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HIV/AIDS in Sub-Saharan Africa
Population (millions), mid-2002 693
Adults age 15-49 with HIV/AIDS, 2001 26,000,000
New HIV infections, 2001 3,500,000
Adult HIV prevalence (%), 2001 8.80
Women age 15-49 with HIV/AIDS, 2001 15,000,000
Children with HIV/AIDS, 2001 2,600,000
AIDS orphans (ages 0-14), 2001 11,000,000
AIDS deaths, 2001 2,400,000
nd = No data
Source: Population Reference Bureau & UNAIDS
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Regional Overview

Abstracted from Fact Sheet 2002: Sub-Saharan Africa UNAIDS factsheet, December 2002.

Epidemiology and Trends

Sub-Saharan Africa has the highest HIV prevalence in the world. The region is now home to 29.4 million people living with HIV/AIDS. Approximately 3.5 million new infections occurred there in 2002, while the epidemic claimed the lives of an estimated 2.4 million people in the past year. Ten million young people (aged 15-24) and almost 3 million children under the age of 15 are living with HIV.

Rampant epidemics are under way in southern Africa where, in four countries, national adult HIV prevalence has risen higher than thought possible, exceeding 30%: Botswana (38.8%), Lesotho (31%), Swaziland (33.4%), and Zimbabwe (33.7%).

Elsewhere, in west and central Africa, the relatively low adult HIV prevalence rates in countries such as Senegal (under 1%) and Mali (1.7%) are shadowed by more ominous patterns of growth. HIV prevalence is estimated to exceed 5% in eight other countries of west and central Africa, including Cameroon (11.8%), Central African Republic (12.9%), Côte d'Ivoire (9.7%), and Nigeria (5.8%). The sharp rise in HIV prevalence among pregnant women in Cameroon (more than doubling to over 11% among those aged 20-24 between 1998 and 2000), shows how suddenly the epidemic can surge.

Against this background, it is too easily forgotten that the vast majority of Africans--more than 90%--have not acquired HIV. Enabling them to remain HIV-free is a massive challenge, with the protection of young people a priority. There are new, hopeful signs that the epidemic could eventually be brought under control.

In South Africa, for pregnant women under 20, HIV prevalence rates fell to 15.4% in 2001 (down from 21% in 1998). This, along with the drop in syphilis rates among pregnant women attending antenatal clinics (down to 2.8% in 2001, from 11.2% four years earlier) suggests that awareness campaigns and prevention programs are bearing fruit. A major challenge now is to sustain and build on such tentative success, not least because HIV infection levels continue to rise among older pregnant women.

A decline in HIV prevalence has also been detected among young inner-city women in Addis Ababa in Ethiopia. Infection levels among women aged 15-24 attending antenatal clinics dropped from 24.2% in 1995 to 15.1% in 2001 (however, similar trends were not evident in outlying areas of the city, nor is there yet evidence of them occurring elsewhere in the country).

Uganda continues to provide evidence that the epidemic does yield to human intervention. HIV infection levels appear to be on the decline recently in several parts of the country--as shown by the steady drop in HIV prevalence among 15-19-year-old pregnant women. Trends in behavioural indicators are in line with this apparent decline in HIV incidence. Condom use by single women aged 15-24 almost doubled between 1995 and 2000/2001, and more women in that age group delayed sexual intercourse or abstained entirely.

Response and Socioeconomic Impact

HIV/AIDS represents a severe development crisis in sub-Saharan Africa. Even if exceptionally effective prevention, treatment and care programmes take hold immediately, the scale of the epidemic means that the human and socioeconomic toll will be massive for many generations. The current food crisis in southern Africa is, most likely, linked to the HIV/AIDS epidemic's toll on the lives of young, productive adults in the region.

In the absence of massively expanded prevention, treatment and care efforts, the AIDS death toll on the continent is expected to continue rising before peaking around the end of this decade. The worst of the epidemic's impact will be felt in the course of the next decade and beyond.

