home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
CNN Newsroom: Global View
/
CNN Newsroom: Global View.iso
/
txt
/
ch
/
ch0592.001
< prev
next >
Wrap
Text File
|
1994-05-02
|
30KB
|
550 lines
<text>
<title>
The AIDS Pandemic in Africa
</title>
<article>
<hdr>
Current History, May, 1992
The AIDS Pandemic in Africa
</hdr>
<body>
<p>By Dennis C. Weeks--president of Sweet Hill Associates
</p>
<p> Does Aids represent a cataclysm for Africa? The fatal disease
has spread throughout the continent quickly in the last ten
years, and the potential impact over the next decade is nothing
short of devastating--given no development of a vaccine, no
cure, and no dramatic increase in the availability of
life-extending medications and treatment.
</p>
<p> The numbers themselves are frightening. In July 1990, the
World Health Organization (WHO) estimated that there were
approximately 8 million HIV-infected adults worldwide, of whom
approximately 3 million were women and 5 million were men. In
July 1991 the agency estimated the total at between 10 million
and 12 million HIV-positive individuals. Seven months later, on
February 12, 1992, revised WHO figures put the global total at
12 million, of whom 1 million are children who are not yet
sexually active. (WHO's data estimates are released too
infrequently to be realistic and are inadequate for purposes of
intervention program planning because of the speed at which the
AIDS pandemic is progressing. Applying the 1990 global ratio of
3 infected women for every 5 infected men to the July 1991 WHO
estimates of infected adults would mean that at least 4,125,000
women and 6,875,000 men are HIV-positive, along with another
million children, approximately half boys and half girls.) Of
this global total, 7.5 million, or 62.5 percent, are Africans.
Among the world's infected female population, at least 81
percent, or more than 3.7 million, reside in Africa, while
approximately 52 percent, or 3.8 million, of the world's
HIV-infected males are Africans.
</p>
<p> WHO estimates that within the next five years the number
infected globally will at least double and possibly triple; it
further estimates that by the year 2000 at least 30 million
people will be infected throughout the world, with some experts
expecting closer to 40 million. Infants and children will
account for up to 10 million of the total, and there will be
approximately 10 million AIDS orphans--children whose parents
have died from AIDS.
</p>
<p> If the gender ratios remain constant, more than 15 million
females and 25 million males will be infected with HIV by the
year 2000. Furthermore, if the same geographical distribution
patterns hold, the number of infected African females could
exceed 12 million while infected African males could reach 13
million, representing five out of every eight global infections,
or nearly 63 percent, could be expected. (There are reasons to
suspect that the African experience could become more extreme
than current ratios indicate. Merely extrapolating current data
gives too low an impression because the data themselves are too
low, among other reasons discussed in the next section.)
</p>
<p>Charting the Impact of AIDS
</p>
<p> Uganda is the African country that has been hardest hit by
AIDS. (This assessment is based on the most recent figures
available from the United States Bureau of the Census, Health
Studies Branch of the Center for International Research: they
were released in November 1991 and cover data collected through
1990.) An ongoing study of pregnant women in the capital city of
Kampala, begun in the mid-1980s, shows that the infection rate
increased from nearly 11 percent of pregnant women in 1985 to
more than 25 percent today. The women studied are considered a
low-risk group; those in a high-risk group--prostitutes and
others with many sexual partners--had a 75 percent infection
rate. Outside major cities in Uganda, current infection rates
approximate the 1985 major city rate, with a wave of infection
moving toward the rural areas.
</p>
<p> Other countries with seriously high rates of HIV infection
among low-risk populations in major cities include Burundi,
Malawi, Rwanda, Tanzania, and Zambia. Among these countries,
Burundi appears to have the lowest rate of infection of low-risk
groups in major cities at nearly 18 percent, while the others
show rates in excess of 22 percent, with Rwanda and Zambia at
or above 25 percent. High-risk urban populations in those same
countries have infection rates ranging from 18 percent in
Burundi to 80 percent in Rwanda; most have rates between 40 and
60 percent. Other African countries that appear to have
infection rates between 5 and 10 percent in the low-risk urban
populations include the Central African Republic, Congo, Ivory
Coast, Kenya, Sierra Leone, and Senegal.
</p>
<p> The available data describing African HIV infection rates are
not very reliable, and probably underestimate infection levels.
Most African governments have denied AIDS is a problem in their
countries, fearing that tourists would abandon plans to visit,
which would disrupt the flow of hard currency. The denial is so
extensive that data for rates of HIV infection and/or AIDS are
not available from many African countries.
</p>
<p> Statistics from some African countries show a reduction in
the rate of increase of infection and death. Often this merely
demonstrates that hospitals are already operating beyond
capacity and are not yet accepting more patients. After being
rejected by hospitals and clinics, many people stricken with
AIDS simply return home, so their illnesses and deaths are not
included in the data. Conversely, initially high rates of
infection might reflect implementation of data-gathering
systems, followed by a more accurate accounting of morbidity
and mortality.
</p>
<p> The governments that have been the most aggressive in
acknowledging the presence of AIDS in their country were also
the first to receive technical and financial assistance from
WHO's Global Program on AIDS. WHO's assistance in most cases
led to the development of plans to fight AIDS in those
countries. The earlier the assistance was received and plans
developed, the more extensive are the data-reporting systems now
in place. Two examples are Uganda and Zambia, which allowed the
development of AIDS education and prevention strategies.
</p>
<p> Data are the foundation on which successful programs are
built. Because some countries have shown early initiative in
acknowledging the presence of AIDS, their relatively
well-developed reporting systems give the appearance that they
have higher rates of infection than their neighbors. But a more
realistic assumption is that countries bordering other countries
with highly infected populations also have high rates of
infection.
</p>
<p> Only a handful of African governments have reliable data on
infection rates in rural populations. The rural data that do
exist, however, show a worrisome trend toward higher and growing
rates of transmission. Most Africans live in rural areas--as
much as 85 percent of the total population in many countries--which means that the spread of AIDS into the rural population
will heighten the tragedy. Most programs have targeted
urban-based Africans, with specific emphasis on locations where
many people are in one place at the same time, such as
workplaces. With the exceptions of religious institutions and
some agriculturally oriented cooperative societies,
opportunities for informing large groups at one time about the
facts of AIDS, and its transmission and prevention, are
relatively limited in rural Africa. Compounding the difficulties
are the linguistic and tribal barriers to communicating with
large numbers of rural residents.
</p>
<p>Health Care and AIDS
</p>
<p> How can one begin to discuss the broad implications of HIV
infection and AIDS for the poorest continent on earth, where
average annual government health-care expenditures are about $2
for each man, woman, and child? How does a continent cope with
nearly 10 million AIDS orphans by the turn of the century, of
which there already nearly 500,000 in Uganda alone, and the
number is growing rapidly in areas surrounding La