Africa’s HIV burden shifting to Central and West Africa

A woman has a blood prick sample taken for an HIV Test
A woman has a blood prick sample taken for an HIV Test Copyright: Panos

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  • HIV infection is on the rise among young women and girls
  • Burden of HIV is shifting westwards due to successful programmes in hotspots
  • Donor funding is dropping for most vulnerable countries

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[AMSTERDAM] More than five million children are likely to be newly infected with HIV by 2050, while the disease burden is shifting from East to West Africa, according to the latest data presented at the AIDS 2018 conference.
A report compiled by Unicef, the UN’s children’s fund, found that Sub-Saharan Africa still sees high rates of HIV infection, especially among young people and women. Infection trends uncovered by the study show that the rate of infections is falling in Southern and East Africa, but is actually on the increase in Central Africa and West Africa.

“If donors falter in their support for HIV, the consequences could be devastating”

Linda-Gail Bekker, International AIDS Society

Around two-thirds of those aged 0-19 years who will be newly infected by 2050 will be girls and women, the Unicef report, which was published in March 2018, projected.
“We need to plan for an epidemic that is not over,” said Aleya Khalifa, UNICEF’s statistics officer for HIV/AIDS. “Sub-Saharan Africa is definitely not on track to eradicate AIDS by 2030.
HIV incidence among young people in Africa has fallen slowly, by just 3 per cent a year, the AIDS 2018 conference held last week (23-27 July) in the Netherlands, heard.
Among girls and women, infections are on the rise, which is partly because of health interventions and awareness programmes are less likely to reach them, Khalifa explained.
The westward shift in infection rates is not yet fully understood, said experts at the event.
Linda-Gail Bekker, president of the International AIDS Society, said that prevention and treatment efforts had focused on the areas that were most strongly affected by the virus, and have proven to be successful.
But as a result, areas where HIV/AIDS was neglected are now seeing rising infection rates, the event heard.
Other studies presented at the event showed that timely interventions that take into account the challenges faced by African patients could be successful in a short time. The Government of Eswatini, a country in which 31 per cent of people aged 18-49 are living with HIV, introduced a programme under which antiretroviral drugs were given to all patients without requiring them to confirm their viral load, the abundance of the virus in their bodies.
According to Velephi Okello, the deputy director for clinical services at Eswatini’s Ministry of Health, this resulted in a 44 per cent reduction of new infections since 2011. “It increased retention. 86 per cent of people continued to take the drugs regularly,” she told the event. “We found that early access works, regardless of the state of the patient.”
In Botswana, the Ya Tsie Botswana Prevention Project began offering a combination of HIV treatment and other healthcare options, such as testing as part of male circumcision practices, in 2013. A study presented by Moeketsi Makhema, a researcher at the Botswana Harvard AIDS Institute Partnership, showed that this lowered infection rates by about 30 per cent. The study, which ended in 2018, covered ten per cent of Botswana’s population.

Bekker told the conference that these advances showed Africa has the capacity to turn the tide on HIV/AIDS. She warned countries that are seeing growing rates of infection to spend money on expanding HIV prevention. “The data presented today underscore the urgent need for treatment programmes that can turn back the epidemic in Africa,” she said.
But funding might become a central issue. A report published by the Kaiser Family Foundation and the UNAIDS this month showed that eight of the 14 biggest donor governments reduced their spending on the disease in 2017. The central and West African countries where HIV/AIDS is on the rise are among the poorest and most conflict-ridden on the continent, and up to 80 per cent of their budget to combat the virus comes from external bodies.
“If donors falter in their support for HIV, the consequences could be devastating,” Bekker said.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.


[1] Donor government funding for HIV in low- and middle-income countries in 2017 (Kaiser Family Foundation & UNAIDS, July 2018)
[2] Progress for every child in the SGD era  (UNAIDS, March 2018