AIDS crisis will get worse in Sub-Saharan Africa

By John Kiwanuka Ssemakula, 24 June 2002

There is a possibility that the AIDS pandemic will worsen rapidly in Sub Saharan Africa in the next five years and the numbers of AIDS cases could double according to analysis by US intelligence officials it was reported in the Boston Globeon June 16 2002.

Analysts at the National Intelligence Council (NIC), an arm of the Central Intelligence Agency that studies issues of long-term strategic interest to the US government, came to these conclusions based on data in Nigeria and Ethiopia. Together the two countries make up almost a third of the people in sub- Saharan Africa, with a combined population of 200 million.

According to the NIC analysts the AIDS pandemic will also worsen worldwide mainly in India. The Boston Globe reports that “the new projections almost surely will be given considerable weight among leading global health officials because the National Intelligence Council has a strong track record in forecasting trends about HIV and AIDS. The council was the lone voice in the US government a decade ago that called attention to the disease. In 1991, it predicted 45 million infections by the year 2000.”

Both Nigeria and Ethiopia are past the 5% prevalence rate among adults, the point at which the epidemic in several other African countries entered the “explosive phase.”

The “explosive phase” occurs when under certain circumstances the epidemic suddenly explodes with rates of infection increasing rapidly in a very short time. South Africa, where the HIV incidence went from 12.9% to 19.9% in two years and Botswana, where the infection levels rose from 10% in 1992 to over 30% now, are examples of this trend. It is not yet understood what causes this.

In Nigeria, the most populous country in Africa, which had been spared to an extent, HIV prevalence increased from 4.1% in 1997 to 5.1% in 1999 and now officially stands at 6%. Many people believe the real figure is nearer 10%. This worrying increase could indicate that Nigeria is just lagging behind the rest of Africa with the severity of their epidemics.

Ethiopia is one of the most severely affected countries in Africa, exceeded only by South Africa in terms of numbers of people infected. By the end of 1999, according to UNAIDS, almost 3 million people were infected with the HIV virus, and the prevalence rate was almost 11%.

Map of estimated percentage of adults (15-49yrs) infected with HIV at end 1999

According to UNAIDS about 23 million people were infected HIV in 1997 in Africa. The number is almost 30 million now, a 30 percent increase over the previous five-year period. “A doubling of cases in Africa in the next five years would push the number of people infected there to 60 million by 2007, analysts from the National Intelligence Council said.”

In the meantime a report from the UN "HIV/AIDS: Awareness and Behaviour" has found that dramatic changes in sexual and reproductive behaviour are needed to fight the AIDS pandemic. The report found that many Africans are still ignorant about AIDS. Half the women surveyed in Benin, Burkina Faso, Chad, Mali, Madagascar and Niger did not know that they could become HIV positive and develop AIDS through sex and up to 33% of women did not know how to protect themselves against AIDS. Ignorance was especially high in rural areas.

Amid the worsening crisis, Stephen Lewis, the UN special envoy for HIV/AIDS, last week criticised the New Partnership for Africa's Development (NEPAD) for its modest references to HIV/AIDS saying "I privately wish that the African leadership had openly confronted the G8 on the issue of AIDS, rather than muting its impact within NEPAD."

Lewis went on to express disappointment that wealthy nations had only contributed US $2.1 billion dollars over three years to the Global Fund. "It's a shocking piece of international financial delinquency, and it's a shocking rejection of Africa".

In April, the Global Fund's board approved the first round of $378 million over two years for projects, with plans to finance another $238 million. The Global Fund to Fight AIDS, Tuberculosis and Malaria was initiated 14 months ago by Kofi Annan, UN secretary general, who estimated that $7 billion to $10 billion needs to be spent annually. The Global Fund has so far received pledges of $1.9 billion. The WHO estimates around $2.8 billion will be spent this year to fight AIDS.