HIV/AIDS in sub-Saharan Africa July 2002

Trends in the HIV/AIDS Epidemic

HIV prevalence in adults in sub-Saharan Africa, 1986-2001 1991 20 – 39% 10 – 20% 5 – 10% 1 – 5% 0 – 1% trend data unavailable 1996 2001 outside region

Number of people living with HIV/AIDS in sub-Saharan Africa, 1980-2001 30 Millions 25 20 15 10 5 1980 1983 1986 1989 1992 1995 1998 2001 Source: UNAIDS, 2002

Number of people who died from HIV/AIDS in sub-Saharan Africa, 1980-2001 2,500 Thousands 2,000 1,500 1,000 500 1980 1983 1986 1989 1992 1995 1998 2001 Source: UNAIDS, 2002

Percentage of workforce lost to AIDS by 2005 and 2020 in selected African countries 50 2005 2020 40 30 % 20 10 Nigeria Togo Botswana Ethiopia Cameroon Zimbabwe Cote d’Ivoire Mozambique South Africa Guinea-Bissau Central African Republic United Rep. of Tanzania Sources: ILO (2000) POPILO population and labour force projection; UN Department of Economic and Social Affairs, Population Division (1998) World Population Prospects: the 1998 Revision

Projected population structure with and without the AIDS epidemic, Botswana, 2020 80 Projected population structure in 2020 75 Males Females 70 65 Deficits due to AIDS 60 55 Age in years 50 45 40 35 30 25 20 15 10 5 140 120 100 80 60 40 20 20 40 60 80 100 120 140 Population (thousands) Source: US Census Bureau, World Population Profile 2000

Increase in mortality among men between 15 and 60, selected African countries, 1986-1997 80 estimated for 6 years before survey 70 estimated for year of survey 60 50 Probability of dying from all causes 40 30 20 10 Tanzania 1996 Malawi 1992 Zimbabwe 1994 Uganda 1995 Zambia 1996-97 Source: Timaeus I, AIDS 1998, 12 (suppl): S15-S27

Estimated impact of AIDS on under-5 child mortality rates, selected African countries, 2010 250 Deaths per 1,000 live births 200 Without AIDS With AIDS 150 100 50 Botswana Kenya Malawi Tanzania Zambia Zimbabwe Source: US Census Bureau

Changes in life expectancy in selected African countries with high and low HIV prevalence: 1950 - 2005 30 35 40 45 50 55 60 65 Life expectancy (years) with high HIV prevalence: Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali 1950– 1955 1955- 1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980 1980- 1985 1985- 1990 1990- 1995 1995- 2000 2000- 2005 Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision.

Predicted loss in life expectancy due to HIV/AIDS in children born in 2000 Predicted life expectancy Loss in life expectancy due to HIV/AIDS Botswana Zimbabwe South Africa Kenya Zambia Côte d'Ivoire Rwanda Mozambique Haiti Cambodia 10 20 30 40 50 60 70 Life expectancy at birth (years) Source: U.S. Census Bureau, 2000

Leading causes of death in Africa, 2000 25.0 22.6 20.0 15.0 % of Total 10.1 9.1 10.0 6.7 5.5 4.3 3.6 3.1 2.9 5.0 2.3 0.0 HIV/AIDS Malaria Perinatal conditions Tuber culosis Cerebro vascular disease Lower respiratory infections Diarrhoeal disease Measles Ischaemic Heart disease Maternal conditions Source: The World Health Report 2001, WHO

Reduction in production in a household with an AIDS death, Zimbabwe Crops Reduction in output • Maize Cotton Vegetables Groundnuts Cattle owned 49% 37% 29% 47% 61% • • • • Source: Stover & Bollinger, 1999

Estimated and projected deaths at ages 15-34, with and without AIDS in South Africa: 1980-2025 2,000 Without AIDS 1,600 With AIDS 1,200 Deaths (Thousands) 800 400 1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 2020-2025 Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision.

Reduction in size of primary- school-age population by 2010, in selected African countries 30.0 25.0 20.0 % reduction 15.0 10.0 5.0 0.0 Zimbabwe Zambia Kenya Uganda Source: World Bank, 2000

Reduction in life expectancy compared to the ‘no AIDS’ scenario in selected countries: 2000-2005 Botswana Zimbabwe Swaziland South Africa Kenya Mozambique Côte d'Ivoire Cameroon Burkina Faso Haiti Guyana Bahamas Cambodia Dominican Rep. Angola Myanmar Thailand 5 10 15 20 25 30 35 40 Number of years Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision.

who do not know that a HIV-infected person Percentage of 15-19 girls who do not know that a HIV-infected person may look healthy, 1994-1999 100 90 80 70 60 Percentage who do not know 50 40 30 20 10 Chad Niger Nepal Lesotho Mali Benin Eritrea Turkey Togo Kenya Peru Malawi Haiti Zambia Uganda Brazil Madagascar Bangladesh Cambodia Mozambique Guatemala Mongolia Viet Nam South Africa Cape Verde Cameroon Tanzania Côte d'Ivoire Romania Comoros Zimbabwe Papua New Guinea Dominican Republic Central African Republic Sources: UNICEF, DHS surveys and other nationwide surveys, 1994-99.

Public expenditure on health as percentage of general government expenditure in African countries: 1998 18.0 15.0 Abuja Target = 15.0% 12.0 % Expenditure on health 9.0 6.0 3.0 0.0 Guinea-Bissau* Central African Republic* Libyan Arab Jamahiriya Djibouti Equatorial Guinea Sao Tome and Principe* Burundi Morocco Cape Verde Congo Togo Egypt Sudan Eritrea Somalia Nigeria Botswana Niger* Cameroon* Cote d'Ivoire Benin* Angola Gabon Tunisia Mauritius Sierra Leone* Liberia South Africa Madagascar* Kenya* Seychelles Swaziland Mali* Comoros Ethiopia* Mauritania* Burkina Faso Lesotho Algeria Ghana* Uganda* Mozambique* * Heavily indebted, poor countries Gambia Namibia Chad* Zambia* Guinea* Senegal* DR Congo* Rwanda* Malawi* UR Tanzania Zimbabwe Source: WHO, World Health Report 2001