This is according to the Joint United Nations Programme on HIV/AIDS’€™ (UNAIDS) 2008 Report on the Global AIDS Epidemic released yesterday (SUBS: TUES), which reports that almost 33-million people are currently living with HIV/AIDS worldwide with 25-million people having died of HIV-related causes since the beginning of the epidemic.

The report confirmed that HIV data from antenatal clinics in South Africa showed that the country’€™s epidemic might be stabilizing, but added there was no evidence yet of major changes in HIV-related behavior.

The report also points out that the HIV prevalence in South Africa, as well as neighbouring Lesotho and Namibia was stabilising at extraordinary high levels.

UNAIDS Executive Director Peter Piot said the report did show that the world was making some real progress in its response to AIDS, but that for every two people who started antiretroviral (ARV) therapy, another five became newly infected.

Sub-Saharan Africa continued to bear the brunt of the epidemic with an estimated 1,9-million people newly infected with HIV in this region in 2007, bringing   to 22-million the number of people living with HIV.

Two-thirds of the global total of 32,9-million people with HIV lives in this region, and three quarters of all AIDS deaths in 2007 occurred here.

The report also showed that sub-Saharan Africa’€™s epidemics varied significantly from country to country in both scale and scope. Adult national HIV prevalence is below 2% in several countries of West and Central Africa, as well as in the horn of Africa, but in 2007 it exceeded 15% in seven southern African countries ‘€“ Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

Meanwhile the 26% HIV prevalence found in adults in Swaziland in 2006 is the highest prevalence ever documented in a national population based survey anywhere in the world.

In Lesotho and parts of Mozambique, HIV prevalence among pregnant women is increasing with some provinces in the central and southern zones of Mozambique, recording adult HIV prevalence rates exceeding 20%.

The report confirmed that in countries most heavily affected, HIV has reduced life expectancy by more than 20 years, slowed economic growth, and deepened household poverty.

In sub-Saharan Africa alone, the epidemic has orphaned nearly 12-million children under the age of 18 years.

In countries with high HIV prevalence, life expectancy at birth has fallen, sometimes dramatically. In southern Africa, average life expectancy has declined to levels last seen in the 1950s. It is now below 50 years for the sub-region as a whole and below 40 years in Zimbabwe.

By contrast the comparatively smaller HIV epidemics in Western Europe and Asia have scarcely affected life expectancy trends in those regions.

In South Africa, total deaths from all causes increased by 87% between 1997 and 2005. During this period, death rates more than tripled for women aged 20-39 and more than doubled for males aged 30-44, with at least 40% of deaths believed to be attributable to HIV.

The rate of population growth in the country fell from 1,25% in 2001-2002 to slightly more than 0,97% in 2006-2007.

Also, the estimated number of maternal, paternal and double orphans due to AIDS in Malawi, South Africa and Tanzania rose from 1,2-million in 2001 to 2,9-million in 2007.

While the world has rightly focused extraordinary attention on bringing ARV therapy to scale, the report said that much less effort had been directed towards timely prevention, diagnosis and treatment of tuberculosis in people living with HIV. The report added this could yield reductions in HIV-related morbidity and mortality comparable to ARVs.

Up to half of children living with HIV in South Africa are co-infected with TB, the report said.

The report highlighted the increasingly important role of palliative care as an integral component of national HIV responses with existing palliative care programmes under enormous pressure to meet growing demands.

The report refers to a study from the Motheo District of the Free State where there are an estimated 44 000 maternal orphans, 7 736 of whom are living with HIV. More than 25 000 of the children under the age of 10 are thought to be malnourished. The district’€™s one palliative care programme is equipped to serve 1 300 children, a fraction of those in need of support.

Click here to access the full report. ‘€“ health-e news.