Global Disparity in HIV/AIDS
In 2013, the UNAIDS estimated that 35 million people globally were living with HIV/AIDS (UNAIDS 2014a). While sub-Saharan Africa has less than 13% of the world’s population (Population Reference Bureau 2014a), it is home to 71% (24.7 million) of all people living with HIV/AIDS and 91% of children with this condition (UNAIDS 2014b). Despite the introduction of ART in 1996 and the concerted efforts by various international agencies such as The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the Joint United Nations Programme on HIV and AIDS (UNAIDS), and the Bill & Melinda Gates Foundation to increase treatment availability in the last decade, the 2013 data showed that only 37% of sufferers in this region had access to ART (UNAIDS 2014a). In some countries such as Nigeria, 80% of people did not have access to treatment (UNAIDS 2014a). Other countries in the region, including Central African Republic, Democratic Republic of Congo, and South Sudan, faced not only high HIV burden and low treatment coverage but also no or little decline in new infection.
Because of HIV/AIDS infection, life expectancy in sub-Saharan Africa is only at 54.9 years (UNDP 2013), which is more than 20 years lower than that in many developed countries, such as the United States (78.9 years), the United Kingdom (80.5 years), and Canada (81.5 years) (UNDP 2013). Swaziland, which has the highest HIV prevalence in the world (27.4%), has a life expectancy of just 48.9 (UNDP 2013). Botswana, despite having already seen a dramatic decline in AIDS- related deaths (58%) due to the rapid increase of placing patients on ART, maintains a high HIV prevalence (23%) and low life expectancy of 53 years (UNDP 2013, UNAIDS 2014b).
HIV/AIDS infection also perpetuates the cycle of poverty because of its serious impact upon a household’s ability to generate income. When the income earners die or become too sick to work, medical costs can mount, children can be forced to abandon their education, and family members may have to forego any paid employment to care for the sick. In some cases, people have no other viable incomegenerating opportunities but to engage in sex work, which subsequently increases the risk of HIV/AIDS transmission and repeats the cycle (Miller et al. 2011). As HIV infection weakens the immune system, it can increase one’s susceptibility to other infectious diseases and illnesses. In low-resource countries, tuberculosis (TB) is the most common opportunistic infection associated with HIV and a leading cause of death among people with HIV/AIDS, who have 26-31 times greater chance of developing TB than people without HIV infection (WHO 2014).