Nineteen African countries have set up national HIV/AIDS councils or commissions at senior levels of government, and local responses are growing in number and vigour. Across the region, 40 countries have completed national strategic AIDS plans--evidence of their determination to reach the targets outlined in the Declaration of Commitment on HIV/AIDS. Also encouraging is the active involvement of regional bodies, such as the Economic Commission for Africa, the Africa Union, and the Southern African Development Community, in tackling HIV/AIDS as a development issue.

Access to Care and Treatment

Only a tiny fraction of the millions of Africans in need of antiretroviral treatment are receiving it. Many millions are not receiving medicines to treat opportunistic infections, either.

Relatively prosperous Botswana has become the first African country to adopt a policy to ultimately make antiretrovirals available to all citizens who need them. However, comparatively few people (approximately 2,000) are currently benefiting from this commitment.

In addition, a handful of companies (such as AngloGold, De Beers, Debswana and Heineken) have announced schemes to provide antiretrovirals to workers and some family members. These are valuable efforts. Measured against the extent of need, however, they are plainly inadequate.

Selected Documents and Links
Documents and Reports
Core Documents
Fact Sheet 2002: Sub-Saharan Africa
UNAIDS factsheet, December 2002. In English, Spanish, French, and Russian. (Word documents)
UNAIDS Africa Epidemiological Factsheets
Policy Reports and Papers
HIV/AIDS and Food Insecurity in Southern Africa
Joint report from Oxfam and Save the Children, December 1, 2002. [PDF, 50K]
Unraveling the Complexities of HIV-related Stigma and Discrimination in sub-Saharan Africa
Laura Nyblade, Rohini Pande, Sanyukta Mathur, and Kerry MacQuarrie, International Center for Research on Women (ICRW) November 21, 2002. [PowerPoint file]
HIV/AIDS treatment and HIV vaccines for Africa
Weidle P, Mastro T, Grant A, Nkengasong J, Macharia D, Lancet 2002 Jun 29;359(9325):2261-7. [Free registration required]
The spread and effect of HIV-1 infection in sub-Saharan Africa
Buvé A, Bishikwabo-Nsarhaza K, Mutangadura G, Lancet 2002 Jun 8;359(9322):2011-7. [Free registration required]
HIV/AIDS in Nine Central and West African Countries
The Policy Project, 2001. [PDF, 100K]
How Does HIV/AIDS Affect African Businesses?
[PDF, 544K] and How Are African Businesses Responding? [PDF, 544K], both USAID, December 2001.
Africa and the World Trade Organization: The Issues in Brief
Walter Minter, Africa Action, November 7, 2001. Published by Foreign Policy in Focus.
Uprooted People and HIV/AIDS in Africa: Responding to the Risks
and Women, War, and HIV/AIDS Population Reference Bureau, October 2001.
HIV Voluntary Counseling and Testing Among Youth: Results from an Exploratory Study in Nairobi, Kenya, and Kampala and Masaka, Uganda
Horizons Project, Population Council, October 2001. [PDF, 925K]
Investing in Our Future: Psychosocial Support for Children Affected by HIV/AIDS: A Case Study in Zimbabwe and the United Republic of Tanzania
UNAIDS, July 2001.
Biology or Behaviour? HIV Reduces the Fertility of African Women
id21 Health: Communicating Development Research, Institute of Development Studies, University of Sussex, June 25, 2001.
The Impact of HIV/AIDS on Food Security
Food and Agriculture Organization of the United Nations (FAO), May 10, 2001. Report prepared for the 27th Session of the Committee on World Food Security, Rome, May 28 through June 1, 2001. See also from FAO AIDS and Agriculture in Africa: Can Agricultural Policy Make a Difference? Food and Agriculture Organization of the United Nations (FAO), April 2000; Population Movement, Development and HIV/AIDS: Looking towards the Future May 2000; Agriculture and HIV/AIDS: An FAO Perspective April 2000; The Implications of HIV/AIDS for Rural Development Policy and Programming: Focus on Sub-Saharan Africa July 1998; Rural Children Living in Farm Systems Affected by HIV/AIDS: Some Issues for the Rights of the Child on the Basis of FAO Studies in Africa November 1998.
