The spread of HIV and AIDS in subSaharan Africa has far exceeded the worst projections, according to speakers at the 11th international conference on AIDS and sexually transmitted diseases in Africa. In 13 countries the prevalence of HIV infection is more than 10%and in some it is as high as 30%At the conference in Lusaka, Zambia, last week, the epidemic was described as an unprecedented threat to the region’s economic development.
At the end of 1998, 22.5 million people out of the region’s population of 600 million were living with HIV or AIDS; this number includes 1 million children. The epidemic in sub-Saharan Africa accounts for two thirds of the worldwide total of 34 million people with HIV/AIDS. About 7500 people are infected daily.
In only two countries, Uganda and Senegal, does the epidemic seem to be abating. Strong governmental leadership in these countries ensures that there is universal health education, that condoms are easily available, and that there is coordinated action from the government.
Life expectancy in the region has decreased from 64 to 47 years. Sixty five per cent of patients in medical wards in Zambia, and 75%in paediatric wards, are infected with HIV or have AIDS, and the underfunded health system is near to collapse. Even common drugs such as cotrimoxazole are scarce.
In Zambia, a 15 year old has a 60%chance of dying of AIDS. As the epidemic, which is driven largely by poverty, continues to grow, there is little sign of widespread change in sexual behaviour, especially among teenagers, one of the most vulnerable groups.
Tsepo Sitali, aged 8, described to the conference the anguish of her friend who will mark her eighth birthday without a mother or a father because both died from AIDS last year.
Tsepo’s friend is not alone: the number of children orphaned by AIDS in Zambia is forecast to reach 500 000 by the year 2010. The epidemic affects children not only directly through infection being spread from mother to child but also through the deaths of their parents which results in their being forced into prostitution and other forms of exploitation.
Children, especially girls, are taken out of school to nurse sick relatives or because school fees are no longer affordable. Only an estimated 10%of the predicted illness and death has occurred: the full impact on people, communities, and economies is still to come.
Figure.
AP PHOTO/THEMBA HADEBE
Children, orphaned by AIDS, carry benches to their classroom at a relief agency near Lusaka, Zambia