With approximately 5 million new infections having occurred in 2001, the HIV/AIDS pandemic is rapidly spreading and threatens all countries and regions. More than 40 million people are living with HIV/AIDS¹. The magnitude of human suffering and the increased burden of care and support associated with the pandemic make HIV/AIDS a major challenge facing the global community today.

UNFPA has worked in the field of population and development for more than three decades and has addressed the issue of HIV/AIDS for the last decade. However, no organization by itself has the capacity or the resources needed to address and halt the pandemic.

An effective response requires careful collaboration and coordination among organizations, with each bringing to the partnership a distinct set of capabilities, strengths and comparative advantages.

As one of the eight cosponsors of UNAIDS (the other cosponsors being UNICEF, UNDP, UNDCP, UNESCO, ILO, WHO and World Bank), UNFPA chairs Theme Groups in many countries and supports HIV-prevention interventions in almost all of its country programmes.

To maximize its response and to strengthen coordinated activities with other partners, it is critical for staff at every level to have a common understanding of the Fund’s policies and strategic priorities.

The aim of this document is to provide such guidance to staff, delineating the niche in which UNFPA as an organization has a definite comparative advantage in addressing the HIV/AIDS epidemic, especially at the country level.

Scope of the Pandemic

The HIV/AIDS pandemic consists of multiple, concurrent epidemics. Globally, the number of women is rapidly reaching the number of men infected, and in certain countries in sub-Saharan Africa, young women are now two to six times more likely than young men to be infected with HIV.

Of the global total of 37.2 million adults living with HIV/AIDS in 2001, 17.6 million (or 47 per cent of adults) were women. Young people between the ages of 15 and 24 constituted about one third of those living with HIV/AIDS in 2001 and made up more than half of all persons with newly acquired HIV infections.

From a geographic standpoint, many countries and communities with relatively low prevalence rates until recently are now experiencing faster growth of the pandemic. The apparently low national prevalence rates are dangerously deceptive; as such rates often mask the fact that at sub-national levels and among specific population groups the rates are high.

Sub-Saharan Africa, the region with the highest infection rates, shows signs that HIV incidence may be stabilizing in a few countries. In others, infection rates are still escalating. About 28.1 million Africans were living with the virus in 2001, with an estimated 3.4 million new HIV infections. It is estimated that 2.3 million Africans died of AIDS in 2001. In parts of southern Africa, the HIV prevalence rates have increased by 50 per cent over the two-year period 1999-2000. In several parts of southern Africa, prevalence rates among pregnant women exceeded 30 per cent. In West Africa, national adult HIV prevalence exceeded 5 per cent in at least five countries in 2001.

Asia and the Pacific, by virtue of the sheer size of the region’s population, has the potential to influence the course and overall impact of the HIV/AIDS pandemic significantly. The countries in this region fall into the moderate and low prevalence categories but with prevalence diversities and increases that need to be acknowledged. The spread of HIV has recently been faster in this region than in others, with the epidemic claiming the lives of 435,000 people in the region in 2001. An estimated 7.1 million people were living with HIV or AIDS in the region in 2001. In India alone, with a national prevalence rate of 0.7 per cent, 3.9 million people were living with HIV/AIDS by the end of 2000.

In Eastern Europe and Central Asia, drug injection fuels the epidemic as it did in communities of Southeast Asia a decade ago, increasing the number of adults and children newly infected with HIV by 250,000 in 2001. In the Russian Federation, the cumulative number of reported HIV infections was 129,000, up from 11,000 in 1998. In Ukraine, the HIV prevalence rate is 1 per cent, the highest in the region. HIV infections related to injecting drug use have also been reported in several Central Asian republics.

Latin America and the Caribbean have a complex mosaic of transmission patterns, in which marginalized populations seem to be paying a disproportionately high toll. About 1.8 million adults and children were living with HIV or AIDS in 2001. With an average adult HIV prevalence of approximately 2 per cent, the Caribbean is the second-most affected region in the world.

In North Africa and the Middle East, because of lack of accurate data, it has been difficult to produce estimates. However, recent figures suggest that new infections may be on the rise, particularly in those countries that are already experiencing complex emergencies (such as Somalia and the Sudan). With an estimated 80,000 new infections in the region during 2001, the number of adults and children living with HIV/AIDS by the end of 2001 had reached 440,000.

High-income countries: There is evidence of rising HIV infection rates in North America and parts of Europe and Australia, with unsafe sex and injecting drug use among the reasons. More than 75,000 people acquired HIV in 2001, and 1.5 million were living with HIV or AIDS in these areas.

Adults and children estimated to be living with HIV/Aids as of end 2001:

Map: Source: UNAIDS and WHO, AIDS Epidemic Update, December 2001

Footnotes: 1 Unless otherwise indicated, all statistics in this section are from UNAIDS and WHO, AIDS Epidemic Update: December 2001 (Geneva, 2001).

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