Global Policy Forum

By David Fox

Nairobi - The rate of new HIV infections is finally falling in Africa - but only because the epidemic has already struck so many people, a new report by the United Nations said on Tuesday. "The epidemic in many (African) countries has gone on for so long that it has already affected many people in the sexually active population, leaving a smaller pool of people still able to acquire the infection," the UN's Aids body (UNAIDS) said.

The report - released ahead of World Aids Day on 1 December - says 3.8 million Africans were infected with HIV this year compared to four million in 1999, the first decline since the epidemic first struck. Sub-Saharan Africa now accounts for 25.3 million of the 36.1 million people living with HIV or Aids globally – a figure that amounts to nearly one in every ten African adults. "One continent is touched by Aids more than any other," the report says. "Africa is home to 70 percent of the adults and 80 percent of the children living with HIV, and has buried three-quarters of the more than 20 million people world-wide who have died of Aids since the epidemic began." Some 2.4 million people died of Aids-related diseases in Africa this year - more than those killed by war, famine and flood combined.

Over a Third of Botswana Adults Infected Botswana remains the country worst hit by the epidemic with 35.8 percent of the country's adults infected. But South Africa has the highest absolute number of infected people in the world, with 4.2 million of its 39.9 million people infected - nearly 20 percent of the population. The reasons given for the stranglehold of the virus in Africa are numerous and often controversial. Africa has less access to basic health care and sanitation than other continents. As a result many people are not treated for the sexually transmitted diseases that help spread HIV.

Discussing sex is still taboo in many African societies and governments have been loath to upset their constituencies by promoting condom campaigns or HIV/Aids testing. But most controversial is the belief held by many scientists but considered politically incorrect in UN corridors - that Africans have more sex than the people of any other continent do. "It is not a popular theory," one senior UN Aids official told Reuters. "You certainly won't find it in any UN material, but the scientific community is rapidly accepting the reality that there is more sex in Africa. There is no other affordable leisure activity."

Mind-boggling Problems

The statistics produced by the United Nations are mind-boggling when it comes to Africa.

- Life expectancy in Zimbabwe has shrunk from 65 to 43 years - less than it was at the beginning of the 20th century.

- One in every four South African women between the ages of 20 and 29 is HIV positive.

- HIV patients occupy nearly 40 percent of all hospital beds in Kenya and 70 percent in Burundi.

- Over 10 million Ethiopians will die of Aids within the next decade.

There are some good signs for Africa, however. The report says that in countries, which have embraced anti-Aids campaigns, rates of infection do eventually slow. Uganda, where as a result of civil war in the early 1990s Aids spread more rapidly than elsewhere on the continent, has seen the adult HIV prevalence rate drop to 8.3 percent from nearly 14 percent at its peak. But while Uganda remains the UN's model for fighting Aids in Africa, few other nations have followed its example. The UN says at least $3 billion a year is needed to promote Aids programmes in Africa that would make a difference. "This seems like a small price to pay to help a whole continent avoid a future dominated by the social disruption that defines the Aids era," it says.

However, help may not immediately be at hand. "It is estimated, for example, that the United States alone spends around $52 billion coping with the medical consequences of obesity - more than 15 times what would be needed to change the face of Aids in Africa."

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