Transcript Funding ART programs

AIDS
impact
Wim Van Damme
Department of Public Health
ITM, November 2006
AIDS = political issue
Why?
People living with HIV/AIDS
(estimation end 2003)
Eastern Europe
& Central Asia
Western Europe
North America
790 000 – 1.2 million
520 000 – 680 000
1.2 – 1.8 million
East Asia & Pacific
700 000 – 1.3 million
North Africa & Middle East
Caribbean
350 000 – 590 000
470 000 – 730 000
South
& South-East Asia
4.6 – 8.2 million
Latin America
1.3 – 1.9 million
Sub-Saharan Africa
25.0 – 28.2
million
Total: 34 – 46 million
Australia
& New Zealand
12 000 – 18 000
A global view of HIV infection
38.6 million people [33.4‒46.0 million] living with HIV, 2005
2.4
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 Africa, 2005
2.5
Millions
People living with HIV/AIDS
in sub-Saharan Africa, 1980-2001
30
25
20
15
10
5
0
1980
1983
Source: UNAIDS, 2002
1986
1989
1992
1995
1998
2001
Thousands
People who died from HIV/AIDS
in sub-Saharan Africa, 1980-2001
2,500
2,000
1,500
1,000
500
0
1980
1983
Source: UNAIDS, 2002
1986
1989
1992
1995
1998
2001
HIV prevalence rate,
adults 15-49 (%), end 2003
Selected countries in Southern Africa
Swaziland
37-40%
Botswana
36-39%
Zimbabwe
22-28%
Namibia
18-25%
South-Africa
19-25%
Zambia
14-20%
Malawi
11-18%
Mozambique
9-16%
Deaths in South-Africa
(a model for of future AIDS and non-AIDS Deaths)
1200000
number of deaths
Other deaths
AIDS Deaths
1000000
800000
600000
400000
200000
0
1995
2000
2005
year
2010
2015
Deaths at ages 15-34
South Africa: 1980-2025
(Estimated and projected )
Deaths (thousands)
2,000
1,600
Without AIDS
With AIDS
1,200
800
400
0
1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 2020-2025
AIDS’ Toll on Population Structure, Botswana
Population Structure in 2020 (Projected)
Thousands
Age
80+
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
150
Males
100
Females
50
0
With AIDS
50
Without AIDS
Source: U.S. Census Bureau demographic estimates and projections, 2002.
100
150
South Africa’s Population With and Without AIDS
Millions
70
60
50
40
30
20
10
0
1985
2000
2010
2020
2030
Without AIDS
With AIDS
Source: U.S. Census Bureau demographic estimates and projections, 2002.
2040
2050
Changes in life expectancy
in selected African countries
with high and low HIV prevalence: 1950-2005
65
Life expectancy (years)
60
with high HIV prevalence:
Zimbabwe
South Africa
Botswana
55
50
45
with low HIV prevalence:
Madagascar
Senegal
Mali
40
35
30
1950–1955- 1960- 1965- 1970- 1975- 1980- 1985- 1990- 1995- 20001955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
Lifetime risk of AIDS death for 15-year-old boys,
(assuming unchanged or halved risk of becoming infected with HIV)
risk halved over next 15 years
current level of risk maintained
100%
Risk of dying of AIDS
Botswana
80%
Zimbabwe
South Africa
Zambia
60%
Zimbabwe
South Africa
Zambia
Kenya
40%
20%
0%
Botswana
Côte d’Ivoire
Cambodia
Kenya
Côte d’Ivoire
Burkina
Faso
Cambodia
Burkina Faso
0%
5%
10%
15%
20%
25%
30%
35%
Current adult HIV prevalence rate
Source: Zaba B, 2000 (unpublished data)
40%
Reduction in production in a household
with an AIDS death, Zimbabwe
Crops
•
•
•
•
•
Reduction in output
Maize
61%
Cotton
47%
Vegetables
49%
Groundnuts
37%
Cattle owned
29%
Source: Stover & Bollinger, 1999
AIDS  famine??
Lancet article: October 2003
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
AIDS orphans in South Africa
2000000
1500000
1000000
500000
0
Disease
Dead
Orphans
Malawi 2004
Malawi 2006