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

7. AIDS = political issue Why?

8. People living with HIV/AIDS (estimation end 2003) Total: 34 – 46 million Western Europe 520 000 – 680 000 North Africa & Middle East 470 000 – 730 000 Sub-Saharan Africa 25.0 – 28.2 million Eastern Europe & Central Asia 1.2 – 1.8 million South & South-East Asia 4.6 – 8.2 million Australia & New Zealand 12 000 – 18 000 North America 790 000 – 1.2 million Caribbean 350 000 – 590 000 Latin America 1.3 – 1.9 million East Asia & Pacific 700 000 – 1.3 million

9. A global view of HIV infection 38.6 million people [33.4 ‒ 46.0 million] living with HIV, 2005 2.4

10. 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 19962001

11. HIV prevalence (%) in adults in Africa, 2005 2.5

12. People living with HIV/AIDS in sub-Saharan Africa, 1980-2001 0 5 10 15 20 25 30 19801983198619891992199519982001 Millions Source: UNAIDS, 2002

13. People who died from HIV/AIDS in sub-Saharan Africa, 1980-2001 0 500 1,000 1,500 2,000 2,500 19801983198619891992199519982001 Thousands Source: UNAIDS, 2002

14. HIV prevalence rate, adults 15-49 (%), end 2003 Selected countries in Southern Africa Swaziland37-40% Botswana36-39% Zimbabwe22-28% Namibia18-25% South-Africa19-25% Zambia14-20% Malawi11-18% Mozambique 9-16% 9-16%

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

16. Deaths at ages 15-34 South Africa: 1980-2025 (Estimated and projected ) 0 400 800 1,200 1,600 2,000 Deaths (thousands) Without AIDS With AIDS 1980-19851985-19901990-19951995-20002000-20052005-20102010-20152015-20202020-2025

17. Population Structure in 2020 (Projected) Thousands MalesFemales With AIDSWithout AIDS Age 80+ 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 AIDS’ Toll on Population Structure, Botswana Source: U.S. Census Bureau demographic estimates and projections, 2002.

18. Millions South Africa’s Population With and Without AIDS Source: U.S. Census Bureau demographic estimates and projections, 2002.

19. Changes in life expectancy in selected African countries with high and low HIV prevalence: 1950-2005 with high HIV prevalence: Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali 30 35 40 45 50 55 60 65 Life expectancy (years) 1950– 1955 1955- 1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980 1980- 1985 1985- 1990 1990- 1995 1995- 2000 2000- 2005

20. Lifetime risk of AIDS death for 15-year-old boys, (assuming unchanged or halved risk of becoming infected with 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 Faso Cambodia Côte d’Ivoire Kenya South Africa Zambia Zimbabwe Botswana 0% 20% 40% 60% 80% 100% 0%5%10%15%20%25%30%35% 40% Risk of dying of AIDS risk halved over next 15 yearscurrent level of risk maintained

21. Reduction in production in a household with an AIDS death, Zimbabwe Source: Stover & Bollinger, 1999 CropsReduction in output Maize Cotton Vegetables Groundnuts Cattle owned 49% 37% 29% 47% 61%

22. AIDS  famine?? Lancet article: October 2003

23. AIDS orphans in South Africa

24. Disease

25. Dead

28. Orphans

29. Malawi 2004

30. Malawi 2006