Global Impacts of HIV and AIDS
Since identification of the human immunodeficiency virus 20 years ago, the HIV/AIDS epidemic has taken a huge toll . An estimated 36 million people are currently living with HIV, and some 20 million people have already died. Globally, HIV/AIDS is now among the top five leading causes of death.
The worst of the epidemic is centered on sub-Saharan Africa
At the end of 2000, an estimated 25.3 million people in sub-Saharan Africa were living with HIV. This region accounts for about three-quarters of global AIDS deaths. In seven countries in the region, more than 20% of the adult population is afflicted with HIV. In another nine countries, at least 10% of the adult population is affected.
HIV impacts socioeconomic development
Infection rates are highest among young men and women who are in their most productive years. In the worst affected countries, the impact of HIV is expected to reduce average life expectancies by 15 years. In the coming decades, societal demographics will be significantly altered.
By the year 2020, it is estimated that in the 15 worst-affected countries, there will be 24 million fewer people in the workforce. When the number of working age adults declines, economic activity will be impacted. And when productivity declines, poverty levels will rise.
The costs of treating HIV/AIDS-related illnesses account for one-third to two-thirds of the health care budgets in these developing nations.
Children are at risk
The primary routes of infection in this region of the world are heterosexual sex and mother-to-child transmission. HIV can be spread from mother to child in utero, during delivery, or through breast feeding.
Over 2.4 million HIV-infected women give birth each year. Each year, there are 600,000 newly infected infants; 9 out of 10 of these are in Africa. In fact, of the children living with HIV, over 90% acquired the infection from their mother.
Gains in child survival in sub-Saharan Africa are being reversed by the HIV/AIDS epidemic. By 2010, child mortality will increase. Some estimates are as follows:
In Botswana, 15% of children will die
In Kenya, 12% of children will die
In Malawi, 23% of children will die
In Zambia, 20% of children will die
What can be done?
Regimens of antiretroviral drugs can reduce the risk of perinatal transmission. However, in developing countries, health resources are limited. High treatment costs are not cost-effective options in countries with annual health expenditures of $2 to $40 per person.
Furthermore, counseling women not to breast-feed may not be an option. Artificial feeding is often impractical due to the cost of formula and lack of clean water.
Nevertheless, access to appropriate medications and health care can help to prevent new infections and to treat those already infected. Preventing infection is estimated to be at least 28 times more cost-effective than treating those already infected with antiretroviral drugs. Many policy-makers thus advocate that the most appropriate strategy is to focus on prevention and to treat opportunistic infections, as well as infections that increase the risk of transmission, such as STDs and mastitis (in breast-feeding mothers).
The situation in Africa requires a three-pronged strategy: direct health care, education and training, and health care promotion.
By:Martha Cox, MSc
Picture taken in Kenya