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AIDS turns 30

In June of 1981, the United States Centers for Disease Control and Prevention noted unusual clusters of rare diseases in San Francisco and Los Angeles. These intial reports foretold AIDS, the "most severe epidemic in modern times" 1. Since then, nearly 30 million people have died of AIDS-related causes, and an estimated 34 million people are living with HIV 2.

Nonetheless, the global AIDS response gives reason for hope, as the rate of new HIV infections has fallen by nearly 25% 3. Even more hopefully, results of a recent trial suggest drugs used to treat AIDS can reduce the risk of transmitting the virus by 96% 4.

Thirty years on, it looks as though the plague can now be beaten, if the world has the will to do so. 5.
The current state of the epidemic

The past thirty years has witnessed significant progress in the struggle against the spectre of HIV / AIDS. At least in rich parts of the world, what was once a death sentence is now a chronic illness. Nonetheless, the effect of AIDS remains debilitating to low and middle income countries. And as the path out of the epidemic starts to come into focus, the scope of the challenge remaining is also becoming clearer.

For every three people who start medication in low and middle income countries, five more became infected. In these countries, 6.6 million people out of 16 million who would most benefit are now receiving drugs, a 22 fold increase since 2001. However, this leaves 9 million who are still waiting. The number of deaths due to AIDS is down from its peak, 2.1 million in 2005. Still, 1.8 million people died from AIDS related causes in 2010, the latest year for which data is available. And there were 2.6 million new HIV infections worldwide in 2009.

The future challenge

Two significant challenges must still be grappled with: extending treatment to all those in need, and controlling the spread of the disease. To meet these challenges, UNAIDS and its partners have development an investment framework, focussing on cost effective use of funds, that can achieve the goal of universal access to HIV prevention, treatment, care and support by 2015. Detailed in The Lancet, 6 an annual investment of approximately US$ 22 billion would be needed by 2015, US$ 6 billion more than the US$ 16 billion currently available. However, according to the study, the extra money would be largely offset by expected savings on treatment avoided.

strategy cost
( Graphic extracted from The Economist 7 )

In the current environment, however, budgets are under pressure in the rich world, and austerity threatens to reduce, rather than augment, the funds available. As of this update, the Netherlands and Spain have plans to cut contributions to the Global Fund, and Italy has stopped contributing altogether 8.

But AIDS can be beaten - with enough people on drugs, not only will lives be saved directly, but the chain of transmission of HIV can be broken. With another large push right now, perhaps the world can acheive the stated UNAIDS goal of "zero new HIV infections, zero discrimination and zero AIDS-related deaths".

HIV / AIDS in sub-Saharan Africa

"East and Southern Africa remains the area most heavily affected by the HIV epidemic. Out of the total number of people living with HIV worldwide in 2009, 34% resided in 10 countries of Southern Africa.

The vast majority of people newly infected with HIV in the region are infected during unprotected heterosexual intercourse. Having unprotected sex with multiple partners remains the greatest risk factor for HIV in the region. New HIV infections among children due to mother-to-child transmission of HIV are also significant in the region." 9.

HIV / AIDS in Kenya

In Kenya, national HIV prevalence has fallen from approximately 14% in the mid-1990's, to 5% in 2006. From 2002 to 2007, AIDS death from AIDS related causes fell by 27%.

As in the rest of Africa, HIV is transmitted mostly through heterosexual sex, 40% within marriage or cohabitation. New infections linked to the sex trade amounts to 14% of the total. Amongst homosexual men, 40% are living with HIV. Injection drug use is also an important mode of transmission 10.

General Information

Busia District

Busia district is one of six districts in Western Province, Kenya. It is bordered by Uganda to the west and Lake Victoria to the south.

Agriculture, fishing and commercial undertakings on small scale are the main economic activities in the district. Many women are involved in cross border production and small businesses in the market centre. The informal sector supports the largest group of workers in the areas of carpentry, bicycle repair, brick laying and bicycle taxis (boda-boda). Commercial sex is also a common source of income in Busia. Being a border town, cross border trade exists, using child labour to ferry goods back and forth from Uganda. The average household in the district generates approximately $84 per month.

Busia district has 227 primary school and 27 secondary schools. Many of the districts schools are under utilized due to low enrolment and high drop out rates. 60% of boys and almost 70% of girls who begin class one drop out before they complete class eight. Child labour, pregnancy, early marriage, death of parents and lack of parental support drive these high drop out rates.

Busia

Busia is located in Busia District, approximately 431 km, by road, from the capital, Nairobi. It is in south-western Kenya, near Lake Victoria and close to the border with neighbouring Uganda.

Busia has an urban population of 30,777 people, based on the 1999 census.

Some background on Kenya

Kenya gained its independence from the UK in 1963 under founding president Jomo Kenyatta. Its current president is Mwai Kibaki, first elected in December 2002 in what was considered a free and fair election.

Kibaki was re-elected in 2007, amidst allegations of vote rigging, resulting in two months of violence and as many as 1500 deaths. UN sponsored talks produced a power sharing agreement between Kibaki and opposition candidate Raila Odinga, who currently holds the restored position of prime minister.11

Although the current president initially ran on an anti-corruption platform, corruption remains a large problem in Kenya. According to a 2010 report by Transparency International, Kenya still ranks as one of the world's most corrupt countries.12

Information Resources on the Web

1 UNAIDS publication AIDS at 30 : Nations at the crossroads, pg 15.
2 UNAIDS press release, June 3, 2011.
3 UNAIDS press release, June 3, 2011.
4 UNAIDS publication AIDS at 30 : Nations at the crossroads, pg 13.
5 The Economist, June 4, 2011, pg. 11.
6 Schwartlander, Bernard et al., The Lancet, 9782 (2011), 2031-2041
7 The Economist, June 4, 2011, pg. 91.
8 The Economist, June 4, 2011, pg. 11.
9 http://www.unaids.org/en/regionscountries/regions/easternandsouthernafrica
10 UNAIDS 2010 fact sheet for sub-Saharan Africa.
11CIA World Factbook: Kenya
12Transparency International 2010 Corruption Perceptions Index (154 of 178)

(This page last updated July, 2011)

kenyan orphans