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HIV / AIDSa global
emergency
A development education resource from World Vision New ZealandEducation Version 1.0 April 2003
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What is HIV / AIDS?
uman
mmuno-deficiency irus
• The HIV virus attacks the cells that fight disease, damaging the immune system. People who have the virus are known as HIV-Positive.
• Many people who are HIV-positive don't get sick for many years, but the virus slowly wears down the immune system, until the body can no longer fight disease.
• Once the immune system is damaged, HIV-positive people develop a group of diseases that are known as AIDS.
Slide 2
H IV
Image copyright Russell Kightley Media
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A set of diseases
that people get
once their immune
system is damaged
by the
HIV virus.
a pattern of signs or symptoms that indicate the presence of a disease
=
weakness of the immune system
=
What is HIV / AIDS?
People with HIV usually develop some or all of:
• Tuberculosis
• Herpes (cold sores, genital herpes)
• Septicaemia
• Pneumonia • Recurring fungal infections of the skin,
mouth and throat
• Other skin diseases
• Unexplained fever
• Meningitis
• Cancers such as Kaposi sarcoma• Chronic diarrhoea with weight loss
("slim disease")
Slide 3
A
IDS
cquired
mmuno -
eficiency
yndrome
“caught” not inherited=
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How do people get HIV / AIDS?
The HIV virus is spread through human body
fluids, especially blood and sexual fluids.
The most common way to get the HIV virus is:
Other common ways:
- mother to child transmission
- dirty medical equipment especially poorly equipped hospitals in developing countries
- drug users sharing needles especially in Eastern Europe
- unprotected heterosexual sex
- blood products if not screened
What is HIV / AIDS?
- unprotected male-to-male sex especially in developed countries like New Zealand, but world-wide, only 5% of those who have died from AIDS were gay men.
Slide 4
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1980 81 82 83 84 85 86 87 88 89 1990 91 92 93 94 95 96 97 98 99 2000 01 02
Nu
mb
er o
f p
eop
le li
vin
g w
ith
HIV
/ A
IDS
(M
illio
ns) 40
35
30
25
20
15
10
5
Sou
rce:
Bas
ed o
n U
NA
IDS
20
Yea
rs o
f HIV
/ A
IDS
HIV / AIDS epidemic
discovered among
heterosexuals in Africa
HIV virus identified as the cause of
AIDS
HIV screening of blood products
starts in US
1st unusual cases of
weak immune systems among
gay men in USA
AIDS defined for
the first time
First AIDS drug therapy approved for use in US
HIV prevalence begins to fall in
Uganda - first time in a developing country
First treatment to reduce mother-to-child transmission developed
First development of Highly Active Anti-retroviral Therapy (AIDS drugs)
Global Fund for AIDS, TB and Malaria created
Brazil becomes first developing country to provide anti-retroviral therapy through its
public health system
Outbreak in Eastern Europe among injecting
drug users
UNAIDS is created
What is HIV / AIDS?
