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3. The Impact of HIV/AIDS on Sub-Saharan Africa


The impact of HIV/AIDS on the African region is clearly depicted in the table below which indicates the highest prevalence rate of the epidemic in the world according to the UNAIDS Report on the Global HIV/AIDS Epidemic (2000). Most of these countries are reflected in the map on the following page, drawing attention to the profound impact on the African continent. Particular attention is drawn to the countries that are the subject of this study.

As clearly articulated by Table One, countries worst affected by HIV/AIDS in the global context are predominantly African. This is a region that can least afford the direct and indirect costs associated with the epidemic as it is characterised by illiteracy, poverty and lack of access to housing, health care and nutrition. Altogether, at the end of 1999, there were 16 countries, all in Sub-Saharan Africa, in which more than one-tenth of the adult population aged 15 - 49 years were infected with HIV (Schonteich, 2001). Of these countries, Lesotho, South Africa and Kenya were the fourth, sixth and ninth worst affected in the world respectively. The ranking of the countries according to prevalence of HIV shows that the eight highest rates of infection are in the SADC region, including South Africa and Lesotho, which carries the major burden of HIV/AIDS in both the Sub-Saharan Africa region and also in the world. Six countries in East Africa, starting with Kenya, and then five other countries, only one outside of Africa, follow these:

TABLE ONE: Countries worst affected by HIV/AIDS

HIV/AIDS estimates in countries with HIV prevalence rates > 4% of adult population, end 1999

Country

Adult Rate (%)

Adults & Children

Adults (15-49)

Orphans cumulative

1. Botswana

35.80

290,000

280,000

66,000

2. Swaziland

25.25

130,000

120,000

12,000

3. Zimbabwe

25.06

1,500,000

1,400,000

900,000

4. Lesotho

23.57

240,000

240,000

35,000

5. Zambia

19.95

870,000

830,000

650,000

6. South Africa

19.94

4,200,000

4,100,000

420,000

7. Namibia

19.54

160,000

150,000

67,000

8. Malawi

15.96

800,000

760,000

390,000

9. Kenya

13.95

2,100,000

2,000,000

730,000

10. Cen African Rep

13.84

240,000

230,000

99,000

11. Mozambique

13.22

1,200,000

1,100,000

310,000

12. Dijbouti

11.75

37,000

35,000

7,200

13. Burundi

11.32

360,000

340,000

230,000

14. Rwanda

11.21

400,000

370,000

270,000

15. Cote d’Ivoire

10.76

760,000

730,000

420,000

16. Ethiopia

10.63

3,000,000

2,900,000

1,200,000

17. Uganda

8.30

820,000

770,000

1,700,000

18. Rep. Tanzania

8.09

1,300,000

1,200,000

1,100,000

19. Cameroon

7.73

540,000

520,000

270,000

20. Burkina Faso

6.44

350,000

330,000

320,000

21. Congo

6.43

86,000

82,000

53,000

22. Togo

5.98

130,000

120,000

95,000

23. Haiti

5.17

210,000

200,000

74,000

24. DRC

5.07

1,100,000

1,100,000

680,000

25. Nigeria

5.06

2,700,000

2,600,000

1,400,000

26. Gabon

4.16

23,000

22,000

8,600

27. Bahamas

4.13

6,900

6,800

970

28. Cambodia

4.04

220,000

210,000

13,000

Source: UNAIDS cited in Louwenson & Whiteside, 2001

The main consequence of the impact of HIV/AIDS in these affected countries is the reversal of the social and economic progress made during the last few decades, coupled with the serious negative impact both on households and organisations focused on development interventions. This is because infection with HIV will certainly result in AIDS-related death, whether soon after infection or several years later. This ensures that the epidemic will have an impact on the demographic structure of countries and communities (Haacker, 2002). AIDS-related mortality is leading to plummeting life expectancy and climbing infant and child mortality rates, with life expectancy at birth falling to less than 1950’s levels in highly affected countries. The demographic consequences of HIV/AIDS are clearly depicted in the table below:

TABLE TWO: Life expectancy & population growth, 2010

-------- Life expectancy --------

-----Population growth-----

Country

Without HIV/AIDS

With AIDS

Years lost

Without AIDS

With AIDS

Namibia

70.1

38.9

31.2

2.8%

1.2%

Botswana

66.3

37.8

28.5

1.9%

0.2%

Swaziland

63.2

37.1

26.1

3.1%

1.7%

Zambia

60.1

37.8

22.3

3.1%

2.0%

Kenya

69.2

43.7

25.5

1.8%

0.6%

Malawi

56.8

34.8

22.0

2.2%

0.7%

South Africa

68.2

48.0

20.2

1.4%

0.4%

Source: Fourie and Schonteich, 2001: 31

HIV/AIDS especially affects mortality rates for the working age population and, due to mother-to-child transmission, child mortality (Haacker, 2002: 5). HIV/AIDS illnesses and deaths affect people in their most productive years - those between 15 and 49 years of age (FAO, 1994). Up to 60 percent of all new HIV infections are among 15 to 24 year olds, with female members of the population outnumbering the male members by a ratio of two-to-one in that population group (Balyamujura et al, 2000: 9). In Sub-Saharan Africa, 55 percent of the infections occur among women (Collins and Rau, 2000: 1), the only region in the world where female infection rates are higher than among men (Walker, 2002: 7).

Increased deaths, fewer births and reduced fertility will slow or potentially reverse population growth particularly in southern Africa (Collins and Rau, 2001: 1; Louwenson and Whiteside, 2001: 7). As a result of HIV/AIDS, Sub-Saharan Africa will have 71 million fewer people by 2010 and the increase in widows, widowers and orphans will expand dependency.


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