HIV / AIDSa global

emergency

A development education resource from World Vision New ZealandEducation Version 1.0 April 2003

click to continue

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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=

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

• 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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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

end show

skip slide

click to continue

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.