HIV And AIDS in Africa

Sub-Saharan Africa is more heavily affected by HIV & AIDS than any other region of the world. An estimated 22 million people are living with HIV in the region - around two thirds of the global total. In 2007 around 1.5 million people died from AIDS in sub-Saharan Africa and 1.9 million people became infected with HIV. Since the beginning of the epidemic more than eleven million kids have been left orphans by HIV & AIDS

In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll in sub-Saharan Africa will continue to rise. This means the impact of the AIDS epidemic on these societies will be felt most strongly in the course of the next ten years and beyond. Its social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general. The AIDS epidemic in sub-Saharan Africa threatens to devastate whole communities, rolling back decades of development progress.

Sub-Saharan Africa faces a triple challenge:

* Providing health care, antiretroviral treatment, and support to a growing population of people with HIV-related illnesses.
* Reducing the annual toll of new HIV infections by enabling individuals to protect themselves and others.
* Coping with the impact of over 20 million AIDS deaths, on orphans and other survivors, communities, and national development.

How are different countries in Africa affected by HIV and AIDS?

Both HIV prevalence rates and the numbers of people dying from AIDS vary greatly between African countries.

In Somalia and Senegal the HIV prevalence is under 1% of the adult population, whereas in Namibia,South Africa, Zambia and Zimbabwe around 15-20% of adults are infected with HIV. In three southern African countries, the national adult HIV prevalence rate now exceeds 20%. These countries are Botswana (23.9%), Lesotho (23.2%) and Swaziland (26.1%).2 3

est Africa has been less affected by HIV and AIDS, but some countries are experiencing rising HIV prevalence rates. In Cameroon HIV prevalence is now estimated at 5.1% and in Gabon it stands at 5.9%. In Nigeria HIV prevalence is low (3.1%) compared to the rest of Africa. However, because of its large population (it is the most populous country in sub-Saharan Africa), this equates to around 2.6 million people living with HIV.
Adult HIV prevalence in East Africa exceeds 5% in Uganda Kenya and Tanzania.5

Overall, rates of new HIV infections in sub-Saharan Africa appear to have peaked in the late 1990s, and HIV prevalence seems to have declined slightly, although it remains at an extremely high level.
What is the impact of AIDS on Africa?

HIV and AIDS are having a widespread impact on many parts of African society. The points below describe some of the major effects of the AIDS epidemic.
# he effect on life expectancy. In many countries of sub-Saharan Africa, AIDS is erasing decades of progress made in extending life expectancy. Millions of adults are dying from AIDS while they are still young, or in early middle age. Average life expectancy in sub-Saharan Africa is now 47 years, when it could have been 62 without AIDS.
# The effect on households. The effect of the AIDS epidemic on households can be very severe. Many families are losing their income earners. In other cases, people have to provide homebased care for sick relatives, reducing their capacity to earn money for their family. Many of those dying from AIDS have surviving partners who are themselves infected and in need of care. They leave behind orphans grieving and struggling to survive without a parent's care.
# The effect on healthcare. In all affected countries, the epidemic is putting strain on the health sector. As the epidemic develops, the demand for care for those living with HIV rises, as does the number of health care workers affected.
# The effect on schools. Schools are heavily affected by AIDS. This a major concern, because schools can play a vital role in reducing the impact of the epidemic, through support and HIV education
# The effect on productivity. The HIV and AIDS epidemic has dramatically affected labour, which in turn slows down economic activity and social progress. The vast majority of people living with HIV and AIDS in Africa are between the ages of 15 and 49 - in the prime of their working lives. Employers, schools, factories and hospitals have to train other staff to replace those at the workplace who become too ill to work.
# The effect on economic growth and development. The HIV and AIDS epidemic has already significantly affected Africa's economic development, and in turn, has affected Africa's ability to cope with the epidemic.

HIV prevention in Africa

A number of African countries have conducted large-scale HIV prevention initiatives in an effort to reduce the scale of their epidemics. Senegal, for example, responded early to the emergence of HIV with strong political and community leadership.6 It is impossible to predict how Senegal's epidemic would have progressed without intervention, but Senegal now has one of the lowest HIV prevalence rates in sub-Saharan Africa.

The situation in Uganda is similarly successful. HIV prevalence among pregnant women in Uganda fell from a high of around 30% in the early 1990s to around 10% in 2001;7 a change which is thought to be largely a result of intensive HIV prevention campaigns. Declines in HIV prevalence have also been seen in Kenya, Zimbabwe and urban areas of Zambia and Burkina Faso.

However, not all African countries have had such successful HIV prevention campaigns. In South Africa, the government's failure to respond to the AIDS crisis has lead to an unprecedented number of people living with HIV. An estimated 70,000 babies are born with HIV every year, reflecting significant failures in mother to child transmission initiative

Condom use and HIV
Condoms play a key role in preventing HIV infection around the world. In sub-Saharan Africa, most countries have seen an increase in condom use in recent years. In studies carried out between 2001 and 2005, eight out of eleven countries in sub-Saharan Africa reported an increase in condom use.8

The distribution of condoms to countries in sub-Saharan Africa has also increased: in 2004 the number of condoms provided to this region by donors was the equivalent of 10 for every man,9 compared to 4.6 for every man in 2001.10 In most countries, though, many more condoms are still needed. For instance, in Uganda between 120 and 150 million condoms are required annually, but less than 40 million were provided in 2005.11


Relative to the enormity of the HIV/AIDS epidemic in Africa, providing condoms is cheap and cost effective. Even when condoms are available, though, there are still a number of social, cultural and practical factors that may prevent people from using them. In the context of stable partnerships where pregnancy is desired, or where it may be difficult for one partner to suddenly suggest condom use, this option may not be practical.