South Africa has the largest HIV/AIDS population in the world and one of the fastest growing epidemics, with one in four women between the ages of 20 and 29 already infected with the virus.

However, for the first time there are signs that HIV incidence – the annual number of new infections – may have stabilised in parts of sub-Saharan Africa.

These statistics are according to the AIDS Epidemic Update released in Johannesburg today (Tuesday) by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO).

Some 4,2-million South Africans are living with HIV/AIDS, while 36,1-million people worldwide are HIV positive.

UNAIDS and WHO said that African countries were showing signs of buckling under the impact of large-scale disease and death. In South Africa, the epidemic is projected to reduce the economic growth rate by between 0,3% and 0,4% annually, resulting by the year 2010 in a gross domestic product (GDP) 17% lower than it would have been without AIDS and wiping U$22-billion off the country’s economy.

Even in diamond-rich Botswana, the country with the highest per capita GDP in Africa, in the next 10 years AIDS will slice 20% off the government budget, erode development gains, and bring about a 13% reduction in the income of the poorest households.

A shocking 35,8% of adults in Botswana are now infected with HIV.

Africa saw a reduction in new infections in 2000 totalling some 3,8-million, compared with 4-million in 1991, but this may change if rates go up in countries there they are still relatively low, UNAIDS and WHO said.

The report said Africa’s slight fall in new infections was probably a result of two factors.

On the one hand, the epidemic in many countries has gone on for so long that it has already affected many people in the sexually active population, leaving a smaller pool of people still able to acquire the infection.

At the same time, successful prevention programmes in a handful of African countries, notably Uganda, have reduced national infection rates and contributed to a regional downturn.

The report said that although the scale of action necessary to make a difference had increased dramatically it was not too late.

The report identified the following resources needed annually to expand the response to AIDS to a level that might have a major impact on the African epidemic:

 At least U$1,5-billion a year could make it possible to achieve massively higher levels of implementation of successful prevention programmes for the whole of sub-Saharan Africa These would cover sexual, mother-to-child and blood and transfusion-related HIV transmission.

In the area of care for orphans and for people living with HIV/AIDS, costs depend on what kind of care was being provided. It is estimated that, with at least U$1,5-billion a year, countries in sub-Saharan Africa could buy symptom and pain relief for at least half the AIDS patients in need of it; treatment and prophylaxis for opportunistic infections for a somewhat smaller proportion; and care for AIDS orphans.

Making a start on coverage with combination antiretroviral therapy would add several billion dollars annually to the bill.

 In another development Health minister Dr Manto Tshabalala-Msimang last week accused UNAIDS and WHO of putting South Africa in a “state of panic”.

She said the health department was collaborating with the US-based Centres for Disease Control (CDC) to determine South Africa’s “real” HIV/AIDS statistics. – Health-e News