HIV/AIDS has been labelled as one of the major problems facing the African continent and the most severe evidence of the problem is concentrated within the region commonly called Sub Sahara Africa. Sub-Sahara Africa is made up of the forty-eight countries (42 on the mainland and 6 on surrounding islands) located south of the Sahara desert (see Figure 1). This regional space excludes Arab dominated North African countries of Egypt, Libya, Tunisia, Algeria, and Morocco. In addition, the island of Mauritius is also not considered a part of Sub Sahara Africa.
Sub Sahara Africa is home to just over 10% of the world’s population however, it accounts for 60% of the world’s population infected with HIV (UNAIDS & WHO 2005, pg6). As at 2005, the cumulative count of fatalities attributed to the disease in Africa is estimated to be about 11million (UNAIDS & WHO 2005, pg2). Some of the yearly fatality breakdowns are as follows, 2 million in 1998 (Yankah, 2004, pg182), 2. 1 million in 2002, and 2. 3 million in 2004 (UNAIDS & WHO 2005, pg2) and 2. 9 million in 2006 (UNAIDS & WHO 2006, pg1).
According to UNAIDS and WHO (2005), the prevalence rate of 7. 4% (UNAIDS & WHO, 2005 pg2) in Africa, seems to indicate stabilisaation in prevalence. Although this sounds positive, it is no cause for celebration because in reality, it only indicates that equal numbers of people are getting infected and dying simultaneously. Also, the actual prevalence of the disease is not evenly distributed in the different regions and countries of the sub continent. Therefore, the reported stabilisaing effect hides the severity of the disease in individual countries and in the sub-regions.
Figure1. Countries of Sub Sahara Africa Source: http://www. worldmap. org/region. php? region=Sub-Saharan%20Africa Prevalence rates in Southern and Eastern Africa are as high as 25%, compared to 1% in West Africa (UNAIDS & WHO 2004, pg2). In the area informally known as the ‘AIDS belt’ of Africa (starting in southern Sudan, and running from East Africa through Southern Africa), the disease’s impact is so severe that in some villages, most adult residents have died of the disease – leaving the villages ‘virtually empty’ of adults.
With the exception of Angola, the countries of southern Africa (South Africa, Botswana, Lesotho, Zimbabwe, Zambia, Malawi, Namibia, Swaziland, Central African Republic, Rwanda, and Burundi) collectively account for a third of all AIDS deaths in the world (UNAIDS & WHO 2004, pg23-24). However, Angola’s exception hinges on the fact that the country is just emerging from a long-standing war so little reliable information is available on the disease. The high prevalence rate of the disease in this area has further reduced the already low life expectancy of the people.
Currently life expectancy rate in nine out of the ten countries in the supposed ‘AIDS belt’ is less than 40 years (Again, Angola is the exception) (UNAIDS & WHO 2004, pg23). In West and Central Africa however, the problem is not as severe as in the so-called ‘AIDS belt’. This not withstanding, infection rates are said to be gradually increasing therefore the need to deal with the problem before it escalates into the likes of what prevails in southern and eastern Africa. According to the 2004, 2005 and 2006 disease update by UNAIDS and WHO, West and Central Africa prevalence levels have stayed steady at lower levels of between 3 to 4 percent.
Generally, prevalence rates have remained low in the Sahel (meaning border or margin of the desert) countries, a greater portion of which falls within West Africa. The Sahel Africa region is the transition zone between the Sahara desert in the north, and the tropical rainforests to the south. The region stretches from the Atlantic Ocean on the west (covering the following countries; Senegal, Mauritania, Mali, Burkina Faso, Niger, Northern Nigeria, Chad and Sudan) to the “Horn” of Africa (the area covering Ethiopia, Eritrea, Djibouti and Somalia) on the east.
Despite the fact that the Sahel region boasts of some of the lowest prevalence rates on the sub-continent, figures from Burkina Faso, Cote d’Ivoire, and Nigeria raises concern for the region and for Ghana, the focus country of this study. These three countries have the highest prevalence rates in the West African sub-region (UNAIDS & WHO 2004). Nigeria, the report further states, accounts for the world’s third highest number of people living with HIV, coming after South Africa and India respectively (UNAIDS 2004 pg27-28).
In addition, recent data from Togo, Ghana’s immediate neighbor on the east, points to a serious epidemic (UNAIDS & WHO 2006). As pertains in other parts of the world, majority of those infected in West Africa are women. The ‘feminisation of HIV’ infection has had serious economic, social, and cultural implications for the countries. One such effect of the ‘feminisation of HIV’ and its attendant high mortality of women due to complications from AIDS is the creation of a generation of orphans who are also infected with HIV.
According to recent population based household surveys, adult women in Sub Sahara Africa are up to 1. 3 times more likely to be infected with HIV than their male counterparts (UNAIDS 2005, pg22). The unevenness, the report continues, is greatest among women within the age bracket of 15 to 24. Women within this group are about three times more likely to be infected compared to young men within the same age group. At the various national levels, the situation of women as it relates to HIV infection is even more disturbing — especially in countries located within the so-called ‘AIDS belt’.
In South Africa, Zambia and Zimbabwe, women aged between 15 to 24 years are three to six times more likely to be infected than young men in the same age group (UNAIDS & WHO 2004). Despite this bleak overview of the disease in Africa, the epidemic in West Africa has not yet reached catastrophic levels as is being experienced in parts of eastern and southern Africa. The situation in Nigeria demands that steps are taken to prevent a spill over of the disease into other neighboring countries in the West African sub-region.