Slide 5
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The HIV / AIDS pandemic
Source: UNAIDS AIDS Epidemic Update, December 2002
HIV / AIDS: global impact
Number of people living with HIV/AIDS in December 2002
People newly infected with HIV in 2002
AIDS deaths in 2002
Total 42 millionAdults 38.6 million
Women 19.2 million
Children under 15 years 3.2 million
Total 5 millionAdults 4.2 million
Women 2 million
Children under 15 years 800 000
Total 3.1 millionAdults 2.5 million
Women 1.2 million
Children under 15 years 610 000
Slide 6
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People living with HIV / AIDS (end of 2001)
Total: 42 million
Sub-Saharan Africa29.4 million
North America
980 000
Caribbean440 000
Latin America
1.5 million Australia & New Zealand
15 000
North Africa & Middle East
550 000
Western Europe570 000
Eastern Europe
& Central Asia 1.2 million
South & South-East Asia
East Asia & Pacific
1.2 million
6 million
Source: UNAIDS, AIDS Epidemic update, December 2002
HIV / AIDS: global impact
Slide 7
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Tanzania: 7.8%
Kenya: 15%
Uganda: 5.0%
Mozambique: 13.0%
Malawi: 15%
Zambia: 21.5%
Zimbabwe: 33.7%South Africa: 20.1%
Swaziland: 33.7%Lesotho: 33.4%
Namibia: 22.5%
Botswana: 38.8%
Angola: 5%
D.R. Congo: 4.9%
Percentage of adults aged
15-49 living with HIV
Burundi: 8.3%
Rwanda: 8.9%
Source: UNAIDS Barcelona Report
HIV / AIDS: local impact
Slide 8
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40
45
50
55
60
65
1965-1970 1970-1975 1975-1980 1980-1985 1985-1990 1990-1995 1995-2000
Bangladesh: low HIV rate
Botswana
Kenya
Zimbabwe
Zambia
Uganda
Malawi
HIV / AIDS
is reversing
gains in life
expectancy
Life
exp
ecta
ncy
Sou
rce:
UN
Pop
ulat
ion
Div
isio
n
HIV / AIDS: local impact
Slide 9
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• 25% of Africa’s agricultural workers will be sick or dead from AIDS by 2020
• Botswana: 25% of families will lose an income earner by 2010
• Tanzania: women become caregivers for the sick – a woman with a sick husband spends 60 % less time doing agricultural work
Sources: NORAD, Socio-economic effects of HIV/AIDS in African countries, 2002; World Vision, HIV / AIDS and Human Development in Africa, 1999.
HIV / AIDS: local impact
HIV / AIDS impacts on...
family income
social services
• Rwanda: families with an AIDS patient spend 20 times more on health care
• Uganda: one study showed up to 47% of households with orphans can’t afford to send children to school
• HIV / AIDS will account for 60-70% of Zimbabwe’s public health budget by 2005
• In Malawi and Zambia, more than 30% of school teachers are HIV positive. In the Central African Republic, 100 schools have closed because so many teachers have died.
Agriculture and food
production
Slide 10
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Sou
rce:
UN
AID
S S
ocio
-Eco
nom
ic Im
pact
of H
IV/A
IDS
in A
fric
a
HIV / AIDS is overwhelming
health and social services
2000
% hospital beds
occupied by AIDS
patients in Zambia
AIDS patientsNon-AIDS patients
1990
HIV / AIDS: local impact
The cost of treating
one AIDS patient is equivalent to putting
ten children through primary school S
ourc
e: W
orld
Ban
k (A
fric
a) 1
999
Slide 11
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Children aged 0-14 living with HIV / AIDS
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
Botswana
28,
00
0
Malawi
65,
00
0
Zambia
22,
00
0
Uganda
19,
00
0
HIV / AIDS impacts on children and young people
• 3.2 million children (under 15) live with HIV / AIDS
• 2200 are infected with the HIV virus everyday
•1700 die of AIDS everyday
• 14 million have been orphaned by AIDS
World-wide...
HIV / AIDS: local impact
Source: UNAIDS Barcelona Report; UNAIDS AIDS Epidemic Update, December 2002.
Slide 12
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0
2
4
6
8
10
12
14
16
18
20
% of all children who are orphans
AIDS Orphans
HIV / AIDS: local impact
Sou
rce:
UN
AID
S ‘C
hild
ren
on th
e B
rink
2002
’
Slide 13
1990
Malawi
Other orphansAIDS orphans
1990
Botswana
1990
Zambia
1990
Uganda
1995
1995
1995
1995
2000
2000
2000
2000
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My son Pirirani is four. He has been ill with diarrhoea, stomach pains, weight loss, a cough and fever for more than three years. My baby Davis is
13 months old, and he is wasting away. I also am unwell, and my wife Celina. And I look after my parents, who are old, and two orphans.
I had a lot of pigs, but I would sell anything to save the life of my children. I always thought I would live a happy life with my beautiful wife, working hard
on my land for my children’s future. I thought we would own cattle and I would have a pleasant home. But the story has come out differently to my
dreams because of this sickness.
We have no cash, but I need 400 kwacha (NZ$13) for the next round of medicine for the children. A chicken sells for 150 kwacha.
Slide 14
Vincent - Malawi
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And my staff are not safe. If you stick yourself with a
needle – and that’s a common thing – there is no chance
of getting anti-retroviral treatment if you get HIV. So you find you don’t
always want to know, and most
staff don’t get tested after a needle-stick.
