Geog 102 Case Study 4

Case Study 4 – AIDS in Africa : Serial Killer at Large: 

Case Study 4 – AIDS in Africa : Serial Killer at Large 1 – The AIDS Epidemic 2 – AIDS in Africa 3 – Consequences

The AIDS Epidemic: 

1 The AIDS Epidemic Chronology 1930s: Mutation and transmission of HIV (human immunodeficiency virus) from a chimpanzee to a human. 1950s: First likely cases and deaths in Africa. 1981-83: First cases of an unknown disease that destroys the immune system are detected in the United States. Mainly prevalent among homosexuals and drug users. 1984: The HIV virus is first identified. Virus is identified as spreading through blood. 1985: First World AIDS conference held in Atlanta. Blood screening test introduced in North America and Europe. 1987: First possible treatment (AZT: Zidovudine) launched.

The AIDS Epidemic: 

The AIDS Epidemic 1992: Women are recognized to be as risky as men to catch HIV. 1993: First estimates of HIV infected reach 13 million. 1996: Efficient HIV inhibitors introduced (“cocktails”). 1997: Drug resistant forms of HIV start to appear, notably in new-born children. 1998: Sharp decline of new cases in the developed world due to access to new treatments. AIDS continues to be rampant in the developing world. 2000: AIDS officially recognized by the US as a threat to national security. 1

The AIDS Epidemic: 

The AIDS Epidemic 2001: First UN special session on AIDS. All 189 member nations agreed on a set strategies for comprehensive prevention and treatment programs. Issues of women’s rights, AIDS orphans and HIV discrimination. 1

The AIDS Epidemic: 

The AIDS Epidemic Strains Destroys white blood cells. HIV 1: A similar virus found in some sub-species of chimpanzees. Only present in West Central Africa. Most prevalent among adults aged 15-49. Greater effect on population rates. Most prevalent form of HIV in Africa. HIV 2: A mutation of HIV 1. Occurs primarily in older age cohorts. People under 30 account for only 10% of infections. 1

The AIDS Epidemic: 

The AIDS Epidemic Global Context More than 40 million people were HIV positive in 2000. One person every six second contracts the disease. By the end of 2000, 21.8 million people have died of AIDS. About 5 million contracted the virus in 2001. 14,000 people a day contracted HIV. 95% in developing countries. 5.6 million in 1999. 3.0 million died, of which 2.4 million in Africa. 70% of all HIV positive population. 80% of all deaths. 47% HIV positive persons are women. 13.2 million children (-14) have been orphaned (end of 1999). 1

Global Estimates of Cumulative HIV/AIDS Infections and Deaths Worldwide, 1980-2001 (in millions): 

Global Estimates of Cumulative HIV/AIDS Infections and Deaths Worldwide, 1980-2001 (in millions) 1

The AIDS Epidemic: 

The AIDS Epidemic Epidemiology Pattern 1: Homosexual/bisexual activity and intravenous drug use. Most prevalent in the developed world. Pattern 2: Heterosexual activity. Mainly prevalent in the developing world. Especially the case of Africa. 1

Adults and children estimated to be living with HIV/AIDS as of end 1999-2001 (in millions): 

Adults and children estimated to be living with HIV/AIDS as of end 1999-2001 (in millions) 1

Estimated deaths due to HIV/AIDS from the beginning of the epidemic to end 1999 (in millions): 

Estimated deaths due to HIV/AIDS from the beginning of the epidemic to end 1999 (in millions) 1

Estimated number of adults and childrennewly infected with HIV during 2000 (in millions): 

Estimated number of adults and children newly infected with HIV during 2000 (in millions) 1

HIV Prevalence and Percentage of Infected Women, 2000: 

HIV Prevalence and Percentage of Infected Women, 2000 1

AIDS in Africa: 

AIDS in Africa African Context AIDS is reaching epidemic proportions. About 25 million infected. Most will die within 8 years. One new HIV positive case every 25 seconds. The transmission is mainly heterosexual. 55% of infected people are women. In several large cities, 33% of pregnant women are infected. Death rates are rising. Infant mortality rates are rising. Life expectancy is declining. Most of the population will die around 30. Back 100 years in time. The population of some countries is expected to drop. First time since the Black Death of the 14th century. 2

