AIDS impact Wim Van Damme Department of Public Health ITM, November 2006.

AIDSAIDSimpactimpact

Wim Van DammeWim Van Damme

Department of Public HealthDepartment of Public Health

ITM, November 2006ITM, November 2006

AIDS = political issueAIDS = political issue

Why?Why?

People living with HIV/AIDS(estimation end 2003)

Total: 34 – 46 million

Western Europe520 000 – 680 000520 000 – 680 000

North Africa & Middle East470 000 – 730 000470 000 – 730 000

Sub-Saharan Africa25.0 – 28.2 25.0 – 28.2

millionmillion

Eastern Europe & Central Asia1.2 – 1.8 million1.2 – 1.8 million

South & South-East Asia

4.6 – 8.2 million4.6 – 8.2 million

Australia & New Zealand

12 000 – 18 00012 000 – 18 000

North America790 000 – 1.2 million790 000 – 1.2 million

Caribbean350 000 – 590 000350 000 – 590 000

Latin America1.3 – 1.9 million1.3 – 1.9 million

East Asia & Pacific700 000 – 1.3 million700 000 – 1.3 million

A global view of HIV infectionA global view of HIV infection38.6 million people [33.4‒46.0 million] living with HIV, 2005

2.4

HIV prevalence in adults in sub-Saharan Africa, 1986-

2001

20 – 39%

10 – 20%

5 – 10%

1 – 5%

0 – 1%

trend data unavailable

outside region

1986 1991

1996 2001

HIV prevalence (%) in adults in Africa, 2005HIV prevalence (%) in adults in Africa, 2005

2.5

People living with HIV/AIDS in sub-Saharan Africa, 1980-2001

0

5

10

15

20

25

30

1980 1983 1986 1989 1992 1995 1998 2001

Mill

ion

s

Source: UNAIDS, 2002

People who died from HIV/AIDSin sub-Saharan Africa, 1980-2001

0

500

1,000

1,500

2,000

2,500

1980 1983 1986 1989 1992 1995 1998 2001

Th

ou

san

ds

Source: UNAIDS, 2002

HIV prevalence rate,HIV prevalence rate,adults 15-49 (%), end 2003adults 15-49 (%), end 2003

Selected countries in Southern AfricaSelected countries in Southern Africa

SwazilandSwaziland 37-40%37-40%

BotswanaBotswana 36-39%36-39%

ZimbabweZimbabwe 22-28%22-28%

NamibiaNamibia 18-25%18-25%

South-AfricaSouth-Africa 19-25%19-25%

ZambiaZambia 14-20%14-20%

MalawiMalawi 11-18%11-18%

MozambiqueMozambique 9-16%9-16%

Deaths in South-AfricaDeaths in South-Africa(a model for of future AIDS and non-AIDS Deaths)(a model for of future AIDS and non-AIDS Deaths)

0

200000

400000

600000

800000

1000000

1200000

1995 2000 2005 2010 2015

year

num

ber o

f dea

ths

Other deaths AIDS Deaths

Deaths at ages 15-34Deaths at ages 15-34South Africa: 1980-2025South Africa: 1980-2025

(Estimated and projected )(Estimated and projected )

0

400

800

1,200

1,600

2,000

Dea

ths

(th

ou

san

ds)

Without AIDS

With AIDS

1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 2020-2025

Population Structure in 2020 (Projected)Thousands

150 100 50 0 50 100 150

Males Females

With AIDS Without AIDS

Age80+757065605550454035302520151050

AIDS’ Toll on Population Structure, BotswanaAIDS’ Toll on Population Structure, Botswana

Source: U.S. Census Bureau demographic estimates and projections, 2002.

Millions

South Africa’s Population With and Without AIDSSouth Africa’s Population With and Without AIDS

0

10

20

30

40

50

60

70

1985 2000 2010 2020 2030 2040 2050

With AIDS Without AIDS

Source: U.S. Census Bureau demographic estimates and projections, 2002.

Changes in life expectancyChanges in life expectancyin selected African countries in selected African countries

with high and low HIV prevalence: 1950-2005with high and low HIV prevalence: 1950-2005

with high HIV prevalence:ZimbabweSouth AfricaBotswana

with low HIV prevalence:MadagascarSenegalMali

30

35

40

45

50

55

60

65

Lif

e e

xp

ecta

ncy

(y

ears

)

1950– 1955

1955- 1960

1960-1965

1965-1970

1970-1975

1975-1980

1980-1985

1985-1990

1990-1995

1995-2000

2000-2005

Lifetime risk of AIDS death for 15-year-old Lifetime risk of AIDS death for 15-year-old boys, boys,

(assuming unchanged or halved risk of becoming infected with (assuming unchanged or halved risk of becoming infected with HIV)HIV)

Source: Zaba B, 2000 (unpublished data)

Current adult HIV prevalence rate

Burkina Faso

Cambodia

Côte d’Ivoire

Kenya

South Africa

Zambia

Zimbabwe

Botswana

Burkina FasoCambodia

Côte d’Ivoire

Kenya

South AfricaZambia

Zimbabwe

Botswana

0%

20%

40%

60%

80%

100%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Ris

k o

f d

yin

g o

f A

IDS

risk halved over next 15 years current level of risk maintained

Reduction in production in a Reduction in production in a household household

with an AIDS death, Zimbabwewith an AIDS death, Zimbabwe

Source: Stover & Bollinger, 1999

•

•

•

•

•

Crops Reduction in output

Maize

Cotton

Vegetables

Groundnuts

Cattle owned

49%

37%

29%

47%

61%

AIDS AIDS famine?? famine??Lancet article: October 2003Lancet article: October 2003

AIDS orphans in South Africa

Disease

Dead

Orphans

Malawi 2004Malawi 2004

Malawi 2006Malawi 2006