(Not for release before 3 December 2002)
HIV/AIDS poses a great threat to development in poor coun-tries
and the impact is hardest among the poor. Striking
14,000 men, women and children daily, AIDS is the leading
cause of death in sub-Saharan Africa and the world’s fourth
biggest killer. By 2010, about 40 million children will have
been orphaned by the pandemic.
Women are more vulnerable to infection
and sex workers are far more likely than the population
at large to be infected. But the sexual behaviour of
men is largely responsible for spreading the disease.
One half of new HIV infections are among young people
aged 15-24, many of whom have no information or prevention
services and are still ignorant about the epidemic and how
to protect themselves. Studies in seven African countries
show that at least 40 per cent of 15-19 year olds did not believe
they were at risk.
The health-care system in Africa is overwhelmed and
health workers are being struck down, leaving a decimated
staff to confront an exploding crisis. Education systems
are also collapsing. A recent forum in Cameroon suggested
that 10 per cent of teachers and 20 per cent of students could
be infected with HIV in the next five years.
HIV/AIDS is already slowing economic
growth and activity in the worst-affected countries.
In the 1990s, AIDS reduced Africa’s per capita annual
growth by about 0.8 per cent.
Models suggest that in the worst-affected
countries 1-2 percentage points will be sliced off per
capita growth in coming years. This means that after
two decades, many economies will be about 20-40 per
cent smaller than they would have been without AIDS.
The poor have little access to prevention
services, condoms, or any form of treatment. Only about
one in five people at risk for HIV have access to prevention
information and services. Fewer than 5 per cent of people
in need get anti-retroviral drugs. Action against the
epidemic has been impeded by the slowness of leadership,
at all levels, to recognize and admit the nature of
the advancing crisis. The universal culture of silence
that surrounds sexual behaviour has kept eyes averted
and voices silenced.
Effective strategies to turn back the epidemic involve a
combination of treatment, education and prevention. Such
strategies must go beyond medicine and health care and
reach into the community. Strong and committed leadership
is also necessary.