Overview of HIV & AIDS in Africa

1. Overview of HIV & AIDS in Africa Dr Flavia Senkubuge Specialist Public Health Medicine University of Pretoria 28 February 2011

2. Introduction • HIV&AIDS remains of Public Health concern in Africa • Significant strides made but much still to be achieved

3. Some statistics • Sub-Saharan Africa- more heavily affected by HIV&AIDS compared to any other region of the world: • 22.5 million people living with HIV in the region. • 2009 around 1.3 million people died from AIDS in sub-Saharan Africa • 1.8 million people became infected with HIV • 14.8 million children have lost one or both parents to HIV/AIDS

4. Consequences far reaching! • Consequences of the AIDS epidemic are social and economic in: • health sector • Education • Industry • Agriculture • Transport • human resources and the economy in general

5. The triple challenge • Providing health care, antiretroviral treatment, and support to people with HIV-related illnesses. • Reducing the annual toll of new HIV infections • Coping with the impact of AIDS deaths on national development, orphans and other survivors and communities.

6. The prevalences in Africa • HIV prevalence rates and the numbers of people dying from AIDS vary between African countries: • Somalia and Senegal - HIV prevalence is under 1% of the adult population • Namibia, Zambia, Zimbabwe - 10-15% of adults are infected with HIV • South Africa the HIV prevalence - 17.8% • Exceeding 20% Botswana (24.8%), Lesotho (23.6%) , Swaziland (25.9%).

7. The prevalences in Africa • Cameroon HIV prevalence - 5.3% • Gabon - 5.2% • Nigeria HIV prevalence - (3.6%) compared to the rest of Africa BUT 3.3 million people living with HIV • HIV prevalence in East Africa more than 5% in Uganda , Kenya, Tanzania • Rates of new HIV infections in sub-Saharan Africa appear to have peaked in the late 1990s • HIV prevalence declined slightly, although remains at high level.

8. Impact HIV&AIDS in Africa • Life expectancy: • Average life expectancy in sub-Saharan Africa - 52 years • Households: • Loss of income • Home based care • Orphans • Healthcare: • Increased demand- strain • Affecting health care workers

9. Impact HIV&AIDS in Africa • Schools • Affected severely • Play role in education and support of HIV • Productivity: • Labour (15-49)– slow of economy • Replacement due to ill-health • Economic growth and development • Severely affected therefore affecting Africa’s ability to cope

10. HIV Prevention • Large scale HIV prevention initiatives – reduce scale of epidemics e.g Senegal, Uganda, Kenya, Burkina faso • Condom use - 2001 and 2005, eight out of eleven countries in sub-Saharan Africa reported an increase in condom use. • Consideration (condoms)is cultural beliefs and norms and desire to have children • 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

11. HIV Prevention • Provision of VCT– awareness of status leads to prevention in transmission and possible accesessto treatment ,care and support e.g Burkina Faso, Kenya, Tanzania, Malawi • Mother-to-child transmission of HIV • 2009- 300,000 children in sub-Saharan Africa became infected with HIV • Without interventions, there is a 20-45% chance that an HIV-positive mother will pass the virus on to her child • With antiretroviral drugs, this risk can be significantly reduced.

12. Treatment and care • Antiretroviral drugs (ARVs) - significantly delay the progression of HIV to AIDS and allow people living with HIV to live relatively normal, healthy lives • Poor health systems – reduced delivery • Not enough health care workers • 4 in 10 not receiving ARVs • Success • number of people receiving ARVs in Africa doubled in 2005 alone • end of 2009, almost 4 million people in Africa were receiving antiretroviral treatment

13. Treatment and care • Initiatives: • World Health Organisation (WHO) initiated the ‘3 by 5’ programme - three million people in developing countries on ARVs by the end of 2005. • Latest international target, ‘All by 2010’- universal access to treatment by 2010. • VCT • Nutrition • Follow up counselling • Protection from stigma and discrimination • Treatment of STI • Prevention and treatment of opportunistic infection

14. Way forward • International support • Increased funding • Domestic commitment • Increased domestic expenditure • Reducing stigma and discrimination • Empowering women and girls • HOW FAR IS YOUR COUNTRY ( DISCUSSION) – 15 mins

15. Conclusion • Sustained and committed efforts are necessarily not only from international partners but from countries themselves if the fight against HIV& AIDS is to be won!

16. THANK YOU ! flavia.senkubuge@up.ac.za

17. References • UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic' • UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic' • UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic • WHO/UNAIDS/UNICEF (2010) 'Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector' • UNAIDS (2006) 'Report on the global AIDS epidemic' Chapter 7: Treatment and care • WHO/UNAIDS/UNICEF (2010) 'Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector' • The Global Fund (March 2009), 'Scaling up for impact: Results report' • Office of the Global AIDS Coordinator, U.S. Department of State (2009, May), 'Making a difference: funding' • Lu Chunling et al (2010, April 9th) 'Public financing of health in developing countries: a cross-national systematic analysis' Lancet 975(9723) • International AIDS Society (2010) 'Universal Access: Rights Here, Right Now' • UNAIDS (2008) 'Report on the Global AIDS Epidemic' • UNICEF (2009), ‘Preventing HIV with young people: the key to tackling the epidemic’