This second edition of the book provides up-to-date information on new drugs, new proven HIV prevention interventions, a new chapter on positive prevention, and current HIV epidemiology. This definitive text covers all aspects of HIV/AIDS in South Africa, from basic science to medicine, sociology, economics and politics. It has been written by a highly respected team of South African HIV/AIDS experts and provides a thoroughly researched account of the epidemic in the region.
HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.
Few people realize that the familiar HIV/AIDS global statistics are actually estimates. For example, UNAIDS estimated that the Republic of South Africa had 140,000 HIV/AIDS deaths in 1997. However, after tabulating all deaths for 1997, the Republic of South Africa attributed only 6,635 deaths to HIV/AIDS. Such discrepancies are rarely noted. The Republic of South Africa (RSA) stands as the exemplar of these discrepancies, and is reputed to have the world's largest AIDS epidemic with an estimated 5.6 million people living with HIV/AIDS (PLWH) in 2008. Such PLWH estimates, as with the estimates of HIV/AIDS deaths, are highly questionable. The reasons behind these discrepancies are clarified by describing two common misunderstandings of HIV infection that contribute to poor mathematical modeling outcomes. Unfortunately, the health authorities in the Republic of South Africa grant more validity to computer-generated estimates than to their own empirical death counts. The author discusses why these modeled estimates, and the HIV sero-prevalence surveys upon which they are based, are simply implausible. Presented with full references are raw numerical data on: the tabulated number of HIV/AIDS deaths in the RSA; the number of AIDS cases detected by RSA disease surveillance systems; UNAIDS/WHO estimates for AIDS deaths in the RSA; and UNAIDS/WHO estimates for the number of people living with HIV/AIDS in the RSA. The total cumulative HIV/AIDS cases in the United States and Africa are also presented for comparison, and to place the African and RSA data within appropriate epidemiological context. Overall, these data span from 1981 to 2009. Altogether, these data, plus additional information detailing the nature of HIV infection and heterosexual HIV transmission rates, explain why the hyperbolic mathematical estimates and HIV antibody test surveys - the primary sources of HIV/AIDS data in Africa - are simply implausible.
A follow-up to the Nelson Mandela Foundation's 2002 national household survey of HIV/AIDS prevalence in South Africa, this 2005 report seeks to provide further understanding of the HIV pandemic. Using data that tested for HIV incidence rather than just using mortality statistics, this study looks at which socio-demographic groups are most vulnerab≤ whether new policies have been successful in fighting the disease; what exactly is being done by key players, such as the government, churches, and other civil society organizations; and how the spread of HIV can be reduced in South Africa.
South Africa has the world's largest number of people living with HIV. This book offers a history of AIDS activism in South Africa from its origins in gay and anti-apartheid activism to the formation and consolidation of the Treatment Action Campaign (TAC), including its central role in the global HIV treatment access movement.
HIV/AIDS continues to take a tremendous toll on the populations of many countries, especially in sub-Saharan Africa. In some countries with high HIV prevalence rates, life expectancy has declined by more than a decade and in a few cases by more than two decades. Even in countries with HIV prevalence of around 5 percent (close to the average for sub-Saharan Africa), the epidemic can reverse gains in life expectancy and other health outcomes achieved over one or two decades. This volume highlights work conducted under the umbrella of a World Bank work program on The Fiscal Dimension of HIV/AIDS, including country studies on Botswana, South Africa, Swaziland, and Uganda. It covers four aspects of the fiscal dimensions of HIV/AIDS: First, it aims for a comprehensive analysis of the fiscal costs of HIV/AIDS, with a wider scope than a costing analysis focusing on only the policy response to HIV/AIDS. Second, it embeds the analysis of HIV/AIDS costs in a discussion of the fiscal context, and interprets these costs as a quasi-liability, not a debt de jure, but a political and fiscal commitment that binds fiscal resources in the future and cannot easily be changed, and very similar to a pension obligation or certain social grants or services. Third, it develops tools to assess the (fiscal dimensions of) trade-offs between HIV/AIDS policies and measures that take into account the persistence of these spending commitments. Fourth, most of the fiscal costs of HIV/AIDS are ultimately caused by new infections, and this study estimates the fiscal resources committed (or saved) by an additional (or prevented) HIV infection. Building on these estimates, the analysis here is able to assess the evolving fiscal burden of HIV/AIDS over time.
The HIV/AIDS pandemic striking South Africa is of historic proportions. More people are living with AIDS in South Africa than in any other country in the world. Just in the past decade, the life expectancy in South Africa has dropped from 67 to 43 years. The social and economic impact of this disease is hard to overstate. However, what is striking is the paucity of thoughtful, reflective scholarship and writing on the subject. AIDS and South Africa: The Social Expression of a Pandemic addresses the economic, social and cultural impact of HIV/AIDS as it relates to South African society.
Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.
The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.
This book analyzes successive governments' management of the AIDS epidemic in South Africa. The book covers the years 1982-2005, using expert thinking regarding public policy making to identify gaps in the public sector's handling of the epidemic. It highlights critical lessons for policy makers and other public health managers.
