HIV/AIDS IN AFRICA 

For the first time there are signs that HIV incidence may have stabilized in sub-Saharan Africa. First, effective prevention has helped reduce infection rates and second, with over one in four adults already infected in some countries, fewer people are still likely to become infected. New infections in 2000 totalled an estimated 3.8 million, compared with 4 million in 1999. However, this may change if rates go up in countries where they are still relatively low.

• The total number of Africans living with HIV or AIDS is now 25.3 million. In 8 African countries, at least 15% of adults are infected. In these countries, AIDS will claim the lives of around a third of today's 15-year-olds in Africa.
• During 2000, millions of Africans infected in earlier years began falling ill, and 2.4 million people died of HIV-related causes, compared with 2.3 million in 1999.
• Africa is home to nearly 70% of adults and 80% of children living with HIV in the world, and has buried three-quarters of the more than 20 million worldwide who have died of AIDS since the epidemic began.
• Infection rates in young African women are far higher than in young men, with rates in teenage girls in some countries five times higher than in teenage boys. Among young people in their early 20s, the rates were three times higher in women. In Africa, women's peak infection rates occur at earlier ages than men's. This helps explain why there are an estimated 12 women living with HIV for every 10 men in this region.
• A recent study estimates that in 1997, public health spending for AIDS alone already exceeded 2% of gross domestic product (GDP) in 7 of 16 African countries sampled - a staggering figure in nations where total health spending accounts for 3-5% of GDP.
• Studies on economic impact have estimated that in South Africa, GDP is expected to be 17% for 2010 lower than it would have been without AIDS. It will also wipe out US$ 22 billion from the economy. In Botswana, AIDS will slice 20% off the government budget and reduce income for the poorest by 13%.
• In Botswana, a shocking 35.8% of adults are now infected with HIV, while in South Africa, 19.9% are infected, up from 12.9% just two years ago. The adult HIV prevalence rate in Botswana has more than tripled since 1992, when it was an estimated 10%.

• In Botswana, life expectancy at birth is now estimated to be 44 years instead of 69 without AIDS. In Zimbabwe, life expectancy is 43 instead of 65.

• With a total of 4.2 million infected people, South Africa has the largest number of people living with HIV/AIDS in the world, as well as one of the world's fastest-growing epidemics. Already, 1 in 4 South African women between ages 20 and 29 are infected with the virus.
• More than 1 in 4 adults living in Zambian cities are HIV-positive, and more than 1 in 7 Zambian adults are infected in the country's rural areas.
• On the other hand, the percentage of pregnant girls aged 15-19 infected with HIV in the capital, Lusaka, has on average dropped by almost half in the last six years. The percentage of unmarried women who were sexually active fell from 52% to 35% between 1990 and 1996.
• A study in Zambia showed that in one hospital, deaths among health care workers increased 13-fold over the 10-year period from 1980 to 1990, largely because of HIV.
• West Africa is relatively less affected, with prevalence rates of under 2% in some countries. However, Côte d'Ivoire is already among the 15 worst-affected countries in the world. In Nigeria, by far the most populous country in sub-Saharan Africa, over 2.7 million people are infected with HIV.
• By the year 2010, crude death rates in Cameroon will have more than doubled as a result of HIV/AIDS. An estimated 340,000 people in Ghana are currently living with HIV.
• In North Africa, there is insufficient data but localized studies in southern Algeria show rates of around 1% in pregnant women attending antenatal clinics. Surveillance sites in both northern and southern Sudan indicate that HIV is spreading among the general population. In North Africa and the Middle East, there were some 80,000 new infections in the region in 2000.
• Infection rates in East Africa, once the highest on the continent, hover above those in West Africa but have been exceeded by the rates now being seen in the southern cone.
• The prevalence rate among adults in Ethiopia and Kenya has reached double-digit figures and continues to rise.
• Through strong prevention programmes, Uganda has brought its estimated prevalence rate down to around 8% in 1999 from a peak of close to 14% in the early 1990s. HIV prevalence among 13-19-year-old girls has fallen significantly over an eight-year period, while the rate in teenage boys - always much lower because boys are less likely than girls to have partners in the older, more heavily infected age groups - has remained roughly stable. The percentage of teenage girls who had ever used a condom tripled between 1994 and 1997.
• HIV-positive patients have occupied 39% of the beds in Kenyatta National Hospital in Nairobi, Kenya, and 70% of the beds in the Prince Regent Hospital in Bujumbura, Burundi.

December 2000

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