USIS Washington File - November 23, 2005
Washington - While HIV/AIDS is still robbing sub-Saharan Africa
of potential economic gains by decimating whole populations, a
recent United Nations report reveals that the pandemic is
decreasing in intensity among adults in Kenya, Zimbabwe and
According to the report UNAIDS/WHO AIDS Epidemic Update: December
2005, sub-Saharan Africa is home to more than 60 percent of all
HIV/AIDS victims -- around 25.8 million people, and growing. In
2005, an estimated 2.8 million to 3.9 million people in the
region became newly infected. (See related article.)
The good news, however, is that in three African nations, Kenya,
Uganda and Zimbabwe, "declines in adult national HIV prevalence
appear to be under way," the U.N. report states.
"East Africa continues to provide the most hopeful indications
that serious AIDS epidemics can be reversed," it reported, with
"the countrywide drop in HIV prevalence among pregnant women --
seen in Uganda since the mid-1990s -- now being mirrored in urban
parts of Kenya, where infection levels are dropping, in some
places quite steeply." Uganda's HIV prevalence rate now is
estimated to be around 7 percent, one of the lowest in Africa.
The AIDS epidemic in Kenya peaked in the late 1990s with an
overall HIV prevalence of 10 percent in adults, which declined to
7 percent in 2003, the U.N. report said. The "most dramatic
drops in prevalence have been among pregnant women in urban areas
-- especially in Busia, Meru, Nakaru and Thika, where median HIV
prevalence plummeted from approximately 28 percent in 1999 to 9
percent in 2003.
"This is only the second time in more than two decades that a
sustained decline in national HIV infection levels has been seen
in a sub-Saharan African country," the report added.
Significantly, the U.N. report emphasized that "In both
countries, behavioral changes are likely to have contributed to
the trend shifts."
Ironically, the U.N. report also noted a significant decline in
infections in Zimbabwe, where social conditions have declined
precipitously under the political and economic mismanagement of
President Robert Mugabe.
The report says, "Recent data from Zimbabwe's national
surveillance system show a decline in HIV prevalence among
pregnant women from 26 percent in 2002 to 21 percent in 2004. In
Harare, HIV prevalence in women attending antenatal or postnatal
clinics fell from 35 percent in 1999 to 21 percent in 2004. In
rural eastern Zimbabwe, declines in HIV prevalence in pregnant
women were also reflected in declines among both men and women in
the general population."
It adds that, "a significant decline in HIV prevalence among
pregnant young women (15�24 years) -- which fell from 29 percent
to 20 percent in 2000-2004 -- suggests that the rate of new HIV
infections [incidence] could be slowing, too."
On the less positive side, the report continues: "With the
exception of Zimbabwe, countries of southern Africa show little
evidence of declining epidemics. HIV prevalence levels remain
exceptionally high (except for Angola), and might not yet have
reached their peak in several countries -- as the expanding
epidemics in Mozambique and Swaziland suggest."
PROGRESS ALSO SEEN IN WEST, CENTRAL AFRICA
The picture is brighter in West and Central Africa, where, the
United Nations estimates, "national HIV prevalence is
considerably lower than in the south and east of the region."
Attempting to dispel misconceptions about the disease's spread in
Africa, the U.N. report said: "It is inaccurate to speak of a
single 'African' AIDS epidemic. National-level HIV prevalence
data can sometimes prompt incomplete pictures of the actual state
of affairs." For example, "In most countries, HIV prevalence
observed among pregnant women attending antenatal clinics �
differs by wide margins, depending on the location."
The difference in rates might also be prompted by "the social and
socioeconomic status of women, who remain disproportionately
affected by HIV in this region [Africa] and, at the same time,
poorly informed about the epidemics," it said.
The report explained: "Generally, women are less well-informed
about HIV than are men; this is also true of [people living in]
rural areas compared with those living in cities and towns. Data
from 35 of the 48 countries in sub-Saharan Africa show that, on
average, young men were 20 percent more likely to have correct
knowledge of HIV than young women."
Education levels also "make a huge difference," the U.N. report
stated. For example, "young women in Rwanda with secondary or
higher education were five times as likely to know the main HIV
transmission routes than were young women with no formal
According to U.S. Global AIDS Coordinator Randall Tobias,
President Bush's Emergency Plan for AIDS Relief, a $15 billion
worldwide initiative launched in 2003, is on track, especially in
Tobias told reporters at a State Department news conference in
June that "as results are reported from the field, it is
increasingly clear that the launch of the Emergency Plan marked a
turning point in the fight against HIV/AIDS. On the ground, the
reality is changing -- rapidly."
Tobias said: "As of March 31 of this year, the Emergency Plan has
supported antiretroviral treatment for approximately 235,000 men,
women and children through bilateral programs in 15 of the most
afflicted countries in Africa, Asia and the Caribbean. Of that
number, more than 230,000 of those being supported live in
Looking ahead, the U.S. AIDS official said, "These results
indicate that the Emergency Plan remains on track, scaling up to
meet the president's ambitious goal of supporting treatment for
two million people in five years." Additional information is
available on the Office of the U.S. Global AIDS Coordinator Web
The U.N. report, available on the UNAIDS Web site in English,
French, German, Russian and Spanish, was released November 21 in
advance of World AIDS Day, December 1.