Why Now?

Current statistics on the epidemic are staggering: a cumulative total of more than 60 million people infected, of whom 20 million have died. And while the disease is deadly to those individuals directly infected, its effects threaten economic and social development and stability.

Almost half of all new HIV infections are occurring among people younger than 25. Most infected persons — who live in developing countries and of whom almost all are unable to access treatment and care — will die by the age of 35. Botswana, the country with the highest HIV prevalence, is projected to have fewer people aged 40-50 years, in 2020, than people aged 60-80 years, an unprecedented phenomenon for a developing country. Such a shrinking proportion of productive adults relative to the age-groups that are dependent on them, means fewer adults will be supporting more children and the elderly who, when both HIV-infected parents die from AIDS, are increasingly taking care of each other.

The combination of high or rising prevalence rates and growing numbers of people of reproductive age places a staggering number of people at risk of infection. In countries such as Botswana and Zimbabwe, between one-quarter and one-third of adults are HIV-infected. Infection rates are low but rising rapidly in others, as is the case in Russia.

High proportions of young people in developing countries are sexually active. The majority of the world’s youth aged 15-19 — and many even younger — are sexually active and defining different rules for sexual conduct than their parents and grandparents. Their immature reproductive tracts make them more susceptible than adults to acquiring STIs. Their sexual activity is taking place within both socially approved and disapproved contexts, affording them varying degrees of access to protection from HIV.

As infection rates rise, life expectancy is dropping. In sub-Saharan Africa, average life expectancy is now only 47 years, rather than the 62 years it would be in the absence of HIVAIDS, largely because of the pandemic’s toll on the lives of young adults. In Haiti, life expectancy is 53, rather than the 59 years it would have been without AIDS. Life expectancy is also being pushed downward by increasing numbers of infants born HIV-positive, as well as by deaths among those children orphaned by AIDS.

The impact of HIV/AIDS is being felt in both personal and national incomes. The dissolution of families, loss of skilled workers, declines in productivity, and high public expenditures are endangering prospects for sustained economic growth and social progress in the hardest-hit countries. Per capita income (Gross Domestic Product per capita) is projected to drop by 8 percent by 2010 in some countries. By 2020, GDP in those countries most affected by HIV/AIDS could decline by 20 percent.

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