2.3 Social Development II: Economic Report on Africa 2007
2.3 Social Development II: Economic Report on Africa 2007
variations, with the Southern and Eastern subregions being the hardest
hit. The epidemic seems to be slowly gaining ground in Central Africa, while most
of West and North Africa has sustained fairly low levels of prevalence (UNAIDS
2006).
HIV/AIDS does not affect men and women equally. In SSA, close to 60 per cent of
those living with HIV/AIDS are women (box 2.3). In some areas, up to six times
more women than men are infected in the 15-24 age group (WHO-AFRO 2003).
Life expectancy, for biological reasons, is generally higher for women than for men.
However, in four countries – Kenya, Malawi, Zambia and Zimbabwe – the higher
prevalence of HIV/AIDS among women has led to life expectancy for women dropping
below that of men (UN-DESA 2005b).
Given the delayed impact of HIV/AIDS and the continued increase in prevalence,
the worst is yet to come. The pandemic is not only an immediate crisis, but is also
a long-term systemic challenge, with profound consequences for Africa (CHGA
2004a).
One area of particular concern is the impact of HIV/AIDS on food security. In
a recent study of two local communities in rural Ethiopia, UNECA, UNDP and
WFP found that even though the progression of the pandemic in rural Ethiopia was
at an early stage, the impact could already be felt (UNECA/UNDP/WFP 2004).
Households affected by HIV/AIDS have changed their spending patterns, spending
more on health and funerals, financed primarily by borrowing. In addition, the
resource base of these households has been reduced, as they gave up land to sharecropping
and sold livestock. It was also shown that the reliance on social networks
is insufficient to cope with HIV/AIDS. Since most households have continued to
rely on farming as their most important source of income and food, HIV/AIDS has
increased the food insecurity of affected households.
As a result of decades of austerity measures and compression of public expenditure,
the capacity of African health care systems has been cut back while the demand for
services keeps increasing. Health systems are so strained that a large proportion of
Africans do not even have access to the most basic health care. At the same time, the
demand for health care services is rapidly increasing, and the increasing morbidity
as a result of HIV/AIDS adds to the existing burden on overstretched health care
systems (Sandkjaer 2006).
Policy responses to HIV/AIDS - prevention and mitigation
Most African countries have established mechanisms for coordination of the response
to HIV/AIDS, usually through a National AIDS Commission. With assistance from
national and international partners, governments are focusing on how to prevent
new infections, while simultaneously keeping those infected healthy for as long as
possible.
Until very recently, the country-level response to HIV/AIDS was limited to prevention
interventions and minimal care and support for those infected. Today, scaledup
resources, coupled with the decreasing costs of treatment and the emergence of
simpler treatment regimes, provide an opportunity to expand national HIV/AIDS
treatment and care responses. As a result, treatment coverage increased from 100,000
people on antiretroviral treatment in December 2003, to 810,000 in December
2005, or an estimated 17 per cent of those in need (WHO 2006a).
In a study exploring the consequences of a prevention-centred response to HIV,
a treatment-centred response, and a combined response, Salomon et al. (2005)
show that an integrated response works best. In the long term, such a response also
reduces both direct and indirect HIV/AIDS-associated costs as fewer people will be
infected.
A number of lessons have been learnt and are being applied in the scaling-up of
treatment in Africa. With regard to prevention, traditional individual-focused
approaches are hotly debated. Proponents of an approach that mainly centers on
individual behaviour change argue that, given that HIV/AIDS is mainly transmitted
through unprotected sex between men and women, effective interventions must
focus on severing this transmission route by encouraging individuals to change their
behaviour, and ultimately abstain from sex before marriage, be faithful within marriage,
and use condoms – the so-called ABC approach.
Others argue that a more comprehensive approach is required, as individual behaviour
is conditioned by many contextual factors which, unless addressed, make individuals
unable to change their behaviour even if they so wish. For example, 10-55
per cent of African women surveyed stated that they believe that a wife cannot ask
her husband to use a condom and cannot refuse sex, even if she knows that he has
a sexually transmitted infection. For these women, HIV/AIDS can still meet them
in the conjugal bedroom, regardless of their willingness to protect themselves. Thus,
there is a pressing need for an effective, comprehensive response to the disease in
Africa.
