*EPF209 07/02/2002
Fact Sheet: UNAIDS Tracks Global Impact of HIV/AIDS
(Disease causes serious erosion in development) (1380)

The Joint United Nations Program on HIV/AIDS (UNAIDS) released July 2 a "Report on the Global HIV/AIDS Epidemic 2002." The results are summarized in a fact sheet that says that 60 million people have been infected in the 20-year epidemic. In the most severely affected nations, the disease is reversing the gains of economic development and shortening life expectancy.

Following is a fact sheet from UNAIDS:

(begin fact sheet)

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
2 July 2002

The impact of HIV/AIDS

Most countries have made impressive progress in human development since World War II. But those achievements are being undermined as countries lose young, productive people to HIV/AIDS, households fall into deeper poverty, economies stumble and the impact of the epidemic is felt across societies.

The demographic impact

--More than 60 million people have been infected with HIV since the epidemic began two decades ago. In 2001, it claimed an estimated 3 million lives.

--In the 45 most affected countries, it is projected that, between 2000 and 2020, 68 million people will die prematurely as a result of AIDS. The projected toll is greatest in sub-Saharan Africa where 55 million additional deaths can be expected.

--In many countries, AIDS is erasing decades of progress in life expectancy. The average life expectancy in sub-Saharan Africa is currently 47 years. Without AIDS, it would have been 62 years. Life expectancy at birth in Botswana (which, at 38.8%, has the highest adult prevalence rate in the world) has dropped below 40 years-a level not seen in that country since before 1950.

--Children and young people are especially hard-hit by the epidemic. The under-five mortality rates of seven countries in sub-Saharan Africa have increased by 20-40%, due to HIV/AIDS. The number of excess AIDS-related deaths among South Africans aged 15-34 is projected to peak in 2010-2015, with an estimated 17 times as many deaths as there would have been in the absence of AIDS.

--Current HIV prevalence levels only hint at the much greater lifetime probability of becoming infected. In Lesotho, for example, it is estimated that a person who turned 15 in 2000 has a 74% chance of becoming infected with HIV by his or her 50th birthday. Even in Guyana, where adult prevalence is a comparatively low 2.7%, the probability of contracting HIV between the ages of 15 and 50 in 2000-2035 is 19%.

The impact on households

--AIDS pushes people deeper into poverty as households lose their breadwinners, livelihoods are compromised and savings are consumed by the cost of health care and funerals. Research shows that, in two-thirds of Zambian families where the father died, monthly disposable income fell by more than 80%. In C��e d'Ivoire, income in AIDS-affected households was half that of the average household income.

--A study of three countries (Burkina Faso, Rwanda and Uganda) has calculated that AIDS will increase the percentage of people living in extreme poverty from 45% in 2000 to 51% in 2015. In Botswana, per capita household income for the poorest quarter is expected to fall by 13%, while every income-earner in this category can expect to take on four more dependants. New, stronger safety nets are needed.

--Women are almost invariably left bearing even bigger burdens-as workers, caregivers, educators and mothers. At the same time, their legal, social and political status often leaves them more vulnerable to HIV/AIDS.

--The loss of assets and productive workers severely affects households' capacities to produce and purchase food. Some 20% of rural families in Burkina Faso are estimated to have reduced their agricultural work or even abandoned their farms because of AIDS. In Ethiopia, AIDS-affected households were found to spend between 11.6 and 16.4 hours per week performing agricultural work, compared with a mean of 33.6 hours for non-AIDS-affected households. Securing the right of women and children to retain the land and assets of a deceased husband/father can help households cope.

The impact on the health sector

--In all affected countries, the HIV/AIDS epidemic is putting the health sector under more strain. In sub-Saharan Africa, the annual direct medical costs of AIDS (excluding antiretroviral therapy) are estimated at US$30 per capita, when overall public health spending is less than US$10 per capita for most African countries.

--The epidemic is reducing the overall quality of care provided. A shortage of hospital beds, for example, means that people tend to be admitted only in the latter stages of illness, which reduces their chances of recovery.

--At the same time, the demand for health services is expanding and more health-care personnel are being affected by HIV/AIDS. Malawi and

Zambia, for example, is experiencing 5-6-fold increases in health worker illness and death rates. To compensate for such losses, an estimated 25-40% more doctors and nurses need to be trained in southern Africa in 2001-2010.

--Home-care initiatives are a key coping mechanism for mitigating impact. Initiated by communities and often operated from a religious or nongovernmental organization base, home-based care depends on support from formal health, welfare and other social sectors, as well as from the private sector.

The impact on education

--A decline in school enrolment is one of the most visible effects of the epidemic. According to the World Bank, the number of primary school pupils in 2010 will shrink by 24% in Zimbabwe, 14% in Kenya and 12% in Uganda.

--AIDS is hampering the ability of education systems to fulfill their basic social mandates, as more teachers succumb to the disease. A study in Manicaland, Zimbabwe, found that 19% of male teachers and almost 29% of female teachers were infected with HIV. Nationwide AIDS-related deaths among South African teachers rose by more than 40% in 2000-2001. The loss of teachers can be especially devastating in rural communities where schools depend heavily on only one or two.

--The extent to which education institutions adapt and continue functioning (as part of the essential infrastructure of societies and communities) will influence how well societies recover from the epidemic.

Impact on enterprises and workplaces

--The vast majority of people living with HIV/AIDS worldwide are in the prime of their working lives. By 2005, Zimbabwe will have lost 19% of its workforce to AIDS, Botswana 17%, South Africa 11%, the United Republic of Tanzania 9% and C��e d'Ivoire 8%.

--AIDS weakens economic activity by squeezing productivity, adding costs, diverting productive resources, and depleting skills. The epidemic hits productivity mainly through increased absenteeism, organizational disruption, and the loss of skills and 'organizational memory'. Production cycles can be disrupted, equipment stands idle, and temporary staff may need to be recruited and trained.

--A study in several southern African countries has estimated that the combined impact of AIDS-related absenteeism, productivity declines, health-care expenditures, and recruitment and training expenses could cut profits by at least 6-8%.

--Loss of know-how tends to be the most often-cited cost factor on the shop floor. Thus, even in high unemployment areas (with an apparently 'bottomless' pool of unskilled or semi-skilled labor), the drain on visible and invisible skills and knowledge ends up being considerable.

Macroeconomic impact

--AIDS has a profound impact on growth, income and poverty. For those countries with national HIV/AIDS prevalence rates of 20% or more, GDP growth has been estimated to drop by an average of 2.6 percentage points annually.

--Nationally-focused studies have forecast that, by 2015, the economies of Botswana and Swaziland would grow by 2.5 and 1.1 percentage points less, respectively, than they would have in the absence of the epidemic.

Breaking the cycle

--The most potent way to avert the devastating impact of HIV/AIDS is to act before the epidemic takes hold. Calculations of the rates of return on Thailand's investments in HIV/AIDS prevention suggest that, in 1990-2020, the avoided medical expenditures alone will have yielded rates of return in the order of 12-33%. Brazil's widely praised efforts to provide universal treatment and care, in addition to its well-planned prevention programs, are estimated to have avoided 234 000 hospitalizations in 1996-2000.

(end fact sheet)

(Distributed by the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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