/ 29 November 2001

Aids: the divide of the disease

Paris | Wednesday

AIDS is cutting such a swathe through sub-Saharan Africa that in some countries, life expectancy is nearly half that in the West and the economy could shrink by a fifth over the next two decades, the UN said on Wednesday.

Some states may be so weakened by the epidemic that they could break down, the specialist UN agency UNAids and the World Health Organisation (WHO) warned.

“Sub-Saharan Africa remains the region most severely affected by HIV/Aids,” they said in their annual report on the pandemic.

“The estimated 3,4-million new HIV infections in sub-Saharan African in the past year mean that 28,1-million Africans now live with the virus.

“Without adequate treatment and care,” it warned bluntly, “most of them will not survive the next decade.”

In five West African countries — Burkina Faso, Cameroon, Ivory Coast, Nigeria and Togo — at least five percent of the population aged 15-49 has HIV or Aids.

In 16 other sub-Saharan countries, the rate is at least 10%.

The nightmare record is held by Botswana, where the nationwide adult infection rate is over 35% and in some areas nearly 44% of pregnant women have HIV.

“Were it not for HIV/Aids, average life expectancy in sub-Saharan Africa would be approximately 62 years; instead it is about 47 years,” the report said.

In four countries — Botswana, Malawi, Mozambique and Swaziland — life expectancy is now under 40 years, it said.

By comparison, the life expectancy in the United States is 76,7 years, while in Britain it is 77,82 years and in Japan it is 80,8 years, according to national statistics for those countries.

The epidemic is having a profound impact on many African economies, devastating the ranks of managers, teachers, doctors and engineers and other skilled workers, weakening law and order and creating a poor, ragged army of Aids orphans, the report said.

“By 2010, per capita GDP in some of the hardest-hit countries may drop by eight percent,” it said. “Heavily-affected countries could lose more than 20% of GDP by 2020.”

The disease’s devastating spread is chiefly pinned on ignorance, which prevents “the vast majority” of Africans living with HIV, especially women, from knowing they have the virus.

Despite this, the report says there are encouraging signs of progress in some of the most heavily-affected countries.

Condom use is increasing and sexual promiscuity is declining in Zambia. Belated information campaigns in South Africa are bearing some fruit, with a big increase in condom distribution and use by sexually active teenage girls.

The star performer is Uganda, “the first African country to have subdued a major HIV/Aids epidemic,” thanks to information, education and communication and decentralised programmes reaching down to village level.

HIV incidence prevalence among pregnant Ugandan women in urban areas has fallen for eight years in a row, from a high of 29,5% in 1992 to 11,25% in 2000, and condom use among sex workers in Kampala, the capital, is as high as 98%.

Without similar efforts in other parts of the continent, some African countries could be prey to violence or breakdown, as the economy, social fabric and structures of state, such as the police force and judiciary, are ravaged by the epidemic, UNAids and the WHO said.

“Aids has become the biggest threat to the continent’s development and its quest to bring about an African Renaissance,” the report said. “(…) The risks of social unrest and even socio-political instability should not be under-estimated.”

NUMBER OF PEOPLE WITH HIV/Aids

Global total: 40 million

Of which: Adults 37,2 million

Children under 15 years 2,7 million

Regional totals (adults + children)

North America 940 000

Caribbean 420 000

Latin America 1 400 000

Western Europe 560 000

North Africa and Middle East 440 000

Sub-Saharan Africa 28 100 000

Eastern Europe and Central Asia 1 000 000

East Asia and Pacific 1 000 000

South and Southeast Asia 6 100 000

Australia and New Zealand 15 000

PEOPLE NEWLY INFECTED WITH HIV IN 2001

Global total: Five million

Of which: Adults 4,3 million

Children under 15 years: 800 000

Regional totals (adults + children)

North America 45 000

Caribbean 60 000

Latin America 130 000

Western Europe 30 000

North Africa and Middle East 80 000

Sub-Saharan Africa 3 400 000

Eastern Europe and Central Asia 250 000

East Asia and Pacific 270 000

South and Southeast Asia 800 000

Australia and New Zealand 500

AIDS DEATHS IN 2001

Global total: Three million

Of which: Adults 2,4 million

Children under 15 years: 580 000

Regional totals (adults + children)

North America 20 000

Caribbean 30 000

Latin America 80 000

Western Europe 6 800

North Africa and Middle East 30 000

Sub-Saharan Africa 2 300 000

Eastern Europe and Central Asia 23 000

East Asia and Pacific 35 000

South and Southeast Asia 400 000

Australia and New Zealand 120 – AFP