The Rapidly Growing HIV/AIDS Epidemic

The spread of HIV/AIDS has exceeded the worst projections by far. Nearly 34 million people in the world are currently living with HIV/AIDS, and one-third of these are young people between the ages of 10 and 24. The epidemic continues to grow, as 16,000 people worldwide become newly infected each day. Fourteen million adults and children have already lost their lives to this devastating disease, and the death toll rises each year (UNAIDS, 1998e). Despite these alarming figures, AIDS is still an emerging and growing epidemic.

The region most affected has been Sub-Saharan Africa (SSA). (In this document, "Africa" and "Sub-Saharan Africa" are used interchangeably.) At the end of 1998, 22.5 million people, including 1 million children, were living with HIV/AIDS in SSA, two-thirds of the worldwide total (Figure 1). At least 4 million Africans were newly infected with the virus in 1998. HIV does not respect borders, and its transmission is often facilitated by subregional trade routes and other migration patterns common throughout the continent. In Botswana, Namibia, Zambia, and Zimbabwe, between 20 and 26 percent of people ages 15 to 49 are infected. In 12 other SSA countries, including Ethiopia, Kenya, Mozambique, South Africa, and Tanzania, 9 to 20 percent of adults are infected (UNAIDS, 1998a; Annex 2). Some countries in West and Central Africa have been less affected and have been able to maintain low and stable HIV infection rates. This is due, in part, to an early response to the threat of the epidemic in some countries, and in part because a less virulent HIV strain (HIV-2) predominates in these countries. However, there is no single factor or clear-cut group of factors that determines the severity of a country's HIV/AIDS epidemic.

Deaths due to HIV/AIDS in Africa will soon surpass the 20 million Europeans killed by the plague epidemic of 1347-1351 (Decosas and Adrien, 1999).

It is estimated that only 10 percent of the illness and death that this epidemic will bring has been seen. The real impact on people, communities, and economies is still to come. There is no affordable cure or vaccine likely to be available in developing countries for a decade or more. The only options are to prevent further spread of the epidemic, minimize its impact, and provide a caring and compassionate environment for those infected and affected. This crisis calls for an expanded and intensified response to mobilize governments, civil society, the private sector, and the international community to take action, increase resources, and build capacity to sustain efforts to slow the spread of the epidemic.

Figure 1. Global and Sub-Saharan Africa Disease Burden, December 1998 (Millions)

Source: UNAIDS, 1998e.