Transcript Document

The Political Geography
of AIDS
Alan Whiteside
Director,HEARD, University of
KwaZulu-Natal and
Leverhulme Visiting Professor,
Centre for AIDS Research
Southampton University
Outline of presentation
• Physical geography
• Economic geography
• Human geography
–Demography
–Development
HIV prevalence in adults
in sub-Saharan Africa, 1986-2001
1986
1991
20 – 39%
10 – 20%
5 – 10%
1 – 5%
0 – 1%
trend data unavailable
outside region
1996
2001
HIV prevalence in adults
in sub-Saharan Africa, end 2001
2001
20 – 39%
10 – 20%
5 – 10%
1 – 5%
0 – 1%
trend data unavailable
outside region
5
Intro.
Progression of HIV Prevalence in South Africa
Trends Amongst Provincial AnteNatal Clinic Attendees, 1994-2000
2000
1994
Northern Province
Gauteng
Northern Province
Gauteng
Mpumalanga
Mpumalanga
North West
North West
Free State
Free State
KwaZulu-Natal
KwaZulu-Natal
Northern Cape
Northern Cape
Eastern Cape
Eastern Cape
Western Cape
Western Cape
1999
1995
Northern Province
Northern Province
Gauteng
Gauteng
Mpumalanga
Mpumalanga
North West
North West
Free State
Free State
KwaZulu-Natal
KwaZulu-Natal
Northern Cape
Northern Cape
Eastern Cape
Eastern Cape
Western Cape
Western Cape
1998
1996
Northern Province
Gauteng
Northern Province
Mpumalanga
Gauteng
Mpumalanga
North West
North West
Free State
Free State
KwaZulu-Natal
Northern Cape
KwaZulu-Natal
Legend
Northern Cape
HIV Prevalence
Eastern Cape
1997
Eastern Cape
Northern Province
Western Cape
Western Cape
Gauteng
Mpumalanga
North West
1 - 3%
21 - 24%
3 - 6%
24 - 27%
6 - 9%
27 - 30%
9 - 12%
30 - 33%
12 - 15%
33 - 36.2%
15 - 18%
Provinces
18 - 21%
Free State
KwaZulu-Natal
Northern Cape
Developed by Susan Erskine & Lucinda Franklin
The Health Economics & HIV/AIDS Research Division
University of Natal
King George V Avenue
Durban, 4041
Tel: +27 31 260 2592
Fax: +27 31 260 2587
Email: [email protected]
Internet: www.und.ac.za/und/heard
We wish to acknowledge the assistance of staff at
EduAction in the development of this output.
In particular, we wish to thank Daniel Wilson for his
invaluable guidance, time and provision of resources.
Eastern Cape
Western Cape
Source: National HIV and Syphilis Sero-Prevalence
Survey of Women Attending Public AnteNatal
Clinics in South Africa, 1994 - 2000.
Outline of presentation
• Physical geography
• Economic geography
• Human geography
–Demography
–Development
Wealth and HIV
Botswana
South Africa
3000 $
Namibia
2000 $
Swaziland
Cote d’Ivoire
1000 $
Zimbabwe
Per capita
1999
Uganda
Zambia
10
10
20
Adult HIV prevalence end 1999
30
% HIV positive employees in each job band
Debswana Diamond Company (Pty) Ltd
HIV Prevalence by Job Band
35
30.9%
30.7%
30
27.6%
25
20
19.3%
18.8%
D Band
F Band
15
10
5
0
A Band
B Band
C Band
World HIV Chart 2001
30
Zambia
Percent adults living with HIV (log)
20
Kenya
Malawi
10
7
5
Sierra
Leone
Burundi
Ethiopia
Burkina
Faso
3
2
1
0.5
0.3
Zimbabwe
Lesotho
Mozambique
Rwanda
Nigeria
Botswana
Swaziland
Central African Rep.
Namibia
Cameroon
Côte d'Ivoire
Haiti
Togo
Uganda
300 000
South Africa
Angola
Ecuador
Colombia
Nicaragua
Mexico
2 000
Cyprus
Greece
Netherlands
Austria
0.1
1 000
Bahrain
5 000
Canada
Singapore
Uruguay
Armenia
500
100 000
10 000
1 000
Equatorial Guinea
Ghana
Chad Benin
Dominican Rep.
Sudan
Eritrea Cambodia
Guyana
Trinidad & Tobago
Honduras
Belize
Thailand
Mali
Jamaica
Barbados
Suriname
Panama
Estonia
Ukraine
United States
Guatemala
Papua New Guinea
Russia
Brazil
of America
Argentina
El Salvador
Nepal
Portugal
Costa Rica
India
Spain
Venezuela
Malaysia
Switzerland
Senegal
Peru
Latvia
Italy
Madagascar
Belarus
Chile
France
GuineaBissau
0.2
300
AIDS deaths per
year
10 000
20 000
Annual income per person in US dollar (ppp & log)
Iceland
Denmark
Continents
Africa
Americas
Asia
Europe
Arab countries
Luxembourg
Belgium
40 000
World HIV Chart 2001
30
Zambia
Percent adults living with HIV (log)
20
Kenya
Malawi
10
7
5
Sierra
Leone
Ethiopia
3
2
Nigeria
GuineaBissau
Chad
Eritrea
Benin
1
Cameroon
Côte d'Ivoire
Haiti
Togo
Uganda
Angola
Ghana
Sudan
0.5
0.3
Madagascar
0.2
Guyana
Suriname
India
Jamaica
Ukraine
Thailand
Panama
Estonia
Russia
Brazil
Argentina
Costa Rica
El Salvador
Colombia
Nicaragua
Chile
Mexico
1 000
2 000
Asia
Switzerland
Europe
Spain
Italy
Bahrain
Cyprus
France
Greece
Netherlands
Austria
5 000
Canada
Singapore
Uruguay
Armenia
500
United States
of America
Portugal
Malaysia
Latvia
Belarus
Americas
Barbados
0.1
300
Africa
Trinidad
and Tobago
Peru
Ecuador
Continents
Dominican Rep.
