Geography Reference
In-Depth Information
(which means that they are infected and that their
blood when tested with two standard tests reacts
positively) and someone being ill with AIDS (which
means that they are exhibiting a number of clinical
symptoms that indicate that the virus has affected
the ability of their body to fight infections to which
it would normally be resistant). In Africa, these
symptoms may include an otherwise rare cancer
called
Kaposi's sarcoma,
abrupt and extreme weight
loss, severe diarrhoea,
herpes zoster,
and fungal
infections of the respiratory tract, as well as some
other conditions. An increasingly common
associated symptom of AIDS is tuberculosis, and in
recent years new forms of drug-resistant
tuberculosis have been appearing in close
correlation with the epidemic of HIV/AIDS. This
is a very serious development indeed, as tuberculosis
is spread by droplet infection and could therefore
move rapidly into the general population.
In Asia and Africa, the time between onset of
illness and death is anything between a few
months and two years. This is a shorter survival
time than that found typically in Western Europe
and North America and reflects the lower health
status of the population, the greater number of
infectious agents in the environment and the
unavailability of some expensive palliative
treatments.
In some countries, HIV/AIDS will reverse the
declines in infant and child mortality rates
observed over recent years, will slow population
growth rates, and will mean negative growth rates
for some countries (particularly Botswana,
Zimbabwe and Guyana); and life expectancies will
decline (Stanecki and Way 1997).
In many African countries with major
epidemics, the ratio of dependants to supporters,
of mouths to hands has been reduced. However,
the precise impact of increased death and
mortality appears to be quite specific to regions
and areas and is mediated through cultural,
political, environmental and economic variables,
making all but the broadest generalisations difficult
to substantiate.
At a local level, there may not be enough
hands to grow the crops to feed the family well
at satisfactory levels of nutrition. At the district
Box 39.1
Life expectancy and HIV/AIDS
Life expectancy has already been reduced in many
countries which have had serious epidemics of HIV/AIDS
in the late 1970s and early 1980s. Thus estimated life
expectancies in Kenya have fallen from 65 to 55.6 years,
in Uganda from 53.2 to 40.3 years, and Zimbabwe from
64.1 to 41.9 years. Such declines are all the more
worrying when it is considered that they reflect a decline
from what was an
improving
situation. For example, in
the case of Zimbabwe, life expectancy had been
expected to increase to 70 years by the year 2010.
There will also be reductions in life expectancy—but
of a lesser degree—in countries such as Brazil (from 72.5
to 65.1 years) in Haiti (from 58.8 to 52.2 years, and in
Guyana (from 67.9 to 49.9 years). In Thailand, it is
estimated that the decline will be from 75.1 to 72.9 years.
Box 39.2
The HIV/AIDS epidemic in Africa
In nineteen African countries, HIV prevalence among
low-risk urban adult populations (age group 15-49) has
now reached 5 per cent or will reach this level within a
few years. Such levels of prevalence may mean that a
young person has a lifetime risk of around 30 per cent of
contracting the disease (Blacker and Zaba 1997). In
Zambia and Malawi, some groups of urban ante-natal
clinic attenders have been found to have rates of 25 per
cent (Stanecki and Way 1997), while in Francistown,
Botswana, rates of 40 per cent have been reported
(personal communication).
In Uganda, where the epidemic began in the late
1970s/ early 1980s, recent reports indicate that the rate
of increase of infection may now be levelling off or even
declining (Stanecki and Way 1997).
The sub-Saharan African countries currently most
affected by the epidemic are Botswana, Burkina Faso,
Burundi, Cameroon, Central Africa Republic, Congo,
Côte d'Ivoire, Ethiopia, Kenya, Lesotho, Malawi, Nigeria,
Rwanda, South Africa, Tanzania, Uganda, Republic of
Congo, Zambia and Zimbabwe.
Caldwell and Caldwell (1994) have put forward the
hypothesis that the most affected areas of Africa are
correlated with areas where men do not practise
circumcision.
