The Business Response to HIV/AIDS: Impact and lesson learned

TABLE 1 Main modes of transmission* for adults living with HIV/AIDS
Region Mode of transmission
Sub-Saharan Africa Hetero
North Africa & Middle East IDU, Hetero
South & South-East Asia Hetero
East Asia & Pacific IDU, Hetero, MSM
Latin America MSM, IDU, Hetero
Caribbean Hetero, MSM
Eastern Europe & Central Asia IDU, MSM
Western Europe MSM, IDU
North America MSM, IDU, Hetero
Australia & New Zealand MSM, IDU
*MSM (sexual transmission among men who have sex with men, IDU (transmission through injecting
drug use), Hetero (heterosexual transmission).
Treatment: Significant drug developments have been made in antiretroviral therapy that has been able
to prolong life for many in the more developed countries, but there is still no cure. Moreover, for the
majority in developing countries the costs of treatment are currently too high and the care infrastructure
insufficient. Research into vaccines is currently being undertaken, yet there is little expectation amongst
medical specialists of any vaccines being available for at least 10 years. As a result, recent efforts have
been undertaken to extend research into drugs and behavioural changes to reduce the virulence and
prevalence of the opportunistic diseases.
2. THE GLOBAL AND REGIONAL TRENDS
Nearly two decades after HIV/AIDS emerged as a new virus, it has now reached almost every country
in the world. UNAIDS figures, reported in June 2000, estimated that globally there were 34.3 million
people living with HIV, 5.4 million of which became infected in 1999 alone. This brings the
cumulative number of estimated HIV infections worldwide to over 50 million since the beginning of
the epidemic.
Breaking these figures down reveals that around half of all people who become infected with HIV do so
before they reach the age of 25 and most will die of AIDS or related illnesses before they are 35. This
means that HIV/AIDS is affecting some of the most creative and economically active people. In
addition, some 95 percent of people with HIV/AIDS live in developing countries, where the ability to
provide prevention and care is more limited. As Figure 1 shows, the result will be to reduce significantly
the life expectancies within many of these countries. The U.S. Bureau of Census has predicted that by
the year 2010, eight to 31 years of life will have been lost in those countries most affected by
HIV/AIDS in sub-Saharan Africa. HIV/AIDS is also leading to the resurgence of other diseases, such as
tuberculosis (TB), increasing public health threats and reducing the gains made over many years of
health programmes.
It is worth noting that the reliability of the HIV/AIDS surveillance data is variable and discrepancies
between reported and actual cases may be considerable. This is largely due to low capacities to undertake
surveillance and diagnostic tools in some developing countries. In addition, the prevalence of
opportunistic infections such as TB and the stigmatisation of HIV/AIDS may result in considerable
masking and under-reporting of HIV/AIDS data.
As can be seen from Figure 2, HIV/AIDS has impacted on different regions of the world at very different
levels. Sub-Saharan Africa is the worst affected region, constituting 70 percent of people living with

HIV/AIDS in the world and 85 percent of the estimated deaths due to HIV/AIDS since the beginning
of the epidemic. Another region that has experienced a serious epidemic is Central America and the

THE BUSINESS RESPONSE TO HIV/AIDS: Impact and lessons learned