Abuja Declaration on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases
Organization of African Unity, April 27, 2001.
Youth in sub-Saharan Africa: A Chartbook on Sexual Experience and Reproductive Health
Population Reference Bureau, April 2001.
Global Health: U.S. Agency for International Development Fights AIDS in Africa, But Better Data Needed to Measure Impact
U.S. General Accounting Office, March 2001. [PDF, 656K]
A Media Handbook for HIV Vaccine Trials for Africa
UNAIDS Best Practice Collection, February 2001.
The Economic Impact of HIV and AIDS in Southern Africa
Alan Whiteside, Mary O'Grady, and Anita Alban, AIDS Infothek, vol. 2, 2000. Special issue on HIV/AIDS in Africa published by Swiss Federal Office of Public Health.
The African Consensus and Plan of Action: Leadership to Overcome HIV/AIDS
African Development Forum 2000: AIDS: The Greatest Leadership Challenge, Addis Ababa, December 3-7, 2000. Sponsored by the U.N. Economic Commission for Africa.
A Human Rights Approach to AIDS Prevention at Work: The Southern African Development Community's Code on HIV/AIDS and Employment
UNAIDS Best Practice Collection, July 2000. [PDF, 426K]
Leadership and Investment in Fighting an Epidemic (LIFE) Initiative
Summary released by U.S. Office of National AIDS Policy, July 19, 2000.
Science: Special Issue on AIDS Research in Africa
June 23, 2000.
Media & HIV/AIDS in East and Southern Africa: A Resource Book
UNESCO, 2000.
Economic Impact of AIDS in Africa
Regional and country analyses by the POLICY Project of the Futures Group, 1999.
Other Documents
Directory of Associations of People Living with HIV/AIDS
Includes Network of African People Living with HIV/AIDS and USAID, December 2001. [PDF,705K]
AIDS: The Agony of Africa
Pulitzer Prize-winning, eight-part series by Mark Schoofs, The Village Voice, November 3 to December 29, 1999.
International Organizations
UNAIDS Intercountry Team for West and Central Africa
In English and French. Includes information on migration, debt, and strategic planning, and directory of regional AIDS programs.
World Bank Sub-Saharan Africa Regional Page
World Health Organization (WHO) Regional Office for Africa
In English and French.
Subregional Organizations and Projects
Catholic Institute for International Relations/International Cooperation for Development
Health Systems Research in the Southern African Region
Media For Development Trust Assists local NGOs to develop capacity to use film and video.
Organization of African Instituted Churches Provides support to orphans and other vulnerable children.
Panos Southern Africa AIDS Program Based in Lusaka. Works with media and other information actors to enable developing countries to shape and communicate their own development agendas through informed public debate; particular focus on amplifying the voices of the poor and marginalized. Numerous HIV/AIDS-related activities and publications.
Project Support Group Assists southern African districts, municipalities, nonprofits, and faith-based partners to develop, manage, and sustain HIV/AIDS prevention and mitigation projects in priority migrant communities and areas.
Southern Africa Communications for Development Coalition of filmmakers and organizations that produce and distribute socially responsible films and videos, including those on HIV/AIDS-related issues.
Southern Africa Orphanage Hope Foundation
Southern African AIDS Training (SAT) Program Based in Harare.
Southern African AIDS Information Dissemination Service (SAfAIDS) Based in Harare.
Southern African Development Community (SADC)
Southern African Network of AIDS Service Organizations (SANASO) Based in Harare.
Southern African Regional Poverty Network Managed by South Africa's Human Sciences Research Council.
Steps for the Future Collection of films about life in southern Africa in the presence of HIV/AIDS.
Women in Law in Southern Africa Research and Education Trust (WLSARET) Manages an HIV/AIDS research project.
Women In Need, Inc. Provides support to women and children affected by HIV/AIDS.
HIV/AIDS Web Sites
Advance Africa
Funded by USAID; seeks to improve family planning and reproductive health services reaching underserved groups.
Africa Alive
