1. Overview of HIV & AIDS in Africa
Dr Flavia Senkubuge
Specialist Public Health Medicine
University of Pretoria
28 February 2011

2. Introduction HIV&AIDS remains of Public Health concern in Africa
Significant strides made but much still to be achieved

3. Some statistics
Sub-Saharan Africa- more heavily affected by HIV&AIDS compared to any other region of the world:
22.5 million people living with HIV in the region.
2009 around 1.3 million people died from AIDS in sub-Saharan Africa
1.8 million people became infected with HIV
14.8 million children have lost one or both parents to HIV/AIDS

4. Consequences far reaching!
Consequences of the AIDS epidemic are social and economic in:
health sector
Education
Industry
Agriculture
Transport
human resources and the economy in general

5. The triple challenge
Providing health care, antiretroviral treatment, and support to people with HIV-related illnesses.
Reducing the annual toll of new HIV infections
Coping with the impact of AIDS deaths on national development, orphans and other survivors and communities.

6. The prevalences in Africa
HIV prevalence rates and the numbers of people dying from AIDS vary between African countries:
Somalia and Senegal - HIV prevalence is under 1% of the adult population
Namibia, Zambia, Zimbabwe % of adults are infected with HIV
South Africa the HIV prevalence %
Exceeding 20% Botswana (24.8%), Lesotho (23.6%) , Swaziland (25.9%).

7. The prevalences in Africa
Cameroon HIV prevalence - 5.3%
Gabon - 5.2%
Nigeria HIV prevalence - (3.6%) compared to the rest of Africa BUT 3.3 million people living with HIV
HIV prevalence in East Africa more than 5% in Uganda , Kenya, Tanzania
Rates of new HIV infections in sub-Saharan Africa appear to have peaked in the late 1990s
HIV prevalence declined slightly, although remains at high level.

8. Impact HIV&AIDS in Africa
Life expectancy:
Average life expectancy in sub-Saharan Africa years
Households:
Loss of income
Home based care
Orphans
Healthcare:
Increased demand- strain
Affecting health care workers

9. Impact HIV&AIDS in Africa
Schools
Affected severely
Play role in education and support of HIV
Productivity:
Labour (15-49)– slow of economy
Replacement due to ill-health
Economic growth and development
Severely affected therefore affecting Africa’s ability to cope

10. HIV Prevention
Large scale HIV prevention initiatives – reduce scale of epidemics e.g Senegal, Uganda, Kenya, Burkina faso
Condom use and 2005, eight out of eleven countries in sub-Saharan Africa reported an increase in condom use.
Consideration (condoms)is cultural beliefs and norms and desire to have children
Distribution of condoms to countries in sub-Saharan Africa has also increased: in 2004 the number of condoms provided to this region by donors was the equivalent of 10 for every man

11. HIV Prevention
Provision of VCT – awareness of status leads to prevention in transmission and possible accesess to treatment ,care and support e.g Burkina Faso, Kenya, Tanzania, Malawi
Mother-to-child transmission of HIV
,000 children in sub-Saharan Africa became infected with HIV
Without interventions, there is a 20-45% chance that an HIV-positive mother will pass the virus on to her child
With antiretroviral drugs, this risk can be significantly reduced.

12. Treatment and care
Antiretroviral drugs (ARVs) - significantly delay the progression of HIV to AIDS and allow people living with HIV to live relatively normal, healthy lives
Poor health systems – reduced delivery
Not enough health care workers
4 in 10 not receiving ARVs
Success
number of people receiving ARVs in Africa doubled in alone
end of 2009, almost 4 million people in Africa were receiving antiretroviral treatment

13. Treatment and care Initiatives: VCT Nutrition Follow up counselling
World Health Organisation (WHO) initiated the ‘3 by 5’ programme - three million people in developing countries on ARVs by the end of 2005.
Latest international target, ‘All by 2010’- universal access to treatment by 2010.
VCT
Nutrition
Follow up counselling
Protection from stigma and discrimination
Treatment of STI
Prevention and treatment of opportunistic infection

14. Way forward International support Domestic commitment
Increased funding
Domestic commitment
Increased domestic expenditure
Reducing stigma and discrimination
Empowering women and girls
HOW FAR IS YOUR COUNTRY ( DISCUSSION) – 15 mins

15. Conclusion
Sustained and committed efforts are necessarily not only from international partners but from countries themselves if the fight against HIV& AIDS is to be won!

16. THANK YOU !

17. References UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic'
WHO/UNAIDS/UNICEF (2010) 'Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector'
UNAIDS (2006) 'Report on the global AIDS epidemic' Chapter 7: Treatment and care
The Global Fund (March 2009), 'Scaling up for impact: Results report'
Office of the Global AIDS Coordinator, U.S. Department of State (2009, May), 'Making a difference: funding'
Lu Chunling et al (2010, April 9th) 'Public financing of health in developing countries: a cross-national systematic analysis' Lancet 975(9723)
International AIDS Society (2010) 'Universal Access: Rights Here, Right Now'
UNAIDS (2008) 'Report on the Global AIDS Epidemic'
UNICEF (2009), ‘Preventing HIV with young people: the key to tackling the epidemic’