WHO.

There was an analysis done by a colleague here at Harvard University — he was formerly at the WHO, Chris Murray - and they analyzed the top ten leading killers worldwide, HIV-AIDS, of course, being in that list of ten. And according to their analysis, nine out of the ten causes of death were all overestimated.

So this is not a phenomenon that's unique to HIV/AIDS. You know, UNAIDS describes itself as, in part, an advocacy organization, and it's, I think, a little bit problematic for the same organization that is admittedly an activist organization for fundraising and so on to also be the same organization that issues the official statistics.
BOB GARFIELD:
An inherent conflict of interest.
DANIEL HALPERIN:
Potentially, certainly. And I think they acknowledge that. In the report that was issued last week, one of the recommendations is to have much more independent external review of the methodologies used.
BOB GARFIELD:
About ten years ago I did an Op-Ed in USA Today where I [LAUGHS] simply added up the statistics given by various, you know, disease advocacy groups about the number of people afflicted with arthritis, with heart disease, with lung cancer, and so forth.

And I added them all up, and it turned out that everyone in the United States was multiply afflicted and, you know, about three times over, and that as a nation, you know, we were all going to die like tomorrow, which I would say casts some doubt on the statistic generation process.

When you see numbers in the press about HIV/AIDS or anything else, you know, do you just tend to roll your eyes, knowing that they are likely to be inflated, for political reasons or any other?
DANIEL HALPERIN:
Sure, I mean, all the time. Just a common example, we're now 25 years into this epidemic, and still to this day journalists in the leading newspapers will say in country X, one-fourth of the population has HIV, when, in fact, the actual statistic is, in the worst-affected countries, 25 percent of adults have HIV, which actually means that about 12 or 13 percent of the total population has HIV. So that's a very common error.

For me there're sort of a couple of important take-home implications. One is it's still a terrible problem. Even if it were as low as 25 million people globally, that's still a lot of people with the potentially fatal disease.

I hope that nobody takes away from this that well, there's no such thing as an HIV/AIDS problem, it's complete hype.

And the second point is that I'm worried about a potential "boy who cried wolf" syndrome here. I mean, already there have been bloggers on the Internet in the last week or two who are saying, you see, this whole HIV/AIDS thing was hype. It didn't turn out to be the kind of cataclysmic pandemic that it was made out to be. Things like global warming — it's going to turn out to be the same.
BOB GARFIELD:
I want to ask you one final thing. In no way to diminish the significance of this epidemic worldwide, I'm wondering if the fascination with HIV/AIDS, because it's so horrific, if it has pushed aside public health issues that are as important or even more pressing than HIV/AIDS?
DANIEL HALPERIN:
Yeah, I think that's true, for a number of reasons. I mean, I think, you know, one of the reasons, I imagine, that people get so interested in this disease, and I have to confess it's part of the reason that drew me to studying it many years ago, is, you know, it deals with some fundamental issues of human existence - sexuality, death, and so on. [LAUGHS]

Clearly, the media has helped focus attention on a major health problem, HIV/AIDS, and it's had spill-offs more recently in terms of other diseases, like tuberculosis and malaria.

So we've gotten people focused on Africa, but there's about two or three different songs in the playbook that people just keep hitting, you know, the sort of gloom and doom, the orphan lying in the ditch by the side of the village somewhere. That button gets pressed over and over.

The issue around the Bush administration's abstinence policies, that's constantly brought up, to the detriment of talking about other aspects of prevention.

But I'm concerned [LAUGHS] — this snafu around the HIV/AIDS number, I would hate to see that slow down momentum on addressing other diseases and other problems that are more boring, like diarrheal diseases, diseases related to lack of access to safe water and, increasingly, issues related to climate change that maybe aren't as sexy and don't get as much attention, but certainly kill lots of people.
BOB GARFIELD:
Daniel, thank you very much.
DANIEL HALPERIN:
My pleasure.
BOB GARFIELD:
Daniel Halperin is a senior research scientist at the Harvard School of Public Health.