Venezuela
Senegal
100 000
10 000
1 000
200?
Guatemala
Papua New Guinea
Nepal
X
South Africa
Equatorial Guinea
Belize
Honduras
300 000
Namibia
Central African Rep.
Cambodia
Mali
Botswana
Swaziland
Mozambique
Rwanda
Burundi
Burkina
Faso
Zimbabwe
Lesotho
AIDS deaths per
year
10 000
20 000
Annual income per person in US dollar (ppp & log)
Arab countries
Iceland
Denmark
Luxembourg
Belgium
40 000
World HIV Chart 2001
30
Zambia
Percent adults living with HIV (log)
20
Kenya
Malawi
10
7
5
Sierra
Leone
Ethiopia
Burkina
Faso
3
2
Nigeria
GuineaBissau
Chad
Eritrea
Benin
Botswana
Swaziland
10
Central African Rep.
Mozambique
Rwanda
Burundi
Zimbabwe
Lesotho
Cameroon
Côte d'Ivoire
Haiti
Togo
Uganda
Cambodia
Angola
Suriname
Papua
New Guinea
Nepal
0.5
Jamaica
Ukraine
India
Argentina
Costa Rica
El Salvador
Colombia
Barbados
Russia
Brazil
Nicaragua
0.2
Americas
Estonia
Peru
Ecuador
Latvia
Belarus
Chile
Mexico
1 000
2 000
Asia
Switzerland
Europe
Spain
Italy
Bahrain
Cyprus
France
Greece
Netherlands
Austria
5 000
Canada
Singapore
Uruguay
Armenia
500
United States
of America
Portugal
Malaysia
0.1
300
Africa
Thailand
Panama
Venezuela
Madagascar
Continents
Trinidad
and Tobago
Guatemala
Senegal
0.3
100 000
10 000
1 000
Dominican Republic
Guyana
Honduras
1
South Africa
Equatorial Guinea
Ghana
Sudan
Belize
Mali
300 000
20 =200
Namibia
X
AIDS deaths per
year
10 000
20 000
Annual income per person in US dollar (purchasing power) Log
Arab countries
Iceland
Denmark
Luxembourg
Belgium
40 000
Outline of presentation
• Physical geography
• Economic geography
• Human geography
–Demography
–Development
8
50
7
40
6
5
30
4
20
3
2
10
1
0
0
Numbers HIV, AIDS sick and HIV deaths
9
Millions
60
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
Total population
Millions
Numbers infected, sick & dead ASSA2000
Total
population
Total HIV
Total
number
AIDS sick
Cumulative
HIV
deaths
All orphans & orphans due to AIDS by
HIV prevalence Uganda
Total Number
HIV Prevalence
2 million
12%
1.5 million
Total Orphans
AIDS Orphans
HIV Prevalence
1 million
6%
0.5 million
0
1985
1990
1995
2000
2005
0
2010 Year
Estimated and projected deaths 15-34, with
and without AIDS in South Africa: 1980-2025
Deaths (thousands)
2,000
Without AIDS
With AIDS
1,600
1,200
800
400
0
1995-2000
1980-1985
2010-2015
1985-1990
2015-2020
2000-2005
1990-1995
2005-2010
2020-2025
Source: UN Department of Economic and Social Affairs (2002) 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
0
10
20
30
40
50
Life expectancy at birth (years)
Source: U.S. Census Bureau, 2000
60
70
Estimated increase in adult death rates relative to
the 1985 rates
W o m en
3 .5 0 0
3 .0 0 0
2 .5 0 0
1994
1996
Ratio
2 .0 0 0
1 9 9 7 /8
1 .5 0 0
1 9 9 8 /9 9
1 9 9 9 /2 0 0 0
1 .0 0 0
0 .5 0 0
0 .0 0 0
15-19
20-24
25-29
30-34
35-39
40-44
Age
45-49
50-54
55-59
60-64
Outline of presentation
• Physical geography
• Economic geography
• Human geography
–Demography
–Development
Changing life expectancy in African countries with
high and low HIV prevalence: 1950-2005
Source: UNAIDS, 2002. Report on the global HIV/AIDS epidemic
Projected Population Structure:
Botswana 20202020
80
75
Males
Females
Projected population
structure in 2020
70
65
Deficits due to AIDS
Age in years
60
55
50
45
40
35
30
25
20
15
10
5
0
Source: US Census Bureau, World Population Profile 2000
140 120 100
80
60
40
20
0
20
40
Population (thousands)
60
80
100 120 140