1. Unit 2: Impact of the HIV/AIDS Epidemic on Sub-Saharan Africa #1-2-1

2. Warm Up Questions: Instructions v Take five minutes now to try the Unit 2 warm up questions in your manual. v Please do not compare answers with other participants. v Your answers will not be collected or graded. v We will review your answers at the end of the unit. #1-2-2

3. What You Will Learn v By the end of this unit you should be able to: © describe the impact of HIV/AIDS on individuals and families © describe the impact of HIV/AIDS on sustainable development #1-2-3

4. Source: World Health Organization, 2003 #1-2-4 Figure 2.1. Leading Causes of Death in Sub-Saharan Africa, 2003 Note: Additional information can be found in Figure 2.2 in the text.

5. Ages Most Affected v The high mortality rate affects families as well as individuals. v For example, in Botswana, AIDS-related deaths will change the population structure to a society where adolescents predominate instead of children. This results in the so- called ‘chimney effect.’ #1-2-5

6. #1-2-6 Figure 2.3. Projected Population Structures, Botswana: 2020 Source: US Census Bureau, 2000

7. Infant and Child Mortality v In regions most impacted by the HIV epidemic, infant mortality rates may be up to 70% higher than they would have been without HIV. v For example, the infant mortality rate in Zimbabwe would have been 24 per 1000 live births in 2010 without HIV. But with HIV, it will be about 54 per 1000. v This threatens to reverse the recent gains made by child survival programmes. #1-2-7

8. Year #1-2-8 Figure 2.4. Changes in Life Expectancy, 1950-2005

9. Orphans v Eleven million children younger than 15 years of age in sub-Saharan Africa have lost one or both parents to AIDS. v Young children have to work to support their families, including some girls who feel compelled to undertake sex work. v Grandparents and the elderly are also now left to support families when the younger adults die. #1-2-9

10. Effect of HIV on the Workforce v Largest cost to employers is indirect: © absenteeism © loss of productivity © training replacements © increasing benefits payments #1-2-10

11. #1-2-11 Figure 2.5. Percentage of Workforce lost to AIDS

12. Pressure on Health Services v In some urban areas, up to half of hospital beds are occupied by people with HIV/AIDS. v This leaves an insufficient number of beds for patients with other diseases. #1-2-12

13. In Summary v The burden of HIV/AIDS in sub-Saharan Africa has a significant impact on many aspects of life. v For example, the deaths of infants and young adults will disrupt family structures. v The workforce will also be greatly reduced, and healthcare services will be strained. v These will all have negative effects on development. #1-2-13

14. Warm Up Review v Take a few minutes now to look back at your answers to the warm up questions at the beginning of the unit. v Make any changes you want to. v We will discuss the questions and answers in a few minutes. #1-2-14

15. Answers to Warm Up Questions 1.The ‘chimney effect’ refers to the population loss due to HIV that results in the predominance of which part of the population? a. young children b. adolescents c. adults d. the elderly #1-2-15

16. Answers to Warm Up Questions, Cont. 1.The ‘chimney effect’ refers to the population loss due to HIV that results in the predominance of which part of the population? a. young children b. adolescents c. adults d. the elderly #1-2-16

17. Answers to Warm Up Questions, Cont. 2. In some areas, up to ___% of hospital beds are occupied by AIDS patients, leaving insufficient room for patients with other diseases. #1-2-17

18. Answers to Warm Up Questions, Cont. 2. In some areas, up to 50% of hospital beds are occupied by AIDS patients, leaving insufficient room for patients with other diseases. #1-2-18

19. Answers to Warm Up Questions, Cont. 3. True or false? With the death of parents, some families are now headed by children as young as 10 years old or by grandparents. #1-2-19

20. Answers to Warm Up Questions, Cont. 3. True or false? With the death of parents, some families are now headed by children as young as 10 years old or by grandparents. True #1-2-20

21. Answers to Warm Up Questions, Cont. 4. Which country stands to lose the largest percentage of its workforce to AIDS, with an estimated 30% dying from the disease by 2020? #1-2-21

22. Answers to Warm Up Questions, Cont. 4. Which country stands to lose the largest percentage of its workforce to AIDS, with an estimated 30% dying from the disease by 2020? Botswana #1-2-22

23. Small Group Discussion: Instructions v Get into small groups to discuss these questions. v Choose a speaker for your group who will report back to the class. #1-2-23

24. Small Group Reports v Select one member from your group to present your answers. v Discuss with the rest of the class. #1-2-24

25. Case Study: Instructions v Try this case study individually. v We’ll discuss the answers in class. #1-2-25

26. Case Study Review v Follow along as we go over the case study in class. v Discuss your answers with the rest of the class. #1-2-26

27. Questions, Process Check v Do you have any questions on the information we just covered? v Are you happy with how we worked on Unit 2? v Do you want to try something different that will help the group? #1-2-27