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 1991 20 – 39% 10 – 20% 5 – 10% 1 – 5% 0 – 1% trend data unavailable 1996 2001 outside region

HIV prevalence in adults in sub-Saharan Africa, end 2001 20 – 39% 10 – 20% 5 – 10% 1 – 5% 0 – 1% trend data unavailable outside region

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Intro.

Outline of presentation Physical geography Economic geography Human geography Demography Development

Wealth and HIV Adult HIV prevalence end 1999 Botswana South Africa 3000 $ Namibia 2000 $ Swaziland 1000 $ Cote d’Ivoire Zimbabwe Uganda Zambia Per capita 1999 10 10 20 30 Adult HIV prevalence end 1999

World HIV Chart 2001 Percent adults living with HIV (log) AIDS deaths per year Zimbabwe Lesotho Botswana 30 Swaziland Zambia 300 000 20 Kenya Namibia Malawi Central African Rep. South Africa 100 000 Mozambique Cameroon 10 000 10 Burundi Côte d'Ivoire 1 000 Rwanda Sierra Leone 7 Haiti Angola 5 Ethiopia Togo Nigeria Equatorial Guinea Uganda Continents Burkina Faso Dominican Rep. Guinea- Bissau Chad Benin Ghana 3 Eritrea Cambodia Sudan Guyana Trinidad & Tobago Africa 2 Honduras Belize Thailand Mali Americas Jamaica Panama Suriname Barbados Ukraine Estonia 1 Papua New Guinea Guatemala Brazil Russia United States of America Asia Argentina Nepal India El Salvador Costa Rica Portugal 0.5 Senegal Venezuela Malaysia Spain Switzerland Europe Madagascar Peru Latvia Italy 0.3 Belarus Chile France Ecuador Colombia Mexico Bahrain Cyprus Canada Arab countries Nicaragua Uruguay Singapore Iceland 0.2 Armenia Greece China Netherlands Denmark Luxembourg Pakistan Turkmenistan Cuba Egypt Maldives Austria Belgium 0.1 Bhutan Bolivia Fiji Yemen Tajikistan Georgia Morocco Jordan Algeria Turkey Croatia Malta Bulgaria Hungary Slovenia Israel Bangladesh Mongolia Uzbekistan Indonesia Azerbaijan Sri Lanka Philippines Romania Lithuania Sweden Germany Finland Norway Japan Mauritius Czech Republic New Zealand Ireland Republic of Korea United Kingdom Australia 300 500 1 000 2 000 5 000 10 000 20 000 40 000 Annual income per person in US dollar (ppp & log)

X200? World HIV Chart 2001 Percent adults living with HIV (log) AIDS deaths per year Zimbabwe Lesotho Botswana 30 Swaziland Zambia 300 000 20 Kenya Namibia Malawi Central African Rep. South Africa 100 000 Mozambique Cameroon 10 000 10 Burundi Côte d'Ivoire X200? 1 000 Rwanda Sierra Leone 7 Haiti Angola 5 Ethiopia Togo Nigeria Equatorial Guinea Uganda Continents Burkina Faso Guinea- Bissau Chad Benin Ghana Dominican Rep. 3 Eritrea Sudan Guyana Africa Cambodia Trinidad and Tobago 2 Belize Mali Thailand Americas Honduras Jamaica Panama Suriname Ukraine Estonia Barbados 1 Papua New Guinea Guatemala Brazil Russia India United States of America Asia Argentina Nepal El Salvador Costa Rica Portugal 0.5 Senegal Venezuela Europe Malaysia Spain Switzerland Peru Latvia Italy 0.3 Belarus Chile France Madagascar Ecuador Colombia Mexico Bahrain Cyprus Canada Arab countries Nicaragua Uruguay Singapore Iceland 0.2 Armenia Greece Netherlands Luxembourg Pakistan Denmark Cuba China Turkmenistan Maldives Austria Egypt Belgium 0.1 Bhutan Bolivia Fiji Yemen Tajikistan Georgia Morocco Algeria Malta Jordan Bulgaria Turkey Croatia Hungary Slovenia Israel Bangladesh Mongolia Uzbekistan Indonesia Azerbaijan Sri Lanka Philippines Romania Lithuania Mauritius Sweden Germany Finland Norway Japan Czech Republic New Zealand Ireland Republic of Korea United Kingdom Australia 300 500 1 000 2 000 5 000 10 000 20 000 40 000 Annual income per person in US dollar (ppp & log)

10 X 20 =200 World HIV Chart 2001 Percent adults living with HIV (log) AIDS deaths per year Zimbabwe Lesotho Botswana 30 Swaziland Zambia 300 000 10 X 20 =200 20 Kenya Namibia Malawi Central African Rep. South Africa 100 000 Mozambique Cameroon 10 000 10 Burundi Côte d'Ivoire 1 000 Rwanda Sierra Leone 7 Haiti Angola 5 Ethiopia Togo Nigeria Uganda Continents Equatorial Guinea Burkina Faso Guinea- Bissau Chad Benin Ghana 3 Dominican Republic Eritrea Cambodia Sudan Guyana Africa Trinidad and Tobago 2 Belize Mali Thailand Americas Honduras Jamaica Panama Suriname Ukraine Estonia Barbados 1 Guatemala Papua New Guinea Brazil Russia India United States of America Asia Argentina Nepal El Salvador Costa Rica Portugal 0.5 Senegal Venezuela Malaysia Spain Switzerland Europe Peru Latvia Italy 0.3 Belarus Chile France Madagascar Ecuador Colombia Mexico Bahrain Cyprus Canada Arab countries Nicaragua Uruguay Singapore Iceland 0.2 Armenia Greece Luxembourg Pakistan Turkmenistan Netherlands Denmark Cuba China Maldives Austria Belgium 0.1 Egypt Yemen Tajikistan Bhutan Bolivia Fiji Georgia Morocco Algeria Turkey Malta Israel Bangladesh Mongolia Uzbekistan Indonesia Azerbaijan Sri Lanka Philippines Jordan Bulgaria Romania Croatia Lithuania Mauritius Hungary Slovenia Sweden Germany Finland Norway Czech Republic New Zealand Japan Ireland Republic of Korea United Kingdom Australia 300 500 1 000 2 000 5 000 10 000 20 000 40 000 Annual income per person in US dollar (purchasing power) Log

Outline of presentation Physical geography Economic geography Human geography Demography Development

Numbers infected, sick & dead ASSA2000

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 1985 1990 1995 2000 2005 2010 Year

Estimated and projected deaths 15-34, with and without AIDS in South Africa: 1980-2025 2,000 Without AIDS With AIDS 1,600 1,200 Deaths (thousands) 800 400 1980-1985 1995-2000 2010-2015 1985-1990 2000-2005 2015-2020 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 10 20 30 40 50 60 70 Life expectancy at birth (years) Source: U.S. Census Bureau, 2000

Estimated increase in adult death rates relative to the 1985 rates

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 70 65 60 55 50 45 40 35 30 25 20 15 10 5 100 120 140 Males Females Deficits due to AIDS Projected population structure in 2020 Population (thousands) Age in years Source: US Census Bureau, World Population Profile 2000