HIV/AIDS has hit southern Africa harder than any other region in the world. How will this epidemic affect the coming generations and the demographic development of entire nations?
 | A Kenyan woman prepares ribbons ahead of World AIDS Day in Nairobi. Kenya has over a million people infected with HIV, but the situation is even worse in southern Africa (Photo: Reuters) |
In most countries, women live longer than men. They smoke and drink less, eat better, and generally live healthier, less-risky lives than men. But women's life expectancy has sunk below that of men in four sub-Saharan African countries: Kenya, Malawi, Zambia, and Zimbabwe. Here, women run a higher risk of dying during childbirth and of infectious diseases. The biggest factor, however, is the HIV/AIDS epidemic.
Nowhere on Earth has the disease spread more widely than in sub-Saharan Africa. Roughly two thirds of all adults in the world who have HIV/AIDS live in this part of Africa; 60 percent of them are women. The epidemic has particularly hit the southern part of the continent. Nearly 19 percent of the adult population in South Africa - around 5.5 million people - are living with HIV. In Namibia, 19.6 percent; in Botswana, 24.1 percent; and in Swaziland, a staggering 33 percent of the population has HIV.
 | Volunteer Manany Dimakatso Mofokeng looks after a bedridden AIDS patient as part of CARE'S Thespo Home-Based Care Project in South Africa (Photo: Brian Atkinson/CARE) |
Given these statistics, even people who have worked in southern Africa for years find it hard to predict how the epidemic will affect life expectancy rates, mortality rates, and the men-women ratio in the region.
"These are issues that we still don't know about," says Madhu Deshmukh, who heads HIV/AIDS projects at CARE International. "How, for example, will adult mortality impact a nation in terms of its demographic structure? That's a big unknown about the impact of HIV."
Plunging life expectancy
Of the known AIDS-related demographic trends in southern Africa, none are very encouraging. For one thing, HIV/AIDS is reversing the gains in life expectancy that much of southern Africa had made prior to the onset of the epidemic. Lesotho, a country with an average life expectancy of almost 60 years in 1995, has since seen that figure drop to 36 years. Four other countries in the region - Zimbabwe, Swaziland, Botswana, and Zambia - have also seen their life expectancies plunge to under 40 in the same timeframe.
Experts project that by 2015, the population of South Africa will be 50 million people (15 percent) fewer than in a no-AIDS scenario. Despite these figures, however, high birth rates in sub-Saharan Africa could push the region's population from the current 788 million people to 1.7 billion in 2050.
But what will this growing population look like? One striking demographic impact of AIDS is that it distorts the typical age structures of populations. Typically, mortality rates are highest among young children and elderly adults, but today in southern Africa, mortality is highest among people in their thirties - during or following their most sexually active years. These are also people who would otherwise be of prime working age.
The changing male-female ratio is another dangerous trend. More women than men are infected with HIV/AIDS, which means that female life expectancy is going down dramatically. UNAIDS estimates that young women aged 15-24 in sub-Saharan Africa are between two and six times as likely to be HIV-positive than men of a similar age.
Since women traditionally taking care of children, one urgent question is who will care for the orphans - the millions of children whose parents have died of AIDS. This burden often falls on elderly or distant family members who may already be struggling to support their own households. UNAIDS reports that around 12 million children in sub-Saharan Africa have lost one or both parents to AIDS.
Domino effect
Even if children do not inherit their parents' disease, they have to live with its consequences. Because relatives often have no money to pay their school fees, orphans often cannot attend school. In the worst cases, adolescent orphans find themselves heading an entire household once their parents die. Instead of learning, they have to earn money and care for younger brothers and sisters.
"The phenomena of child-headed households creates the situation where your current productive population is sick and dying, and your future population could be illiterate," says Madhu Deshmukh. "That definitely has a huge impact on the national economy. To me, it's like a domino effect."
Surprisingly, researchers have found fairly little correlation between HIV/AIDS and the gross domestic product (GDP) of affected countries. There are, however, signs that the epidemic will have many other long-term effects on the economies and infrastructure in southern Africa.
UNAIDS says that by 2020, HIV/AIDS could kill or disable about 20 percent of the agricultural workforce in countries like Namibia, Botswana, and Zimbabwe - countries that can ill afford reductions in their crop production. Health services in the region, most of which are already short of staff and resources, are on the brink of collapse due to AIDS. Up to 50 percent of the beds in South Africa's large provincial hospitals are occupied by people with AIDS, according to researchers at the University of Natal.
Government policies can make a difference. HIV/AIDS prevalence has declined in some countries, particularly in Kenya, Uganda, and Burkina Faso, where education has spread awareness about AIDS testing, using condoms, and less risky behavior. But without more aggressive national prevention and treatment policies, experts at the US-based Global Prevention Working Group fear there could be tens of millions more infected in sub-Saharan Africa by 2015.
In her work at CARE International, Deshmukh believes that an integrated approach needs to address not only the epidemic, but also the "root problems" - poverty, gender inequality, failing health systems and food insecurity - that have caused HIV/AIDS to hit southern Africa particularly hard.
editor: Valdis Wish
publishing date: October 18, 2007
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Readers' Comments:
The HIV/AIDS pandemic at this moment require the conscience, atleast it has to react each time one fails to sympathise and empathise with those who are suffering with HIV/AIDS. it's the responsibility of everyone and it really has to be prioritised in anything any nation may think of. We shouldn't spend much in wars (killing and terrorism) we should rather spend that in trying to be in solidarity with the suffering, they belong to us and they are our brothers and sisters. we should think more and more on this issue. Should they (we) perish because we simply fail to show concern, care and love, maybe not.
Martin Gwenyambira, currently in Zambia
In zambia, most of the people aquire HIV/AIDS through practicing sex, this is because of poverty in zambia and other developing countries in Africa. Its now government responsibility to see that young people betwin 15 to 35 years are provided with employement, so that they have no enough time play.
Most ladies go for sex in need of money, they have even set prices for; one without condoms is higher than the one with condoms. Despite what goes on, lets show concern to people living with HIV/AIDS, and contribute to the development of our world.
Kennedy Kabati Lwando, Kitwe, Zambia
The dynamics between virus infections and the immune system involve many different components and are multi factorial. In such a scenario, the principles governing the dynamics and the outcome of infection cannot be understood by verbal or graphical reasoning. Mathematical
models provide an essential tool to capture a set of assumptions and to follow them to their precise logical conclusions. They allow us to generate new hypotheses, suggest experiments and measure crucial parameters.
Anonymous Reader