Funded by USAID and DFID; seeks to provide youth with the skills to fight HIV/AIDS through the medium of popular entertainment.
African Medical and Research Foundation (AMREF)
Seeks to improve health care among the poor in Africa through service delivery, training and research in partnership with communities, governments, and donors.
Afrique Santé
Based in France; produces radio and television programs on health issues, including HIV/AIDS.
AIDS Orphans Assistance Database
Association François-Xavier Bagnoud; seeks to facilitate cooperation among people and organizations involved in assisting children orphaned or made vulnerable by HIV/AIDS and to help donors identify potential project partners directly.
Partnership to consolidate the skills, knowledge, and institutional resources of groups and individuals active in the field of sexual and reproductive health, gender equality, and women's rights. Coordinated by RAINBO.
Center for African Family Studies
International NGO that seeks to strengthen the capacity of sub-Saharan African organizations working in family planning, HIV/AIDS, and related reproductive health services. In English and French.
Centre for International Cooperation in Health and Development: AIDS and Africa
Based at Laval Université, Canada. Activities include Francophone Africa AIDS Program and West Africa AIDS Project. NB: Not recently updated.
Centre Muraz: VIH et Maladies Associées
Located in Bobo-Dioulasso, Burkina Faso, and part of the Organization for Coordination and Cooperation against Endemic Diseases, an initiative of eight French-speaking West African countries. Also available in English.
Communities Responding to the HIV/AIDS Epidemic (CORE Initiative)
Funded by USAID and managed by CARE USA. Provides strategic assistance to community and faith-based groups in developing countries. Includes online resource center.
Global Reproductive Health Forum: West Africa Project
From the Harvard School of Public Health.
Network of African People Living with HIV/AIDS (NAP+)
Network on Equity in Health in Southern Africa (EQUINET)
Priorities include monitoring, globalization and macroeconomic policy, governance, rights, resource allocation, and community participation.
Francophone AIDS network.
RHAP SA (Regional HIV/AIDS Programme Southern Africa)
Funded by USAID. Targets high transmission areas at cross-border sites and implements appropriate interventions; participating countries include Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe.
Santé Familiale et Prévention du SIDA
Subregional USAID-funded project that seeks to encourage family planning, reduce infant mortality, and limit the spread of HIV/AIDS in West and Central Africa. Countries participating are Burkina Faso, Cameroon, Côte d'Ivoire, and Togo.
Voices from Africa
A project of the United Nations Non-Governmental Liaison Service. Includes analysis of NGO responses to HIV/AIDS.
13th International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa (ICASA)
Nairobi, Kenya, September 21-26, 2003.
2nd Consultative Meeting on Rethinking HIV/AIDS and Development: A Review of USAID's Progress in Africa
Washington, DC, March 12-13, 2002. The site contains the workshop's agenda, reports, and presentations as well as a collection of supporting publications and tools.
Africa Daily
African Medical News
From African Sciences, based in Nairobi.
All Africa: AIDS
Can also search by country and numerous other topics. Includes Panafrican News Agency stories in French.
Africa News Update
Articles from major African media compiled by Norwegian Council for Africa (NGO). Free email subscription to daily news digests.
Africa Online
News from Côte d'Ivoire, Ghana, Kenya, Namibia, Swaziland, Tanzania, Uganda, and Zimbabwe.
Includes extensive country-level links.
Columbia University: Electronic Journal and Newspapers on Africa
Hans Zell Publishing: African Newspapers and Media
Integrated Regional Information Networks (IRIN)
News service of the UN Office for the Coordination of Humanitarian Affairs, in partnership with ReliefWeb. Reports on political, economic, and social issues affecting humanitarian efforts in Africa. Daily news organized by subregion and country. Includes PlusNews, an HIV/AIDS news service. Some services available in French and Kiswahili.
