00001-E-50– 27 June 2000
Leading causes of death globally, 1999Leading causes of death globally, 1999
1 Ischaemic heart disease
2 Cerebrovascular disease
3 Acute lower respiratory infections
4 HIV/AIDS
5 Chronic obstructive pulmonary disease
6 Perinatal conditions
7 Diarrhoeal diseases
8 Tuberculosis
11 Malaria
12.7
9.9
7.1
4.8
4.8
4.2
4.0
3.0
1.9
Source: The World Health Report 2000, WHO
Rank % of total
2000 Global HIV/AIDS Estimates Children and Adults
• People living with HIV/AIDS
• New HIV infections in 2000
• Deaths due to HIV/AIDS in 2000
• Cumulative number of deaths due to HIV/AIDS
36.1 million
5.3 million
3.0 million
21.8 million
00001-E-19– 27 June 2000
New
infe
ctio
ns
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Highly in dustrialized countries
North Africa & Middle EastEastern Europe & Central asiaSub-Saharan AfricaLatin America & the Caribbean
Southern & Eastern Asia
Estimated annual number of new HIVEstimated annual number of new HIVinfections by region, 1980 to 1999infections by region, 1980 to 1999
Click for larger picture
00001-E-20– 27 June 2000
Peo
ple
livin
g w
ith H
IV/A
IDS
Highly in dustrialized countries
North Africa & Middle East
Eastern Europe & Central Asia
Sub-Saharan AfricaLatin America & the Caribbean
Southern & Eastern Asia
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Estimated number of people living withEstimated number of people living withHIV/AIDS by region, 1980 to 1999HIV/AIDS by region, 1980 to 1999
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00001-E-46– 27 June 2000
Changes in life ex pectancy in sele cted African count rieswith high HIV prevalence , 1950 to 2000
South-Africa
35
40
45
50
55
60
65
1950-55 1955-60 1960-65 1965-70 1970-75 1975-80 1980-85 1985-90 1990-95 1995-00
Life
exp
ecta
ncy
at
birt
h, i
n ye
ars
Botswana
Uganda
Zambia
Zimbabwe
Source: United Nations Population Division, 1998
Click for larger picture
00001-E-15– 27 June 2000
Projected population structure with and Projected population structure with and without the AIDS epidemic, Botswana, 2020without the AIDS epidemic, Botswana, 2020
80757065605550454035302520151050
020406080100120140 0 20 40 60 80 100 120 140
Males Females Deficits due to AIDS
Projected populati on structure in 2020
Population (thousands)
Age
in y
ears
Source: US Census Bureau, World Population Profile 2000
Click for larger picture
00001-E-47– 27 June 2000
0 10 20 30 40 50 60 70
Cambodia
Haiti
Mozambique
Rwanda
Côte d'Ivoire
Zambia
Kenya
South Africa
Zimbabwe
Botswana
Life expectancy at birth ( years)
Predicted life expectancy Loss in l ife expectancy due to HIV/AIDS
Source: U.S. Census Bureau, 2000
Predicted loss in life expectancyPredicted loss in life expectancydue to HIV/AIDS in children born in 2000due to HIV/AIDS in children born in 2000
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00001-E-48– 27 June 2000
Lifetime risk of AIDS death for 15-year-old boys,Lifetime risk of AIDS death for 15-year-old boys,assuming unchanged or halved risk of becomingassuming unchanged or halved risk of becoming
infected with HIV, selected countriesinfected with HIV, selected countries
Source: Zaba B, 2000 (unpublished data)
Current adult HIV prevalence rate
Burkina Faso
Cambodia
Côte d’Ivoire
Kenya
South AfricaZambia
Zimbabwe
Botswana
Burkina FasoCambodia
Côte d’Ivoire
Kenya
South AfricaZambia
Zimbabwe
Botswana
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Ris
k of
dyi
ng o
f A
IDS
current level of risk maintained
risk halved over next 15 year s
Click for larger picture
00001-E-26– 27 June 2000
Reduction in production in a household withan AIDS death, Zimbabwe
Crops
Maize
Cotton
Vegetables
Groundnuts
Cattle owned
Reduction in output
61%
47%
49%
37%
29%
Source: Stover & Bollinger, 1999
HIV/AIDS Prevention
• Condoms- accessible, cheap
• Sex education, early & often
• Counseling, testing
• Prevent mother to child transmission
• Reduce harm of drug use
• Access to care, treatment
PREVENTABLE DEATHS
Measles Child vaccination 98% Malaria Pesticide bednets 50% Tuberculosis DOT-S 60% Diarrheas Oral rehydration 90% Pneumonias Appropriate antibiotics 90% HIV/AIDS Condoms, sex ed, etc 70%
Costs of Prevention Strategies
Intervention Cost-$/person EffectivenessTuberculosis Rx $20 95%
HIV-condoms 1 yr $14 99%
Malaria- bednets $00.05 50%
Diarrhea- salts,H20 $00.33 99%
Pneumonia- antibiotics $00.27 90%
Measles- vaccine $00.26 98%
Total cost to prevent infectious diseases-$7 billion
Which way will the world turn?
Will the nations of the earth make the resources available:
“To prevent disease in the weakest to protect the strongest”
? ? ? ?
00001-E-3– 27 June 2000
HIV prevalence among pregnant womenHIV prevalence among pregnant womenin South Africa, 1990 to 1999in South Africa, 1990 to 1999
Source: Department of Health, South Africa
0.71.7 2.1
4
7.6
10.4
14.2
17
22.8 22.4
0
5
10
15
20
25
90 91 92 93 94 95 96 97 98 99
HIV
pre
vale
nce
(%)
Click for larger picture
00001-E-13– 27 June 2000
HIV prevalence in military personnel in Africa
Nigeria: 11% among peacekeepe rs returning
from Sierra Leone and Liberia vs 5% in adult
population
South Africa: 60-70% in military vs 20% in
adult population
Source: Nigeria AIDS bulletin No 15, May 20, 2000; The Mail & Guardian, Pretoria,March 31, 2000; UNAIDS/WHO 1999 estimate
Life Expectancy at Birth(both sexes, years)
Area 1995-2000 2010-2015 2045-2050
World 65.0 68.7 76.0
Japan 80.5 81.5 88.0
France 78.1 80.3 84.0
USA 76.5 79.2 82.6
China 69.8 73.5 79.0
Russia 66.1 69.3 76.9
Sierra Leone 37.3 40.5 61.5
Life Expectancy at Birth (both sexes, years)
Area 1995-2000
World 65.0
Japan 80.5
France 78.1
USA 76.5
China 69.8
Russia 66.1
Afghanistan 47.0
Sierra Leone 37.3
Infant Mortality Rate(infant deaths per 1000 live births)
Area 1995-2000 2010-2015 2045-2050
World 59.6 43.4 19.4
Japan 3.5 3.3 2.5
France 5.5 4.6 3.6
USA 7.6 5.8 4.4
Russia 16.7 14.0 7.2
China 41.4 28.6 13.3
Sierra Leone 165.4 124.0 53.9
Infant Mortality Rate(infant deaths per 1000 live births)
Area 1995-2000
World 59.6
Japan 3.5
France 5.5
USA 7.6
Russia 16.7
China 41.4
Afghanistan 165.0
Sierra Leone 165.4