Geography Reference
In-Depth Information
America, nearly 2 million are infected. Southeast Asia
now has as many as 6 million cases.
Nowhere is AIDS having the impact that it has had
on Subsaharan Africa, however. In 2006, some 24 percent
of people aged 15 to 49 were infected in Botswana, 20 per-
cent in Zimbabwe, almost 19 percent in South Africa, and
17 percent in Zambia. These are the offi cial data; medical
geographers estimate that 20 to 25 percent of the entire
population of several tropical African countries is infected.
The United Nations AIDS program reports that more
than 1.6 million people died of AIDS in Subsaharan Africa
in 2007 alone. Geographer Peter Gould, in his book
The
Slow Plague
(1993), called Africa a “continent in catastro-
phe,” and the demographic statistics support his view-
point. Life expectancy in Botswana and Swaziland has
declined to 34 (and is projected to fall farther), and in
Zimbabwe it is 36. In a continent already ravaged by other
diseases, AIDS is the leading cause of death.
AIDS is reshaping the population structure of the
countries hardest hit by the disease. Demographers look
at the projected population pyramids for countries with
high rates of infection and no longer see population
pyramids—they see population chimneys. The shape of
the projected population pyramid is altered to look
more like a chimney than a pyramid, refl ecting the
major impact AIDS plays on the younger population in
the country and its future generations (Fig. 2.22). The
United States Census Bureau projects that AIDS will
cause higher rates of death among young women than
young men. In countries with population chimneys,
men will take younger and younger brides, thus increas-
ing the rate of AIDS in younger females.
Geographers are engaging in fi eldwork to under-
stand the human toll of AIDS locally and within families.
Geographer Elsbeth Robson studied the impact of AIDS
in hard-hit Zimbabwe. She found that global processes
such as the diffusion of AIDS and reductions in spending
on health care (often mandated by structural adjustment
programs) “shape young people's home lives and structure
their wider experiences.” In Subsaharan Africa, the num-
ber of children orphaned when parents die from AIDS is
growing rapidly (Fig. 2.23). In 2004, UNICEF reported
that in just two years, between 2001 and 2003, the number
of global AIDS orphans (children who have lost a parent
to AIDS) rose from 11.5 million to 15 million. Robson
found that in addition to the rising number of AIDS
orphans, many young children, especially girls, are taken
out of school to serve as caregivers for their relatives with
AIDS (Figure 2.24). Robson found in her interviews with
young caregivers that “more children are becoming young
carers as households struggle to cope with income and
labor losses through illness and mortality.”
There are few positives to report. The number of
AIDS-related deaths is declining globally from a peak of
2.1 million in 2004 to 1.8 million in 2009. The greatest
SOUTH AFRICA, 2035
.............................
.............................
.........................
......................
..................
..............
.........
......
......
........
.........
.........
.........
80+
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-39
20-24
15-19
10-14
5-9
0-4
Projection without AIDS
Projection with AIDS
..........
...........
............
.............
5
4
3
0
Population (in millions)
2
1
1
2
3
4
5
Figure 2.22
Effect of AIDS on the Population Pyramid for South Africa,
Predicted 2035
. Estimated population, male and female, with
AIDS and without AIDS.
Data from
: United States Census
Bureau, 2005.
decline in AIDS-related deaths was in South Africa
between 2004 and 2009, when AIDS-related deaths in
Subsahran Africa diminished by 20 percent. The declin-
ing death rate from AIDS is due to increased access to
anti-retro viral drugs (ARVs) that slow the progression of
the disease), better health-care access for people living
with HIV, and a decline in the number of new infections
since the late 1990s.
Uganda, once Africa's worst affl icted country, has
slowed the growth of AIDS through an intensive, govern-
ment-sponsored campaign of propaganda and action—
notably the distribution of condoms in even the remotest
part of the country. Access to ARVs in Africa has increased
markedly over the last decade. As a result of pressure from
HIV/AIDS activists and governments, pharmaceutical
companies have decreased prices of ARVs. Today, over 5
million people in developing countries are being treated
with ARVs. Nonetheless, the impact of AIDS will be felt in
African economies and in African demographics for gener-
ations to come. HIV/AIDS will constrain African economic
development (see Chapter 10) and require world interven-
tion to overcome.
