Where did it come from?
The virus evolved in sub-Saharan Africa, crossing over from a group of chimpanzees to people in the 1930’s this could have been contaminated by meat or a bite from a pet. A combination of international travel, urbanisation, contaminated blood, sexual promiscuity and intravenous drug use (IDU) produce a growing pandemic.
AIDs was first seen in the human population in significant numbers in the USA (San Francisco). In San Francisco Aids was regarded as the ‘Gay Plague’ as it was mostly found amongst homosexuals. This prevented the heterosexual and straight community from regarding it seriously or ever considering they could be at risk.
Comparing Countries
I am going to compare the LEDC continent of sub-Saharan Africa with the higher income countries, in the West.
By far the worst affected region is sub-Saharan Africa being home to 29.4 million people living with the HIV/Aids virus. Approximately 3.5 million new infections occurred there in 2002, while the epidemic claimed the lives of an estimated 2.4 million Africans in the past year. Ten million young people (aged 15–24) and almost 3 million children under 15 are living with HIV.
In the absence of prevention, treatment and care efforts, the AIDs death toll on the continent is expected to continue rising and to peak around the end of this decade. Although the worst of the epidemic’s impact will be felt in the course of the next 10 years, possibly longer. It is not too late to introduce measures that can reduce that impact, including wider access to HIV medicines and socio-economic steps that help protect the poor against the worst of the epidemic’s effects. Groups targeted recently include long distance lorry drivers who spread the disease widely throughout the African continent as they travel away from their families. Epidemics are under way in southern Africa where, in four countries the national adult HIV numbers have risen higher than thought possible, Botswana (38.8%), Lesotho (31%), Swaziland (33.4%) and Zimbabwe (33.7%). The food crisis in the last three countries is linked to the effects (on the lives of young, productive adults) of their longstanding HIV/AIDs epidemic. The decrease in the healthy, young working population produces severe problems in the feeding and support of the population as a whole. As a result, the healthier older generation have to give up work to look after the grandchildren who have sick or no parents, further effecting productivity.
There are new, hopeful signs that the epidemic could eventually be brought under control. In South Africa, for pregnant women under 20, HIV rates fell in 2001. This, along with the drop in syphilis rates among pregnant women attending antenatal clinics suggests that awareness campaigns and prevention programmes are beginning to prove a success, possibly due to the Western world influence. A decline in HIV prevalence has also been detected among young inner-city women in Addis Ababa in Ethiopia. Infection levels among women aged 15–24 attending antenatal clinics dropped in 2001 (however, similar trends were not evident in outlying areas of the city, this I believe is because they cannot access clinics and education, nor is there yet evidence of them occurring elsewhere in the country).
Uganda continues to provide evidence that the epidemic does yield to human intervention. HIV infection levels are on the decline in several parts of the country as shown by the steady drop in HIV prevalence among 15–19-year-old pregnant women. Condom use by single women aged 15–24 almost doubled between 1995 and 2000/2001, and more women in that age group delayed sexual intercourse or abstained entirely, although these positive trends do not counteract the severity of the epidemic in these countries. All of them face massive challenges not only in sustaining and expanding prevention successes, but also in providing adequate treatment, care and support to the millions of people living with HIV/AIDS or the people orphaned by the epidemic. Botswana has become the first African country to adopt a policy to ultimately make anti-retrovirals available to all citizens who need them. However, approximately only 2000 people are currently benefiting from this commitment. In addition, a handful of companies such as Anglo Gold, De Beers, Debswana and Heineken have announced schemes to provide anti-retrovirals to workers and some family members. These are all valuable efforts. Though when measured against the extent of need, they are simply proven to be inadequate.
In some areas of Africa, it may be that for cultural reasons and religious beliefs that protected sex is forbidden, although moral values should indicate otherwise. As you can see from Map 1, Sub-Saharan Africa carries the largest amount of HIV/AIDs carriers. Factors causing this may include religious and cultural taboos regarding safe sex, out dated cultural practices such as multiple wives, female circumcise and anal sex. Males tend to be un-educated and have attitude problems relating to these practices. Their attitudes need to be changed.
