| Purpose of the Guidance Note
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.
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
otherwise indicated, all statistics in this section are from UNAIDS
and WHO, AIDS Epidemic Update: December 2001 (Geneva, 2001).
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