Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world. An estimated 22 million people were living with HIV at the end of 2007 and approximately 1.9 million additional people were infected with HIV during that year. In just the past year, the AIDS epidemic in Africa has claimed the lives of an estimated 1.5 million people in this region. More than eleven million children have been orphaned by AIDS.
The extent of the AIDS crisis is only now becoming clear in many African countries, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll in sub-Saharan Africa will continue to rise. This means that impact of the AIDS epidemic on these societies will be felt most strongly in the course of the next ten years and beyond. Its social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general.
Both HIV prevalence rates and the numbers of people dying from AIDS vary greatly between African countries. In Somalia and Senegal the HIV prevalence is under 1% of the adult population, whereas in Namibia, South Africa, Zambia and Zimbabwe around 15-20% of adults are infected with HIV. In three southern African countries, the national adult HIV prevalence rate has risen higher than was thought possible and now exceeds 20%. These countries are Botswana (23.9%), Lesotho (23.2%) and Swaziland (26.1%). West Africa has been less affected by AIDS, but the HIV prevalence rates in some countries are creeping up. HIV prevalence is estimated to exceed 5% in Cameroon (5.1%) and Gabon (5.9%). Until recently the national HIV prevalence rate has remained relatively low in Nigeria, the most populous country in sub-Saharan Africa. The rate has grown slowly from below 2% in 1993 to 3.1% in 2007. But some states in Nigeria are already experiencing HIV infection rates as high as those now found in Cameroon. Already around 2.4 million Nigerians are estimated to be living with HIV. Adult HIV prevalence in East Africa exceeds 5% in Uganda, Kenya and Tanzania.
Trends in Africa's AIDS epidemic
Large variations exist between the patterns of the AIDS epidemic in different countries in Africa. In some places, the HIV prevalence is still growing. In others the HIV prevalence appears to have stabilised and in a few African nations - such as Kenya and Zimbabwe - declines appear to be under way, probably in part due to effective prevention campaigns. Others countries face a growing danger of explosive growth. 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.
Overall, rates of new HIV infections in sub-Saharan Africa appear to have peaked in the late 1990s, and HIV prevalence seems to have declined slightly, although it remains at an extremely high level. Stabilisation of HIV prevalence occurs when the rate of new HIV infections is equalled by the AIDS death rate among the infected population. This means that a country with a stable but very high prevalence must be suffering a very high number of AIDS deaths each year. Although prevalence has declined, the number of Africans living with HIV is rising due to general population growth.
Over and above the personal suffering that accompanies HIV infection, the AIDS epidemic in sub-Saharan Africa threatens to devastate whole communities, rolling back decades of development progress. Sub-Saharan Africa faces a triple challenge of colossal proportions: Providing health care, support and solidarity to a growing population of people with HIV-related illness, and providing them with treatment. Reducing the annual toll of new HIV infections by enabling individuals to protect themselves and others. Coping with the cumulative impact of over 20 million AIDS deaths on orphans and other survivors, on communities, and on national development.
HIV & AIDS are having a widespread impact on many parts of African society. The points below describe some of the major effects of the AIDS epidemic. For a more detailed examination, visit our African impact page. In many countries of sub-Saharan Africa, AIDS is erasing decades of progress made in extending life expectancy. Millions of adults are dying from AIDS while they are still young, or in early middle age. Average life expectancy in Sub-Saharan Africa is now 47 years, when it could have been 62 without AIDS. The effect of the AIDS epidemic on households can be very severe. Many families are losing their income earners. In other cases, income earners are forced to stay at home to care for relatives who are ill from AIDS. Many of those dying from AIDS have surviving partners who are themselves infected and in need of care. They leave behind orphans, grieving and struggling to survive without a parent's care.