1. The PHRplus Project is funded by U.S. Agency for International Development and implemented by: Abt Associates Inc. and partners, Development Associates, Inc.; Emory University Rollins School of Public Health; Philoxenia International Travel, Inc. Program for Appropriate Technology in Health; SAG Corp.; Social Sectors Development Strategies, Inc.; Training Resources Group; Tulane University School of Public Health and Tropical Medicine; University Research Co., LLC. URL: http://www.phrplus.orghttp://www.phrplus.org CURRENT STATUS OF THE HIV/AIDS PANDEMIC

2. “Run to its natural course…..Will lead to devastating scale” Peter Piot, UNAIDS Bostwana: 38% of Adults are estimated to be infected by HIV in 2003

3. Objectives of the presentation  Most recent estimatesBotswana HIV epidemic's scope  Current status of HIV/AIDS impact beyond human tool

4. AIDS STATUS IN 2003 AIDS STATUS IN 2003  Number of PLWHA 40 Million  ADULTS 37 Million  Children under 15 years 3 Million  One third are young aged between 15-24 years  People newly infected with HIV 5 Million  AIDS deaths in 2003 3 Million  In many African countries life expectancy reduced by more than 20 years Source UNAIDS AIDS Epidemic Update, December 2003, AIDS Epidemic Update, December 2003AIDS Epidemic Update, December 2003

5. HIV/AIDS epidemic growth  The number of PLWA is increasing  Hardest hits are sub-Saharan Africa with 70% of PLWHA  Fastest growing AIDS epidemic in Europe and Central Asia (ECA) region  Asia and Pacific region experience expanding epidemic

7. SUB- SAHARAN AFRICA  The worst affected by HIV/AIDS epidemic  Highest level of new HIV infection  Matched with high level of AIDS mortality  26.6 million people infected  Twice as many young women as men are infected  HIV Adult prevalence increases from West to East ( from less than 1% to 39%)

8. HIV/AIDS variations across Africa

9. AFRICAN TRENDS  Average Adult prevalence : 7.5-8.5%  Southern Africa: In Botswana, Lesotho, Namibia and Swaziland, HIV has reached devastating proportion  Hope in Eastern and Central Africa: HIV prevalence continue to recede in Uganda  Western Africa remains affected at lower levels

10. Eastern Europe and Central Asia  ECA is experiencing the world's fastest- growing HIV/AIDS epidemic  1,5 Million PLWHA in 2003  Adult HIV prevalence: 0.5-0.9%  The vast majority of these reported infections are among young people, chiefly injecting drug users  Hardest hits are Russian Federation, Ukraine and the Baltic States

11. South- East Asia and the Pacific  1 million people acquired HIV in 2003  Adult HIV prevalence in South- East Asia: 0.4-0.8  Adult HIV prevalence in East Asia and Pacific: 0.1%  China, India and Indonesia: Three countries with very large population presenting factors for HIV increase

12. Latin America and the Caribbean  2 Million people were living with HIV/AIDS at the end of 2003  Second most affected region in the world  Adult HIV prevalence: 0.5-0.7%  Hardest hit: Haiti with a 6% adult prevalence  Low national HIV prevalence in Central and south America

13. Mode of transmission  Bulk in Central America : sexual transmission ( heterosexual and men)  Bulk of South American countries: Men having Sex with men and injecting drug use

14. North Africa and Middle East  600,000 people were estimated to live with HIV/AIDS at the end of 2003  Adult HIV prevalence: 0.2-0.4%  Hardest Hit : Sudan with a national Adult HIV prevalence of 2%  Weak Surveillance system for HIV/AIDS  Transmission mode through drug use (Iran), blood transfusion and sexual contacts ( main routes)

15. High-income countries  1.6 million PLWHA at the end of 2003  Adult HIV prevalence in North America 0.5-0.7% and Western Europe 0.3%  AIDS death slow down due to ARV treatments  Shift into the poorer and marginalized sub populations ( African-American in the U.S)  Transmission mode: unprotected sex ( sex between men and hetero) and drug use  JAPAN: increase of HIV among Japanese youth

16. Current Status of AIDS impact  Orphans: 14 Million surviving children under 15 had lost one or both parents due to AIDS  Affect the cohesion of family and community life  Education: in 1998, Zambia lost the equivalent of 2/3 of the new teachers trained that year

17. Current Status of AIDS impact on Cities  Explosive HIV factors: High population density, transportation hubs and the existence of large groups of vulnerable persons (e.g., sex workers, unemployed youth, drug users)  A study in Zambia shows that 2/3 of urban households that lost their main breadwinner to AIDS experienced a loss of income of 80%, 61% of these households had moved to cheaper housing

18. Current Status of AIDS impact Rural Areas   Loss of workers during planting and harvesting periods has been shown to reduce harvest sizes significantly   Farmers grow less labor-intensive crops   AIDS could affect the production of cash crops as well as food crops.

19. Current Status of AIDS impact Business sector  Firm expenditures are increased by health care costs, burial fees, and the need to replace workers  In generalized countries affect human welfare, socio-economic advances, productivity, social cohesion, and even national security

20. HIV/AIDS threats  HIV/AIDS threatens economic and social growth, and could even undermine political stability in some countries  AIDS poses serious problems for the health and productivity of many countries  Could lead to economic collapse within several generations ( Botswana)

21. Thank You!