News24, 26 November 2002, Aids + famine = disaster²

Paris - Aids will cruelly amplify the effects of a famine in southern Africa that has more than 14 million people in its grip, warns a United Nations report.

"The famine in southern Africa brings the world face-to-face with the deep and devastating impact of Aids," said Peter Piot, executive director of UNAids, which co-authored the report on the state of the global crisis with the World Health Organisation (WHO).

"The famine is a tragic example of how this pandemic combines with other crises to create even greater catastrophes."

The report, a twice-yearly statistical update, confirmed sub-Saharan Africa's grim position as the biggest victim of the world's Aids storm.

By the end of the year, 42 million people around the world, two million more than in 2001, will be living with the human immunodeficiency virus (HIV) or the disease it causes, acquired immunodeficiency syndrome (Aids).

Of those 42 million, 29.4 million will live south of the Sahara, yet just a "tiny fraction" of them will have access to antiretrovirals that keep the virus at bay and prolong life, it said.

HIV rate beats the 'impossible'

Africans will account for 3.5 million of new infections in 2002, and 2.4 million of the 3.1 million lives claimed by Aids this year.

The report placed special emphasis on southern Africa , saying that in four countries, more than 30 percent of the adult population now had HIV - a rate that experts had once thought was impossible.

It cited Botswana (38.8%); (31%); Swaziland (33.4%) and Zimbabwe (33.7%).

These four countries, along with Malawi and Mozambique, face a devastating famine, and the impact will be horribly magnified by the Aids crisis, the report said.

In 2001 alone, the six countries, whose economies are primarily agricultural, lost nearly half a million workers to Aids.

Even in normal times, the loss of an income-earner to Aids has a devastating effect on a rural household, causing crop output to plummet by up to 60%, it said. Shrinking household incomes leave people with less money to buy food or the simplest medications to sustain life.

In the face of poor or negligible harvests, many communities will no longer have the means, either in financial resources or workers, to survive famine, the UN agencies feared.

The report said it was essential for the world not to write off Africa as irretrievably lost.

"It is too easily forgotten that the vast majority of Africans - more than 90% - have not acquired HIV. Enabling them to remain HIV-free is a massive challenge, with the protection of young people a priority."

Ominous patterns of growth

It handed out plaudits to South Africa. With nearly five million infected people, South Africa has the largest number of HIV/Aids cases in the world, but is chipping away at the toll of pregnant teenagers with the virus.

The rate fell from 21% in 1998 to 15.4% in 2001, which suggests that awareness and prevention efforts are at last bearing some fruit.

Uganda - widely praised by Aids experts for making an early start on tackling the pandemic - has seen a decline in infection rates in several parts of the country, especially among pregnant teenagers.

But "huge challenges remain", the report said.

There were "ominous patterns of growth" in HIV incidence in west and central Africa, where the virus has already been transmitted to more than 5% of the adult population in eight countries.

The astonishing rise among young pregnant women in Cameroon, where the infection rate doubled to more than 11% in less than three years, "shows how suddenly the pandemic can surge".

Massive financial help, medical care in the form of low-cost antiretrovirals, and effective awareness campaigns conducted by authorities and organisations at every level are needed, both now, and for many years to come.

"Even if exceptionally effective prevention, treatment and care programmes take hold immediately, the scale of the pandemic means that the human and socioeconomic toll will be massive for many generations," the report warned. - Sapa-AFP