adf: impact of hiv/aids and governance by prof. alan whiteside commissioner chga the epidemic and...
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ADF: Impact of HIV/AIDS and Governance
by
Prof. Alan Whiteside
Commissioner CHGA
The Epidemic and its Consequences for Africa
Outline of Presentation
• Understanding HIV/AIDS
– The Numbers
– Timeframe
– Impact
• Conclusions
HIV prevalence in adults in sub-Saharan Africa, end 2003
20 – 39%
10 – 20%
5 – 10%
1 – 5%
0 – 1%
No data available
outside region
2003
Source: UNAIDS, 2002.
National trends in HIV prevalenceWomen attending Public Antenatal Clinics
0
5
10
15
20
25
30
35
40
45
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
% H
IV p
os
itiv
e
Botswana
Namibia
South Africa
Swaziland
HIV prevalence rates among pregnant women attending
antenatal clinics in urban sites in Cameroon: 1989-2000
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
198919901991199219931994199519961997199819992000
Bamenda
Limbe
Yaounde
Garoua
% H
IV-
po
siti
ve
Source: National AIDS Programme, Cameroon (1989-2000). Data compiled by the US Census Bureau
Epidemic Curves, HIV
27Aug01 -Report I: Epidem’gy & Lit. p. 27
T1 T2 Time
Numbers
A1
A2
HIV prevalence
A
B
Epidemic Curves, HIV and AIDS
27Aug01 -Report I: Epidem’gy & Lit. p. 27
T1 T2 Time
Numbers
A1
A2
HIV prevalence
AIDS - cumulative
B1
A
B
Epidemic Curves, HIV, AIDS & Impact
27Aug01 -Report I: Epidem’gy & Lit. p. 27
T1 T2 Time
Numbers
A1
A2
HIV prevalence
B1
A
B
AIDS - cumulative
Impact
The Three Challenges
• Prevention
• Appropriate care and treatment
• Impact mitigation
But remember this is a long wave epidemic
Outline of Presentation
• Understanding HIV/AIDS
– The Numbers
– Timeframe
– Impact
• Conclusions
All orphans and orphans due to AIDS by HIV prevalence, Uganda, by year
1985 1990 1995 2000 2005 2010 Year0
0.5 million
1 million
1.5 million
2 million
Total Number
0
6%
12%
HIV Prevalence
Total OrphansAIDS Orphans
HIV Prevalence
Estimated and projected deaths 15-34, with and without AIDS in South Africa: 1980-2025
Source: UN Department of Economic and Social Affairs (2002) World Population Prospects, the 2000 Revision
0
400
800
1,200
1,600
2,000
Death
s (
thou
san
ds)
1980-19851985-1990
1990-1995
1995-20002000-2005
2005-2010
2010-20152015-2020
2020-2025
Without AIDS With AIDS
Outline of Presentation
• Understanding HIV/AIDS
– The Numbers
– Timeframe
– Impact
• Conclusions
Estimated increase in adult death rates relative to the 1985 rates
Women
0.000
0.500
1.000
1.500
2.000
2.500
3.000
3.500
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
Age
Rati
o
1994
1996
1997/8
1998/99
1999/2000
Mortality in Swaziland
0
20
40
60
80
100
120
140
160
180
200
95(1) 96(1) 97(1) 98(1) 99(1)
De
ath
s fo
r fi
rst
six
mo
nth
s o
f e
ach
ye
ar
0-15
16-25
26-40
41-55
55+
17
Declining life expectancy Changes in life expectancy in selected African countries with
high and low HIV prevalence: 1950-2005
Source: UNAIDS, 2002. Report on the global HIV/AIDS epidemic
Percent of children under age 15 that are orphansby year, region and cause, 1990-2010
Percentage of children under 15 years who are orphaned by year, region and cause
0
2
4
6
8
10
12
14
16
1990 1995 2001 2005 2010 1990 1995 2001 2005 2010 1990 1995 2001 2005 2010
Non-AIDS AIDS
Sub-Saharan Africa Asia Latin America
Source: Children on the Brink, 2002
By 2010 orphans will account for 15-25% of all children in 12 countries in SAA
Source: UNICEF
Outline of Presentation
• Understanding HIV/AIDS
– The Numbers
– Timeframe
– Impact
• Conclusions: AIDS and Governance
By-elections in Zambia (number)source IDASA
0
20
40
60
80
100
120
1964-1984 1985 - 2003
total due to deathresignation/expulsion
Non-participation by young women
Non-registration
HIV prevalence_
_
+
+
Pearson’s r = .7
Level of analysis: the nine provinces
Loss of Friends or Relatives to AIDS (Afrobarometer)
8574 71
66 61 57
3627
18 1811
0102030405060708090
% Know Someone Who Has Died of AIDS
ADF: Impact of HIV/AIDS and Governance
by
Prof. Alan Whiteside
Commissioner CHGA
The Epidemic and its Consequences for Africa