THE Executive Director of the advocacy group Section27 has taken issue with the "rosy picture" the United Nations joint agency on HIV/AIDS (UNAIDS) has painted of the world’s response to HIV, saying the end of the epidemic was nowhere nigh.

UNAIDS’ annual report, released last week, said that at 2,5-million globally, the number of new infections last year was 20% lower than in 2001.

However, in a speech delivered on Tuesday at Oxford University, Mark Heywood said: "UNAIDS believes there is a genuine opportunity to plan for the end of AIDS … but because most governments have paid little more than lip service to quality, dynamite has been built into the edifice of the AIDS response, and the clock is ticking." He is expected to make a similar speech to the European Union on Wednesday.

"In many countries there is a lack of qualitative information about drug adherence (and) adverse effects, discrimination and human rights violations, and especially in SA, on the effect of its collapsing public health systems.

"The biggest cause for concern is not the evidence we have but the evidence we don’t have. As a result we have to rely on anecdote. But what we hear and see is not good," Mr Heywood said.

With 5.1-million people infected with HIV, and the world’s biggest treatment programme, South Africa is often hailed as an example of a country that has made great strides in tackling a devastating epidemic. But Mr Heywood described a series of worrying trends that threatened to undermine the country’s progress.

The government had failed to set up a pharmacovigilance centre to monitor serious side effects associated with antiretroviral medicines used to treat HIV. As a result there were growing reports of patients battling unsightly fat redistribution after they used a drug called stavudine.

The side effects were not life-threatening, but were psychologically distressing and were deterring other patients from starting treatment.

Recurrent drug shortages at public hospitals and clinics were undermining patient confidence in SA’s health system, and increasing the risk they would not stick to their daily pill regimens, he said.

Mr Heywood also drew attention to KwaZulu-Natal’s continued use of the controversial Tara Klamp device for circumcision, which carries a higher risk of complications than the guided forceps method used in the rest of the country.

"Young men and boys are being herded into circumcision camps where there is no notion of proper consent.

"Human rights are now being violated in the name of the human right to life and treatment," Mr Heywood said.

Civil society’s response to this and other HIV issues was being undermined by donors "turning their backs" on lobby groups such as the Treatment Action Campaign, he said.