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HIV Crisis in Africa 

Submitted by Stacey White, MSN, MSHA, CRNP

Tags: africa aids hiv hiv crisis

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Auburn University Montgomery
School of Nursing

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I have constant pain, and there is no help for us-just for the rich people-but if I can find someone to look after my children, I can die in peace. -Lillian M., 38, a person with AIDS, Nairobi (Human Rights Watch, 2001)

Introduction 

The human immuno-deficiency virus/acquired immuno-deficiency syndrome (HIV/AIDS) is of pandemic magnitude. The World Health Organization has declared AIDS as a global health emergency.  Awareness of the serious global impact has climaxed, taking its place with the bubonic plague of the Middle Ages.  The worst is yet to come, for there are 36 million infected and 22 million deaths from this disease. The percentage of infection has continued to escalate in Africa over the past decade, almost 80% of the 22 million deaths from AIDS have occurred in Africa. Experts in the U.N. and Census Bureau report “the HIV/AIDS pandemic is producing orphans on a scale of unrivaled in world history” (Human Rights Watch, 2001).

Botswana 

The population of Botswana is currently estimated at 1.6 million. According to UNAIDS, 2001 data, 300,000 or 38.8% of the population in Botswana were infected.  Botswana remains the highest proportion of any country in the world (Online Newshour, 2003).   Botswana is a very wealthy country, having diamonds, copper, nickel, cole, iron, and silver as natural resources.  The economy primarily relies upon the diamond mines and is considered quite prosperous utilizing the standards set forth in Africa. Due to their prosperity, the country has adopted the goal, availability of anti-retroviral drugs to all citizens in need. 

Botswana’s president, Festus Mogae, is spearheading this nation’s effort; is considered one of Africa’s robust democracies.  The CIA, 2000 World Factbook states the literacy rate for male is 80.5% and female 59.9%, the total population estimated 69.8%.  Due to these literacy rates, it is very hopeful that a prevention program will be successfully implemented.

Kenya 

Kenya is currently ranked ninth highest for prevalence of HIV.  Kenya has 1.25 million adults and 100,000 infected children.  Only 14% know their HIV status.  The Center for Disease Control estimates the total population to be 31.3 million.  There were 140,000 deaths in 2003 attributed to AIDS and approximately 890,000 orphans. (Global AIDS Program, Center for Disease Control, 11/2004). 

The people of Kenya are not only plagued with HIV crisis, but also are battling famine and tuberculosis.  The Kenya Food Security Steering Group (KFSSG) estimate one million Kenyans will be in need of food aid this year.  Shortages will be worse in the East and is a result of poor rainfall for many consecutive years.  In 2000, 2.7 million people were affected by famine. The northwest has a history of sustaining a 40 year drought.  Therefore, malnutrition severely impacts the infected population. Tuberculosis and malaria also plays a contributory role in this devastating situation (Tearfund, March 2004).

Many children find themselves in a caregiver or breadwinner role due to their ill parents.  The primary effected age group is 20 to 40 years old.  Many non-infected orphans find themselves labeled with a stigma due to the demise of their parent from AIDS. Many are rejected by their relatives with no facility to care for them.  UnlikeBotswana, many do not attend school.  There are basic rural schools and recent construction of secondary schools in many communities. The prevalence in Kisumu’s population is directly correlated and serves as a sample of the entire region.  The escalating numbers of infected females continues to be a primary concern. One must also consider mother-to-child transmission within this population, impacting the situation even greater (Tearfund, March 2004).

Social and Economic Impact 

HIV/AIDS affects all aspects of social and economic life in Africa. The CDC and USAID have funded the POLICY Project.  The project has contributed greatly to the following findings and  is published in   AIDS IN KENYA. 

• Health-The health sector is affected by an increased burden of caring for those infected with HIV.  It is responsible for delivering effective treatment of opportunistic infections, providing compassionate care and implementing many prevention programs such as STD control, condom promotion and distribution, and health education.  There has been discussion over the feasibility of providing antiretroviral treatment. 
• Education- The education system is affected by AIDS in many ways.  Children infected with HIV at birth do not live to enroll in school. Many drop out when they become orphans or to care for sick family members.  Teachers are dying from AIDS.  Education is also one of the solutions to the problem.  School-based programs can help young people understand how to avoid the risks of unsafe sex. 
• Military-HIV prevalence is particularly high among soldiers in countries around the world. Military service often places young men in risky environments away from their families. Military programs for the prevention of HIV can help protect soldiers, their families and communities from the spread of HIV. 
• Transport-Long-distance truck drivers and other transport workers often spend many nights away from home.  Commercial and casual sex is available at truck stops, border crossing points and major transportation hubs.  Truckers may acquire HIV infection in these environments, spread it along their route, and take it back to their home communities.  Improved programs for transport workers and border communities are needed to reduce this important mode of transmission. 
• Communications and information-People need to know about the risks of unsafe sex and the means by which they can protect themselves. People living with HIV/AIDS need to know about access to care and about the human rights that are guaranteed to them in the constitution. 
• Absenteeism- Directly effects productivity and loss of profit. The indirect effect means increased amount of work for the healthy employees. An increase in amount wages related to overtime was noted. Healthy workers become exhausted and overworked due to the new demands. A significant decline in product quantity and quality of many companies.
• Declining labor productivity- In many industries such as agriculture, labor productivity is the most important determinant of output and profitability. Lower performance due to illness also contributes greatly to this ongoing problem.
• Costs of Mortality-In companies heavily affected by AIDS, death is either the leading or one of the leading causes of employees’ exit from the company. Illness is the second.  AIDS is responsible for the high right of morbidity and mortality currently being experienced ( Sixth Ed., 2001).