In most cases we strongly suspect
AIDS based on the symptoms, but we don’t always carry
out tests because of the lack of
resources and the workload. You should counsel
people before and after the test, and
we don’t have enough staff for
that. It’s desperate if you
really look at it.
We have 240 beds in this hospital, and we have more than 300 patients, with
people sleeping on the floor. The
overcrowding is very definitely related to HIV.
AIDS is making the related problem of tuberculosis very
serious and complicated.
Frankly, sometimes you give a treatment
and you just pray that it will work.
Slide 15
Ntcheu Hospital - Malawi
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Sophy is is often
kicked out of
children's groups
when she tries to play
with them. The shame
and the pain inside
Sophy have
completely changed
her. She is quiet and
rarely laughs.
This is my great-
grandniece, Sophy.
She is three years old.
First her father and
then her mother died
of AIDS. When
Sophy’s mother
started to get sick she
and her three children
came to live with my
sister and I.
My name is Eng. I am
79 years old.
Sophy has HIV from
her mother. She has a
skin infection on her
head. Wherever she
goes, she wears this
hat to protect her head
from flies and to hide
her infection from
other children.
Most children don’t
like Sophy much
because of her
infection and the bad
smell from her body.
Slide 16
Sophy - Cambodia
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I know that men my age are the ones getting HIV. With this killer disease that is affecting our country, I try and keep
myself safe. Zione too, she is not safe. She is too young to date, to go out with boys. I’m doing my best to help her and
look after her.
I work at anything I can, for 50 kwacha a day to buy enough food (about NZ$1.20). Sometimes we have two meals a
day and sometimes only one.
I have gone as far as I can with free education. I did well in school, and I would like to continue. My English is very
strong, and I would like to be a mechanic. But I can't afford my school fees if I am to look after my sister.
Our mother died a year ago, she was sick for a long time. I left school right away to look after Zione. She is 13 and she wants to be a nurse. If she continues at school, and
she wants to, she could start nursing training after she finishes Form 4.
Slide 17
Muziona and Zione - Malawi
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HIV / AIDS: strategies
Slide 18
Blantyre Urban
Project
Malawi
Strategies for tackling HIV / AIDS
1. Prevention
Education and behaviour change
• ‘Breaking the silence’ - tackling the stigma that prevents people talking openly about HIV / AIDS
• Education on how HIV is spread and avoiding high-risk behaviours (ABC)
• Addressing barriers to behaviour change: gender relations,economic barriers, cultural practices
• Focus on high risk groups, like truck drivers, migrant workers and sex workers
• Focus on pregnant & breast-feeding mothers
• Education on prevention strategies
• Health care during and after pregnancy
Mother-to-child transmission
•Breaking the silence, educating a whole new generation about the dangers of HIV/AIDS
•Training school teachers to teach children about AIDS prevention
•Anti-AIDS clubs, dramas, events
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Kagera HIV / AIDS counselling and orphans
support project – Tanzania
Training and equipping volunteers for home-based care and counselling.
These volunteers cook, wash clothes and bed-clothes, and distribute basics like flour, oil, blankets and sheets.
2. Care for the sick
HIV / AIDS: strategies
• HIV testing
• Counselling and emotional support
• Education about living with HIV
• Advocating for wider availability of drug treatments
• Preventing other infections through healthcare, clean water, and sanitation
• Providing practical support such as food, blankets, sheets
• Training and support for care-givers
• Home-based care and counselling, especially where hospital beds are scarce
Slide 19
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HIV / AIDS: strategies
Slide 20
Rakai-Kooki Orphans on their own project
– Uganda
3. Care for those left behind
Meeting the immediate and long term needs of orphans and elderly caregivers in the absence of Mums and Dads.
• Counselling and support for children who have lost their parents
• Helping orphans or elderly guardians to strengthen their income and food supply
• Making sure orphans have access to education
• Improving living conditions
With hardly any income, these orphans had no chance of replacing their unsafe, crumbling mud hut without help from
World Vision.
There are many thousands of other children who still need help.