There are 2 predictions for the population of Botswana in what could cause a difference like this?

AIDS / HIV

What is AIDS? ► Acquired Immunodeficiency Syndrome ► Destructs body’s immune system ► Aids is caused by the virus HIV  HIV is Human Immunodeficiency Virus ► Most severe manifestation of HIV

Symptoms ► Flu-like symptoms ► No symptoms ► Fever, Fatigue, Diarrhea, Skin Rashes, Night Sweats, Loss of appetite  Other possible affects include  Opportunistic infections, cancers, pneumonia, and tuberculosis

The spread It can be spread in 1 of 4 ways ► Exchange of bodily fluids during sex ► Contaminated needles in drug use ► Contaminated blood transfusions ► From mother to child during pregnancy

MEDC’s ► In MEDC’s in the early days it only spread among gay communities and in prostitutes. The heterosexual population was unconcerned and many called it the gay plague. Now it is confined to mostly the gay communities of Europe and the USA.

LEDC’s ► Meanwhile in LEDC’s the disease was being spread in heterosexual communities. This was not known to MEDC’s for a long time.

Adults and children estimated to be living with HIV as of end 2005 Total: 40.3 (36.7 – 45.3) million It is growing in ALL regions of the world Western & Central Europe [ – ] North Africa & Middle East [ – 1.4 million] Sub-Saharan Africa 25.8 million [23.8 – 28.9 million] Eastern Europe & Central Asia 1.6 million [ – 2.3 million] South & South-East Asia 7.4 million [4.5 – 11.0 million] Oceania [ – ] North America 1.2 million [ – 1.8 million] Caribbean [ – ] Latin America 1.8 million [1.4 – 2.4 million] East Asia [ – 1.4 million]

Country Level ► Swaziland38.8% ► Botswana37.3 ► Lesotho28.9 ► Zimbabwe24.6 ► S. Africa21.5 ► Namibia21.3 ► Zambia16.5 ► Malawi14.2 ► CAR 13.5 ► Mozambique12.2 ► S. Africa 5,300,000 ► India 5,100,000 ► Nigeria 3,600,000 ► Zimbabwe 1,800,000 ► Tanzania 1,600,000 ► Ethiopia 1,500,000 ► Mozambique1,300,000 ► Kenya 1,200,000 ► DRC 1,100,000 ► USA 950,000

Case study Zambia ► 1 in 7 adults infected ► Life expectancy is down to 39 years as a result ► 200 new infections every day ► Disease has been present there since 1984 but was kept under wraps by the government until the late 1990’s ► Most of the spread is due to heterosexual intercourse

The role of women in society ► Zambian women have an extremely low status in society. ► Women are taught not to refuse sex, insist on condom use or demand that their partners be faithful. ► Women will often also be sexually active at a very young age with partners many years older than them who may have already had several sexual partners

Cultural issues ► Some practices and beliefs have a direct effect on the transmission of HIV. ► For instance, it is believed that men can cure sexually transmitted diseases by having sex with a virgin. 15% of girls in Zambia admit to have had sex forced on them at some point ► Family and tribal elders are also expected to initiate young girls into womanhood, through sexual intercourse.

Economic problems ► The biggest issue is of course the vast healthcare budge which Zambia must spend on treating the infected. ► There is also the problem of loss of workers. In 2002 Zambia faced famine as so many agricultural workers were killed that the crops could not be effectively harvested.

An improving problem? - NO

Why is the problem not being solved? ► People are reluctant to admit being infected as they might suffer prejudice from employers and the community ► Drugs are not affordable ► Many people do not know they have it ► Many of the churches and government officials refuse to encourage people to use condoms, advocating abstinence instead. They suggest that using condoms is a sign of weak morals. ► Condoms are expensive and very few are given away free from clinics etc.

Homework ► Due Thursday 1 st March ► May have some class time ► Deliver a presentation on a pandemic ► Include information on how your pandemic started, how it spread and what the impact was ► Options – black death, spanish flu, bird flu, swine flu, SARS ► Can work in pairs