On the other hand, looking at the higher income countries
Approximately 76 000 people became infected with HIV in high-income countries in 2002. A total of about 1.6 million people are now living with the virus in these countries, where an estimated 23 000 people died of AIDs in 2002. For such well developed countries this is a number too high to bear thinking about. The introduction of anti-retroviral therapy in 1995/1996 has dramatically reduced the HIV/AIDs related mortality, although this trend has begun to level off in the past two years. Due to the longer survival of people living with HIV there has been a steady increase in the number of people living with the virus in high-income countries. About half a million people were receiving antiretroviral drugs at the end of 2001. The effect on productivity is much less marked than in LEDCs, more money is also available for research. However, both counselling and prevention services need to be stepped up if an increase in HIV transmission is to be avoided.
A larger proportion of new HIV diagnoses in several Western European countries is occurring through heterosexual intercourse. More than half of the 4,279 new HIV infections diagnosed in the United Kingdom in 2001 resulted from heterosexual sex, compared to 33% of new infections in 1998. In Ireland, a similar trend is visible, with the number of heterosexually transmitted HIV infections increasing in 1998. Although injecting drug use remains the main mode of transmission in Spain, about one-quarter of all HIV infections have been heterosexually transmitted.
In the United Kingdom, as in some other European countries, a large share of heterosexually transmitted HIV infections are being diagnosed in people who originate from, or who have lived in or visited, areas where HIV prevalence is high. Prevention, treatment and care activities need to become more culturally appropriate and socially relevant if they are to reach and benefit such communities. Health care provision in England is provided by the state and is funded by tax payers money, most health care to the public is free at the point of delivery
Most high-income countries are contending also with concentrated HIV epidemics, including in the United States of America (USA) where injecting drug use is a prominent route of HIV infection. Reported HIV infections among young people can indicate overall trends in incidence, since those persons are likely to have become exposed to HIV infection fairly recently. In the many areas of the USA and of all the HIV reportings, the majority of infections were found to be among 13–19-year-olds and among females (56%), a disproportionate percentage of them African-American. Clean needle programmes and good nutrition are proving to be a good bulwalk against increased infection. However, most young women acquire the virus through heterosexual intercourse.
In most high-income countries, the successes achieved by, and among, men who have sex with other men are clearly now a thing of the past. Prevention efforts appear not to be reaching the large numbers of men whom increases in unsafe sex are being mirrored by higher rates of sexually transmitted diseases in Australia, Canada, the USA and countries of Western Europe. A telling and ongoing trend of increasing unsafe sex has been documented among men who have sex with men in San Francisco, for example. A survey of self-reported sexual behaviour has shown increases in unprotected anal sex, much of it between sero-discordant partners (i.e., one partner is HIV-positive). The survey also found rising rates of other sexually transmitted diseases among the respondents.
Promoting the need for renewed prevention efforts, especially among young people, are recent findings of increases in high-risk behaviours, less frequent condom use and higher rates of sexually transmitted infections in several countries. In the United Kingdom, for example, rates of gonorrhoea, syphilis and chlamydial infections have more than doubled since 1995.
To Conclude
In conclusion I believe that the economic consequences of the HIV/AIDS virus do spread according to the development of the country. As poor countries still struggle to boost their spending even to levels that fall far short of the need. As a result, millions of people living with HIV/AIDS have to pay for their own health care. In sub-Saharan Africa, some individuals are spending pocket money on HIV/AIDS services themselves. With hard work, funding, education and extra healthcare provisions I do believe that in the future we could reduce the spread of the disease and the spiralling effects on productivity in these countries, hopefully to halt the exponential spread of the disease and maybe even put it on the road to into extinction.
