Mba, C.J.2019-05-142019-05-142007Chapter 6, pp 135-162http://ugspace.ug.edu.gh/handle/123456789/299796 Chapter HIV/AIDS and Survival Challenges in Sub-Saharan Africa: An Illustration with Ghana and South Africa Chuks J. Mba Introduction and Rationale The acquired immune deficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV), emerged in the 1980s as the most terrifying epidemic of modern times. The AIDS pandemic affects primarily young to middle-aged adults, on whom both the national economy and family survival depend. HIV/AIDS has the potential to devastate human development, setting countries backward in their efforts to increase infant and child survival, achieve longer life expectancy and promote better life chances through education, as well as productive and secure livelihoods. Worldwide, AIDS kills more than 8,000 people every day; one person every 10 seconds, while one child dies and one child is infected every minute. Out of a total of 39.4 million adults (defined as people aged 15-49) and children (defined as people below age 15) estimated to be living with HIV as of end of 2004, 25.4 million of them, representing about 64%, are from sub-Saharan Africa (UNAIDS/WHO 2005). Available evidence indicates that whereas 10.6 million adults lived with HIV/AIDS in 1994 in sub-Saharan Africa, there were about 30 million adults and children living with the disease by 2003, with 3.5 million new infections in 2002 alone (UNAIDS/WHO 2004; 2002). According to the estimates of UNAIDS (2002), the HIV prevalence rate in adults aged 15-49 ranges from 1.6 to 11.8% in Western Africa, from 0.1 to 2.6% in Northern Africa, from 3.6 to 12.9% in Central Africa, and from 2.8 to 15.0% in Southern Africa. Of the 45 countries most severely affected by HIV/AIDS, 35 of them (78%) are in sub-Saharan Africa (United Nations, 2001)9. It is conceded that there are no simple explanations as to why some countries are more affected by HIV than others. However, poverty, illiteracy and engaging in identified risk behaviours account for much of the epidemic (Mba, 2003a; Caldwell, 2000; Mbamaonyeukwu, 2001a; 2000; Philipson and Posner, 1995). People who are infected with HIV often have no symptoms of disease for many years and can infect others without realising that they themselves are infected. The HIV continues to spread in Africa and around the world, moving into communities previously little troubled by the epidemic and strengthening its grip on areas where AIDS is already the leading cause of death in adults. Unless a cure is found, or life-prolonging therapy can be made more widely available, the majority of those now living with HIV will die within a decade. Against this background, it is important to raise awareness and expanding knowledge about the deleterious effect of HIV/AIDS on Africa’s life expectancy, with particular reference to South Africa and Ghana, for possible policy interventions. Apart from the fact that relevant data to warrant this study are available for the two countries, available evidence suggests that about 3.1% of the adult population in Ghana are living with the HIV virus, while the prevalence rate is about 21.5% in South Africa. Besides, South Africa has the highest number of HIV/AIDS persons in the world (6 million people; 600 die everyday). It should be noted also that many southern and eastern African countries had HIV prevalence rates 136 POPULATION, HEALTH AND DEVELOPMENT in the late 1980s similar to those currently found in Ghana, but the situation worsened rapidly. This suggests that an unchecked epidemic could lead to much higher prevalence levels in Ghana. The two countries are therefore selected because they lie at opposite ends of the spectrum, so that analyzing their HIV/AIDS profiles will reveal more clearly the devastating impact of the pandemic. Given these unsettling realities, it is important to find out what some of the severely affected countries are doing to combat the HIV/AIDS pandemic. In particular, the following key research questions are addressed in this study: What are the current HIV/AIDS prevalence levels across Africa? How far have we come with respect to combating HIV/AIDS? What is the contribution of HIV/AIDS mortality to the overall mortality of South Africa and Ghana? To what extent will life expectancy be enhanced if HIV/AIDS were absent in the mortality experience of these countries? What are the successes that have been chalked in the endeavour to combat HIV/AIDS? What lessons have been learnt? and...enBook chapter