Major African Media
Media Institute of Southern Africa
Based in Windhoek; activities include facilitating accessibility of local and regional news.
West Africa News
Part of the WorldNews Network.
Online Discussion Groups
Launched by the Fondation du Présent; moderated by Health & Development Networks, and hosted by Health Systems Trust, Durban, South Africa.
African Networks for Health Research & Development (AFRO-NETS)
Hosted by SatelLife; includes links of partner organizations.
Break the Silence
NGO and civil society discussion forum; current focus is the Global Fund to Fight AIDS, Tuberculosis & Malaria.
Funded by the Fondation du Présent, a Swiss nonprofit; hosts numerous HIV/AIDS topical and regional forums. Also hosts Aids Info Docu Switzerland, the Swiss national HIV/AIDS documentation center; materials available in English, French, Italian, and German.
Journalists Against AIDS (JAAIDS) Nigeria
Website offers HIV/AIDS information for the following West African countries: Benin, Burkina Faso, Cameroon, Chad, Niger, Côte d'Ivoire, Gabon, The Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mauritania, Mali, Nigeria, Senegal, Sierra Leone, and Togo. Also contains information on the media and HIV/AIDS in Africa, links, and the Nigeria-AIDS eForum. In English and French.
West and Central African HIV/AIDS Francophone Electronic Network (SAFCO)
Joint initiative of UNAIDS, German Technical Cooperation (GTZ), Canadian International Development Agency, Enda Santé, UNDP, UNFPA, and Fondation du Présent. Seeks to strengthen prevention/treatment/care information exchange, mobilize resources, improve knowledge of existing projects, foster partnerships, and increase access to the results of international conferences.
Databases and Information Portals
Africa Clinical Epidemiology Network
African Journals Online
Africa Counselling Network
African Council of AIDS Service Organisations (AfriCASO)
Includes African HIV/AIDS Directory of Community-based Health Care, with organizational profiles of and contact information for selected CBOs in 23 countries.
African Digital Library
Joint project of the Association of African Universities, Technikon SA, and netLibrary. Free to users in Africa.
Africa Education
Includes access to libraries and learning center. Sponsored by Technikon SA and the Association of African Universities.
Africa-Related Links
Compiled by the University of Wisconsin-Madison African Studies Program.
An HIV/AIDS information portal for southern Africa developed by the South African Medical Research Council (MRC). Site aims to disseminate important information on HIV/AIDS to researchers, the health profession, the public, infected individuals, educators and policy makers
Association for Health Information and Libraries in Africa (AHILA)
Includes African Index Medicus.
Centres Régionaux d'Information et de Prévention du Sida (CRIPS): Afrique
Focuses on treatment information, methodological support to awareness raising and communication efforts, training, and support to research and evaluation projects.
Council for the Development of Social Science Research in Africa
In English and French.
Health and General Information on Africa
Links compiled by USAID.
Index on Africa
Compiled by the Norwegian Council for Africa, a nonprofit organization.
Réseau Africain de Recherche sur le Sida (RARS)
Based in Dakar; members include Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Guinea, Niger, Nigeria, Senegal, Sierra Leone, and The Gambia.
Social Science and Medicine Africa Network (SOMA-Net)
Stanford University Library: Africa
Extensive regional and country links.
University of Pennsylvania, African Studies Center
Includes extensive links and country-specific pages.
Other Information Sources
Statistical, Economic and Social Research and Training Centre for the Islamic Countries (SESRTCIC)
Also known as the as the Ankara Centre, SESRTCIC collects, processes and disseminates socio-economic statistics and information; conducts research; and organizes training programs in selected fields.





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