More than 14 million people are living with HIV/AIDS in Southern Africa. It is the most affected region in the world. Discrimination needs to be challenged, treatment provided, and support given to those living with HIV/AIDS and those affected by it. Governments in the region must meet the challenge and the international community should provide support.

A Closer Look

The Background

An estimated 37.6 million people are living with HIV around the world. 38%, 14.2million people live in Southern Africa which is the most affected region in the world by HIV/AIDS. Swaziland has the highest rate in the world with an estimated 27.2% of the adult population living with HIV/AIDS, this is followed by Lesotho at 22.9% and Botswana at 21.9%. South Africa has 18.9% with the greatest number of any country of people living with HIV/AIDS, 7.1million and the greatest number on Anti Retro-Viral Treatment (ART) 3.5 million. Since the epidemic began an estimated 35 million people around the world have died from AIDS related illnesses, many of these in Southern Africa.

The Issues

Southern Africa is the only region with countries where the estimated HIV/AIDS rate in the adult population is over 10%.

HIV/AIDS has disproportionately impacted on those between 15 and 49 many of whom would have expected to be economically active. HIV/AIDS has led to millions of children without one or both parents and grandparents without children. It has had and is having a health, social and an economic impact.

Around HIV/AIDS there has been silence, discrimination, stigma and superstition. This is changing but still exists. The government of South Africa was for a number of years in denial as to the cause of HIV/AIDS which impacted greatly on its response. This is no longer the case and South Africa operates the largest Anti Retro Viral Treatment programme in the world. It is estimated however that more than 40% who should receive treatment are not. There are also worrying indicators of some starting treatment and then stopping.

Discrimination and stigma needs to be challenged and reduced. Testing encouraged and for those who test positive there needs to be appropriate support including ART. Southern Africa needs international support to meet the challenge of HIV/AIDS. Support needs to include testing, counselling and treatment being fully available and monitoring and counselling to keep those who have been proscribed ART taking it. There needs to be support for those orphaned by AIDS and for the elderly whose children have died.

There are signs the pandemic is leveling out in the region. This simply means the rate of increase is slowing which was expected. Overall there are more people living with HIV/AIDS. Unlike 15 years ago being diagnosed as HIV positive in Southern Africa is no longer a death sentence but to have the best chance of surviving and leading reasonably healthy and active lives people need to be tested and if appropriate put on treatment early. This also reduces the risk of transmission of HIV. There is still no cure for HIV. AIDS is not over and its impact is still great across Southern Africa.

Why did HIV take such a hold in Southern Africa?

There are a number of factors. Migrant labour played a part as for decades industry in South Africa used black southern Africans as cheap, expendable labour with few rights, this brought people from rural areas and neighbouring countries. In the mining industry workers were housed in hostels. These conditions were conducive to the transmission of HIV. There is also relatively good transport and infrastructure in Southern Africa which contributed to the movement of people and the transmission of the disease. In some areas there is polygamy. The denial and the slow inadequate response of South Africa on HIV/AIDS also served as a key factor.  Once the rate of HIV reached a critical level it spread even more quickly. Finally, messages to avoid risky behaviour, abstain from or practice safe sex did not register with a population trying to deal with high levels of youth unemployment and increasing inequality.

Where does ACTSA stand?

ACTSA calls for an end to discrimination against those living with HIV/AIDS. We call on the international community to do more to assist the countries and people of southern Africa to meet the challenge of HIV/AIDS. The UK government does not have a bilateral aid programme with the four countries with the highest rate of HIV/AIDS in the world, Swaziland, Lesotho, Botswana and South Africa. We call on the UK government to do more to support Southern Africa meet challenge of HIV/AIDS.

ACTSA highlights the impact of HIV/AIDS on Southern Africa. We have brought people living with HIV/AIDS to the UK, and highlighted the gender impact of HIV/AIDS, women are disproportionately likely to be infected and to be carers. We have called on the UK government to do more to support governments and civil society organisations in the region meet the challenge of HIV/AIDS. We have also criticised governments in the region who have denied the cause of AIDS and not done all they can to provide testing, counselling and treatment. Additionally we have supported the Treatment Action Campaign(TAC) in South Africa.

ACTSA is a member of the STOPAIDS network.