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Poverty Fanning the Flames of the AIDS Epidemic
By Danielle Knight
The global HIV/AIDS epidemic has grown to such proportions that it is currently devastating whole regions, knocking decades off national development, and widening the gap between rich and poor nations, according to a new report released Tuesday by the joint United Nations Programme on HIV/AIDS (UNAIDS).
While the epidemic of HIV, the virus that causes AIDS, is stabilising in many high-income countries, as well as in a handful of developing nations, HIV prevalence rates among 15-49-year-olds have now reached or exceeded 10 percent in 16 countries, all of them in sub-Saharan Africa, said the report.
About one third of today’s 15-year-olds will die of AIDS in these countries, it said.In most sub-Saharan nations adults and children are acquiring HIV at a higher rate than ever before. In 1999, 5.4 million people - four million of whom were Africans- were newly infected with HIV.
Already, 18.8 million people around the world have died of AIDS, 3.8 million of them children. Nearly twice that number, 34.4 million, are now living with HIV.
The disease is becoming a key contributor to social instability, said the report, since many people are dying in the prime of their lives when they would normally be working or taking care of children or elderly relatives, the report said.
Since the AIDS epidemic began, 13.2 million children 95 percent of them in Africa have lost their mothers or both parents to AIDS while they were under 15-years-old.
“Because of AIDS, poverty is getting worse just as the need for more resources to curb the spread of HIV and alleviate the epidemic’s impact on development is growing,” said Peter Piot, executive director of UNAIDS.
In seven of the countries in the southern cone of Africa, at least one adult in five is living with the virus. In Botswana, 35.8 percent of adults are now infected with HIV, while in South Africa, 19.9 percent are infected, up from12.9 percent just two years ago.
‘’With a total of 4.2 million infected people, South Africa has the largest number of people living with HIV/AIDS in the world,’’ the report said. But UNAIDS said the increased rates are not inexorable.
In Uganda, strong government prevention campaigns brought its prevalence rate down to around eight percent from a peak of 14 percent in the early 1990s.
A large increase in condom use probably contributed to these lower rates of infection, said the report.
“The evidence demonstrates that we are not powerless against this epidemic, but our response is still at a fraction of what it needs to be,’’ said Piot,.
The percentage of 15 to 19- year- olds with the disease in Zambia has also decreased since 1993.
“Yet even in these countries, the suffering generated by HIV infections acquired years ago continues to grow, as millions of adults fall ill and die and as households, communities and whole sectors of the economy stagger under the burden,” said the report.
The infection rates in young African women are much higher than those in men. In the 11 population-based studies presented in the report, the average rates in teenage girls were more than five times higher than those in teenage boys.
“In large measure, this enormous discrepancy is due to age-mixing between young women and older men, who have had much more sexual experience and are much more likely to be exposing the girls to HIV,” said the report.
In comparison to the rates of HIV infection in Africa, those in the general population of Asia and Latin America are low. Yet, within the largest Asian nations, some geographic regions have far more inhabitants than most African countries and have prevalence rates far greater than the national average.
In parts of north-east India where widespread injecting drug use provided an easy early entry-point for HIV - more than two percent of 15 to 49-year-olds are infected.
Epidemics driven by unsafe drug-injecting practices dominate in some provinces of China, Malaysia, Nepal and Vietnam, said Piot. Recent studies suggest that a similar situation is emerging in Indonesia, specifically in the capital, Jakarta.
In Latin America, the countries with the highest HIV rates in the region tend to be found on the Caribbean side of the continent, where it is spreading mainly through sex between men and women.
Haiti is the worst-affected nation in the Caribbean, it said. In some areas, 13 percent of anonymously tested pregnant women were found to be HIV-positive. About eight percent of adults in urban areas and four percent in rural areas are infected.
The report estimated that 74,000 Haitian children had lost their mothers to AIDS by the end of 1999.
Piot said debt burden in developing countries was exacerbating the HIV/AIDS crisis. African governments, he said, are paying out four times more in debt service than they now spend on health and education.
“If the international community relieves some of their external debt, these countries can reinvest the savings in poverty alleviation and AIDS prevention and care,” said Piot. “If not, poverty will just continue to fan the flames of the epidemic.”
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