HIV/AIDS in Africa

With the economic and political flowering known as the African Renaissance continuing its spread across the continent, HIV/AIDS poses the single greatest threat to Africa's efforts to achieve its full potential.

The pandemic is "a threat that puts in the balance the future of nations," South African president Nelson Mandela said in a February 1997 address to the World Economic Forum. "AIDS kills those on whom society relies to grow the crops, work in the mines and factories, run the schools and hospitals and govern countries... It creates new pockets of poverty when parents and breadwinners die and children leave school earlier to support the remaining children."

Indeed, since the start of the pandemic, some 11.5 million people in sub-Saharan Africa have died -- the equivalent of the combined populations of New York City and Los Angeles. One quarter of those deaths were among children. That toll, representing 83 percent of all AIDS deaths worldwide, has been exacted in a region that accounts for just one tenth of the world's population. And sub-Saharan Africa is home to an estimated two thirds of the 34 million people currently living with HIV/AIDS worldwide.

Nor is there any sign that the scourge of HIV/AIDS is abating in the region. In 1998, sub-Saharan Africa was home to seven out of 10 people newly infected with HIV, according to UNAIDS/World Health Organization estimates; among children, the proportion was nine out of 10. The region accounted for four fifths of the world's AIDS deaths in 1998. Adding to the problem is the fact that people in southern Africa are infected predominantly with a singularly aggressive form of HIV -- subtype C -- which is more easily transmitted, and causes sickness faster and death sooner.

THE IMPACT ON WOMEN AND CHILDREN

African women and children have been particularly hard hit by HIV/AIDS. At least half of all infected adults are women ages 15-49; in some countries more than 25 percent of pregnant women are infected. At least 95 percent of all AIDS orphans have been African.

HIV/AIDS IN SOUTH AFRICA, BOTSWANA, NAMIBIA, LESOTHO AND SWAZILAND

Among the world's countries hardest hit by HIV/AIDS are South Africa, Botswana, Namibia, Lesotho and Swaziland -- the nations that are the focus of Bristol-Myers Squibb's SECURE THE FUTURE program. In Botswana, Namibia and Swaziland, an estimated one in four people ages 15-49 are living with HIV/AIDS, most of them undiagnosed. In Botswana, where a quarter of all adults are infected with HIV/AIDS, life expectancy has dropped from 61 five years ago to 47 today, and by the year 2010, the figure is projected to fall below 38. Without HIV/AIDS, it would have been over 66. In Lesotho, life expectancy in 2010 is projected at under 45, compared with over 65 were it not for the pandemic; in Namibia, the figures are 38 and 70; in South Africa, 48 and 68; and in Swaziland, 37 and 63.

The economic implications of this crisis are staggering. In South Africa alone, HIV/AIDS is expected to cost the country 1 percent of its gross domestic product by 2005, and to consume three quarters of the nation's health budget.

The following are brief summaries of the HIV/AIDS pandemic in each of the five countries:

Source: UNAIDS 1997

South Africa: In a country of over 43 million people, an estimated 2.9 million (7 percent) were infected with HIV as of year-end 1997. Of those, half were women ages 15-49. Among pregnant women, 16 percent were HIV-positive. There were 180,000 living children who had been orphaned by the disease, and another 80,000 children infected with HIV.

Botswana: In a country of 1.5 million people, 190,000 (13 percent) were infected with HIV as of year-end 1997. Of these, just under half (93,000) were women ages 15-49. More than a third of pregnant women were HIV-positive. There were 25,000 living children who had been orphaned by the disease, and another 7,300 children infected by HIV.

Namibia: In a country of 1.6 million people, 150,000, or nearly one in 10, were infected with HIV as of year-end 1997. Half of those were women ages 15-49. Roughly a quarter of pregnant women were HIV-positive. There were 7,300 living children who had been orphaned by the disease, and another 5,000 children infected with HIV.

Lesotho: In a country of 2.1 million people, 85,000 (4 percent) were infected with HIV as of year-end 1997. Of those, 41,000, or just under half, were women ages 15-49. One in five pregnant women were HIV-positive. There were 8,500 living children who had been orphaned by the disease, and another 3,100 children infected with HIV.

Swaziland: In a country of just under a million people, nearly 9 percent (81,000) were infected with HIV as of year-end 1997. Of those, more than half (41,000) were women ages 15-49. More than a quarter of pregnant women were HIV-positive. There were 7,200 living children who had been orphaned by the disease and another 2,800 children infected with HIV.

It is widely agreed that only preventive measures, brought about by education, can halt the HIV/AIDS pandemic in these countries and others like them.

"Nothing can prevent infection except our own behavior," said Thabo Mbeki, South Africa's vice president, in a Declaration against the disease that was broadcast on the country's major television and radio networks in October 1998. "The power to defeat the spread of HIV/AIDS lies in our partnership ­ as youth, as women and men, as businesspeople, as workers, as religious people, as parents and teachers, as students, as healers, as farmers and farm workers, as the unemployed and the professional, as the rich and the poor ­ in fact, all of us."

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