Latest figures estimate that by the end of the year there will 28-million people living with HIV in sub-Saharan Africa
Belinda Beresford
Knowing the enemy has failed to help in the battle against HIV. Two decades after the disease was identified, HIV/Aids continues to rampage its way across the world.
The long incubation period of the disease means that one can only ascertain the true numbers of people with the virus about seven years after they become infected. This adds to the horror of the disease, with countries knowing what is coming. For example, one can visit Zimbabwe and see the impact of HIV, knowing that in all likelihood the scenario in South Africa will be the same in a few years’ time.
In its latest Aids Epidemic Update, released this week, UNAids estimates that by the end of this year there will be just more than 28-million people living with HIV in sub-Saharan Africa, of whom 3,4-million will have been infected during the course of the year, mainly through heterosexual sex. Of the 8,4% of adults in the region estimated to be living with HIV, 55% are women.
In Swaziland infection rates among pregnant women last year ranged from 32,2% in urban areas to 34,5% in rural ones. In Botswana almost 44% of pregnant women in urban areas were HIV-positive, compared to 35,5% of rural women. In South Africa more than a third of pregnant women in KwaZulu-Natal carry the virus.
The impact of HIV/Aids continues to hit children especially hard. An estimated 700 000 are likely to have become infected in sub- Saharan Africa this year, bringing to 2,4-million the number of children under 15 living with the virus.
Half a million children are expected to die this year. In Zimbabwe Aids accounts for 70% of all children dying under the age of five. Just more than 12-million African children were thought to have been orphaned by Aids by the end of last year.
UNAids describes HIV/Aids as “the biggest threat to the continent’s development and its quest to bring about an African renaissance”. The report points out that the economic and developmental impact is severe.
The most heavily affected countries could lose 20% of their gross domestic product within two decades, and in half the countries in sub-Saharan Africa annual growth per capita is falling by between 0,5 and 1,2%. Life expectancy is falling in many countries: it is now down to 47 years in South Africa, compared to an estimated 66 years if HIV/Aids were not affecting it.
Poverty and social upheaval continue to play a role in the spread of the disease. In Eastern Europe UNAids cites mass unemployment, economic insecurity, disintegrating public health services, and liberalising social norms as “creating a fertile setting” for the epidemic.
A major driver is the increase of intravenous drug use, especially among young men. An estimated 1% of people in the Russian Federation and other parts of the former Soviet Union are thought to inject drugs, and new infections have doubled annually since 1998.
But high-income countries are also suffering, albeit on a much smaller scale.
This year it is estimated that 1,5-million people will be living with HIV, of whom more than 75 000 will be newly infected. Reflecting the difficulties world wide in changing behaviour, the report says that “Recent advances in treatment and care in these countries are not being consistently matched with enough progress on the prevention front.”
There are success stories. For the eighth consecutive year Uganda has recorded falling infection levels among pregnant women in urban areas to 11,25% last year, compared to 29,5% in 1992. Driven from the highest levels of the government, Uganda’s prevention and education campaign appears to be working, especially among younger people possibly helped by the fact that they will have seen many of their loved ones die.