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AIDS in Africa
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AIDS (Acquired immunodeficiency syndrome or Acquired immune deficiency syndrome) is an infection with a retrovirus called HIV or Human immunodeficiency virus. In a process still imperfectly understood, HIV infects the CD4 cells (also called T4 or T-helper cells) of the immune system. This loss of cellular immunity results in one or more AIDS defining clinical conditions.
AIDS has no known cure. AIDS typically develops within ten years following HIV infection. Without antiretroviral treatment, for an AIDS defining clinical condition death usually occurs soon after diagnosis.
AIDS was first identified in the United States in 1981, from the initial case reports of opportunistic illnesses caused by a then unknown agent in a few large cities. Further research has indicated it originally appeared in Africa during the 1930s, when chimpanzee hunters were infected with simian immunodeficiency virus (SIV). In 2004, about 60 percent of people with AIDS live in Africa, mostly heterosexual women and men.
In December 2004, UNAIDS and the World Health Organization estimated that between 39 and 44 million people around the world were infected with HIV and between 2.8 and 3.5 million people with AIDS died during 2004.
The HIV/AIDS epidemics spreading through the countries of Sub-Saharan Africa are highly varied. Although it is not correct to speak of a single African epidemic, Africa is without doubt the region most affected by the virus. Inhabited by just 10% of the world's population, Africa is also home to more than 60% of people infected with HIV.
HIV prevalence is stable throughout most of Sub-Saharan Africa, is still rising in a few countries such as Madagascar and Swaziland and is falling in smaller areas in several other countries. Uganda is the most successful national response to date, and has witnessed consistent national declines since the mid-1990s. However, several agencies have cautioned against viewing the stablised infection levels as the beginning of the end of the pandemic in Africa. Such trends often result from rising death rates from AIDS, which conceal a continuing high rate of new infections. When HIV prevalence falls, as in Uganda, the number of new infections can remain high. National prevalence statistics can also conceal much higher levels of infections in certain areas or amongst high risk groups.
In the thirty-five African nations with the highest degree of prevalence, average life expectancy is 48.3 years—6.5 years less than it would be without the disease. For the eleven countries in Africa with prevalence rates above 13 percent, life expectancy is 47.7 years—11.0 years less than would be expected without HIV/AIDS.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has predicted outcomes for the region to the year 2025. These range from a plateau and eventual decline in deaths beginning around 2012 to a catastrophic continual growth in the death rate. Which of these will eventually transpire depends largely on the international response to the crisis.
Health spending in Africa has historically been inadequate, leaving a legacy of poor health care capacity in many regions. This situation was often compounded after independence by the distorted spending priorities of the many military regimes across the continent. The health care systems inherited from colonial powers were oriented toward curative treatment rather than preventative programmes. Strong prevention programmes are the cornerstone of effective national responses to AIDS and the required changes in the health sector have presented a huge challenge.
Without the kind of nutrition, health care and medicines, such as anti-retrovirals (ARV's) that are readily available in developed countries, large numbers of people in these countries will begin to develop full-blown AIDS. They will not only be unable to work, but will also require significant medical care. It is forecast that this will likely cause a collapse of economies and societies in the region, further increasing the suffering and hardship faced. In some heavily infected areas, the epidemic has left behind many orphans being cared for by elderly grandparents. UNAIDS, WHO and UNDP have already documented decreasing life expectancies and lowering of GNP in many African countries with prevalence rates of 10% or more.
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Many governments in sub-Saharan Africa denied that there was a problem for years, and are only now starting to work towards solutions. Lack of money is the core reason why most AIDS deaths occur in Third World countries. There is a need for large amounts of money in all of the areas of prevention of the disease: education, health-care, employment, and treatment.
Changes in life expectancy in several African countries. Botswana has been particularly badly hit, whilst public education projects campaigns have had a positive effect in Uganda. An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behavior. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%–40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic.
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