Causes of deaths, globally and in Africa, 1999 (in %): 

Causes of deaths, globally and in Africa, 1999 (in %) 2

AIDS in Africa: 

AIDS in Africa Botswana The world’s hardest hit country. 33% of the reproductive-age population is infected. Life expectancy expected to decline from 61 years in 1990 to 29 years in 2010. Zimbabwe Second-highest infection rate for HIV. 25 % of people between 25 and 45 are HIV positive. 220 deaths a day were attributed to AIDS (1998). Government spent $70 million a month for the war with the Democratic Republic of Congo. $1 million a month for the prevention of AIDS. 2

Projected population structure with and without the AIDS epidemic, Botswana, 2020: 

Deficits due to AIDS Projected population structure in 2020 Projected population structure with and without the AIDS epidemic, Botswana, 2020 2

AIDS in Africa: 

AIDS in Africa Other countries Tanzania and Uganda: 50% of the population that is currently 18 is expected to die before 65. South Africa has the highest absolute number of infected people in the world, with 4.2 million people infected (out of 40 million). 25% South African women between the ages of 20 and 29 are HIV positive. Over 70% of hospital beds in Burundi are taken by AIDS patients. Over 40% in Kenya. 2

Spread of HIV in sub-Saharan Africa, 1987, 1997: 

Spread of HIV in sub-Saharan Africa, 1987, 1997 Estimated percentage of adults (15–49) infected with HIV 16.0% – 32.0% 8.0% – 16.0% 2.0% – 8.0% 0.5% – 2.0% 0% – 0.5% trend data unavailable outside region 1987 1997 2

Life Expectancy in Selected African Countries, 1955-2000: 

Life Expectancy in Selected African Countries, 1955-2000 2

Life Expectancy at Birth in 29 African Countries With and Without AIDS Between 1985-1990 and 2010-2015: 

Life Expectancy at Birth in 29 African Countries With and Without AIDS Between 1985-1990 and 2010-2015 2

Population Projections for the 29 Most-affected Sub-Saharan African Countries, 1980-2050 (in millions): 

Population Projections for the 29 Most-affected Sub-Saharan African Countries, 1980-2050 (in millions) 2

Consequences: 

Consequences Social costs Places the most infected are the least able to fight the disease. Widespread poverty. Poor educational system. Limited employment opportunities. Limited health facilities. Foreign debt. Changed African family structures. Instead of grown children looking after aging parents, these parents have to look after their orphaned grandchildren. One of the main obstacles to fighting AIDS in Africa is patriarchy. Societies (and government) are male dominated. 2

Consequences: 

Consequences AIDS orphans. Most HIV positive themselves. Lost the support of their parents. Perceived as taboo. There are over 12.1 million AIDS orphans in Africa. Economic costs People dying of AIDS are mostly between 25 and 35. Most productive years. Four out of five deaths of the age group are attributed to AIDS. Less attractive context for investment. Recruiting problems. 3

Consequences: 

Consequences Is the health system coping? Governments have other priorities such as repairing the road system and paying civil servants’ salaries. Proper control of AIDS require proper healthcare system. Medication: Medication to prolong life and to prevent the transmission to the fetus is available in the developed world. Cost about $10,000 to $15,000 per person per year. Most African countries spend less than $50 per person on health per year. UN says it will take $3 billion a year in spending on AIDS prevention programs in Africa to make a difference. The US pharmaceutical market represents $126 billion a year. US spends $52 billion a year coping with the costs of the medical consequences caused by obesity. 3

AIDS Related Skin Infection, Tanzania, 1998: 

AIDS Related Skin Infection, Tanzania, 1998 3

Children Watching their Mother Dying of AIDS, Tanzania, 1998: 

Children Watching their Mother Dying of AIDS, Tanzania, 1998 3

AIDS Orphan, Addis Ababa, Ethiopia, 1999: 

AIDS Orphan, Addis Ababa, Ethiopia, 1999 3

AIDS Prevention Advertising, Botswana, 2000: 

AIDS Prevention Advertising, Botswana, 2000 3

AIDS Victim in Final Stages, Harare, Zimbabwe, 2000: 

AIDS Victim in Final Stages, Harare, Zimbabwe, 2000 3

Not Knowing What They're Talking About: 

Not Knowing What They're Talking About 3