2. HIV/AIDS and Trade Presentation by Ngoni Chibukire ngoni@safaids.org.zw SAfAIDS 17 Beveridge Road Avondale Harare Tel: 263-04-336193/4

3. Overview of Presentation Global HIV/AIDS situation Regional An overview of Trade & HIV/AIDS: Interlinkages? 1.Micro & Macroeconomic Impacts. 2.HIV/AIDS & Treatment Issues Conclusion

4. Global summary of the HIV/AIDS epidemic, December 2005 Number of people living with HIV/AIDS Total40.3 million (36.7 – 45.3 million) Adults38.0 million (34.5 – 42.6 million) Women17.6 million (16.2 – 19.3 million Chn under 15 yrs 2.3 million (2.1 – 2.8 million) People newly infected with HIV in 2004 Total4.9 million (4.3 – 6.6 million) Adults4.2 million (3.6 – 5.8 million) Chn under 15 years 700,000 (630 000 – 820 000) AIDS deaths in 2004Total3.1 million (2.8 – 3.6 million) Adults2.6 million (2.3 – 2.9 million) Children under 15 years570 000 (510 000 – 670 000)

5. Adults and children estimated to be living with HIV as of end 2005 Total: 40.3 (36.7 – 45.3) million Western & Central Europe 720 000 [570 000 – 890 000] North Africa & Middle East 510 000 [230 000 – 1.4million] Sub-Saharan Africa 25.8 million [23.8 – 28.9 million] Eastern Europe & Central Asia 1.6 million [990 000 – 2.3 million] South & South-East Asia 7.4 million [4.0 – 9.7 million] Oceania 74 000 [45 000 – 120 000] North America 1.2 million [650 000 – 1.8 million] Caribbean 300 000 [200 000 – 510 000] Latin America 1.7 million [1.3 – 2.2 million] East Asia870,000 [440 000 – 1.4 million]

6. Selected Countries in SA – PR in 2005 Country Rate 2005 Angola2.5-3.1% Botswana37% Malawi20% Mozambique16% South Africa21.5% Swaziland 38.8% Zambia18-20% Zimbabwe21.3%

7. Labour force Living with HIV/AIDS Worldwide Globally (15-64)26 million Africa(70%)18.2 million Kenya1.0 million Mozambique1.1 million South Africa3.7 million Zimbabwe1.3 million (Source: ILO, 2004)

8. Percentage of workforce lost to AIDS by 2005 and 2020 in selected African countries 0 10 20 30 40 50 % 20052020 Botswana Cameroon Central African Republic Côte d’Ivoire Ethiopia Guinea-Bissau Mozambique Nigeria South Africa Togo United Rep. of Tanzania Zimbabwe Sources: ILO (2000) POPILO population and labour force projection; UN Department of Economic and Social Affairs, Population Division (1998) World Population Prospects: the 1998 Revision

9. Micro-level Impact Loss of skilled workers Lower productivity due to increased absenteeism (sickness, funerals), staff turnover, disability, and sub-standard productivity of new recruits Increased costs (health, insurance, benefits, pensions, etc) Recruitment and training new staff

10. Macroeconomic Impact Human capital as a significant factor in trade promotion & development Reduced economic growth (loss of capital & reduced trade) Reduced social & economic welfare in worst affected.

11. HIV/AIDS and Treatment Issues- Regional Overview Aim is to achieve universal access to HIV prevention, treatment, care and impact mitigation. Globally about a third lacks access to essential drugs (Health Action International) In some parts, its over 50% (Africa) In relation to AIDS at least 80% of PWA cant access drugs. (one in every ten has access to ARVs in Africa- (one in every seven in Asia) This is due to various constraints

12. Treatment Map: Regional Overview CountryP/RatePWHAIn Need of ART On ART GvtPvtExp by 05 Botswana 37380,000110,00050,00042,5007,50055,000 Namibia 22350,00058,00018,00014,0004,00043,000 S. Africa 215,3 mil840,000104,00064,000-200,0000 Moza 161,4 mil218,0005,9001,7004,20028,005 Malawi 201,1 mil150,00028,00027,40060080,000 Zimbabwe Source: WHO,MSF UNAIDS (04-05) 212 mil318,00024,00020,0004,00055,000

13. What are the limiting factors Logistical supply bottlenecks (tariffs & non-tariff barriers) Prohibitive prices Hence the need to advocate for policies that ensure equitable access to essential drugs of acceptable quality. HIV/AIDS trade related issues -Accessibility, affordability, availability & acceptance -Quality -Rational drug use

14. Key Questions How far do trade policies take into consideration health concerns including HIV/AIDS epidemic? Sustainability of generic production in resource limited settings? Is a market system efficient in ensuring accessibility of drugs vs government roll out plans?

15. Conclusion AIDS is real….BUT we can do something about it AIDS is far from being a chronic disease like any other, but people can live long and productive lives with HIV given a comprehensive treatment programme.

16. Conclusion - 2 Strategies, policies, and guidelines are available at international, regional and national levels. However, it takes commitment and leadership to turn them into meaningful tools.

17. Concluding Remark “ It is the responsibility of every modern Employer (every stakeholder) to take adequate measures to address the troubling reality of the global AIDS epidemic.” (Kofi Annan, 2003)