The Commission on HIV/AIDS and Governance in Africa (CHGA), which was
launched in 2003 by United Nations Secretary-General, Kofi Annan, aimed at bringing back a sense of urgency to HIV prevention. Its final report contains important
findings on this pandemic and gives useful recommendations (box 2.3).
23 Social Development II Economic Report on Africa 2007 - To learn more about this author, visit United Nations Economic Commission for Africa's Website.
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The patterns of spread and levels of prevalence of HIV/AIDS exhibit marked subregional
variations, with the Southern and Eastern subregions being the hardest
hit. The epidemic seems to be slowly gaining ground in Central Africa, while most
of West and North Africa has sustained fairly low levels of prevalence (UNAIDS
2006).
HIV/AIDS does not affect men and women equally. In SSA, close to 60 per cent of
those living with HIV/AIDS are women (box 2.3). In some areas, up to six times
more women than men are infected in the 15-24 age group (WHO-AFRO 2003).
Life expectancy, for biological reasons, is generally higher for women than for men.
However, in four countries – Kenya, Malawi, Zambia and Zimbabwe – the higher
prevalence of HIV/AIDS among women has led to life expectancy for women dropping
below that of men (UN-DESA 2005b).
Given the delayed impact of HIV/AIDS and the continued increase in prevalence,
the worst is yet to come. The pandemic is not only an immediate crisis, but is also
a long-term systemic challenge, with profound consequences for Africa (CHGA
2004a).
One area of particular concern is the impact of HIV/AIDS on food security. In
a recent study of two local communities in rural Ethiopia, UNECA, UNDP and
WFP found that even though the progression of the pandemic in rural Ethiopia was
at an early stage, the impact could already be felt (UNECA/UNDP/WFP 2004).
Households affected by HIV/AIDS have changed their spending patterns, spending
more on health and funerals, financed primarily by borrowing. In addition, the
resource base of these households has been reduced, as they gave up land to sharecropping
and sold livestock. It was also shown that the reliance on social networks
is insufficient to cope with HIV/AIDS. Since most households have continued to
rely on farming as their most important source of income and food, HIV/AIDS has
increased the food insecurity of affected households.
As a result of decades of austerity measures and compression of public expenditure,
the capacity of African health care systems has been cut back while the demand for
services keeps increasing. Health systems are so strained that a large proportion of
Africans do not even have access to the most basic health care. At the same time, the
demand for health care services is rapidly increasing, and the increasing morbidity
as a result of HIV/AIDS adds to the existing burden on overstretched health care
systems (Sandkjaer 2006).
Policy responses to HIV/AIDS - prevention and mitigation
Most African countries have established mechanisms for coordination of the response
to HIV/AIDS, usually through a National AIDS Commission. With assistance from
national and international partners, governments are focusing on how to prevent
new infections, while simultaneously keeping those infected healthy for as long as
possible.
Until very recently, the country-level response to HIV/AIDS was limited to prevention
interventions and minimal care and support for those infected. Today, scaledup
resources, coupled with the decreasing costs of treatment and the emergence of
simpler treatment regimes, provide an opportunity to expand national HIV/AIDS
treatment and care responses. As a result, treatment coverage increased from 100,000
people on antiretroviral treatment in December 2003, to 810,000 in December
2005, or an estimated 17 per cent of those in need (WHO 2006a).
In a study exploring the consequences of a prevention-centred response to HIV,
a treatment-centred response, and a combined response, Salomon et al. (2005)
show that an integrated response works best. In the long term, such a response also
reduces both direct and indirect HIV/AIDS-associated costs as fewer people will be
infected.
A number of lessons have been learnt and are being applied in the scaling-up of
treatment in Africa. With regard to prevention, traditional individual-focused
approaches are hotly debated. Proponents of an approach that mainly centers on
individual behaviour change argue that, given that HIV/AIDS is mainly transmitted
through unprotected sex between men and women, effective interventions must
focus on severing this transmission route by encouraging individuals to change their
behaviour, and ultimately abstain from sex before marriage, be faithful within marriage,
and use condoms – the so-called ABC approach.
Others argue that a more comprehensive approach is required, as individual behaviour
is conditioned by many contextual factors which, unless addressed, make individuals
unable to change their behaviour even if they so wish. For example, 10-55
per cent of African women surveyed stated that they believe that a wife cannot ask
her husband to use a condom and cannot refuse sex, even if she knows that he has
a sexually transmitted infection. For these women, HIV/AIDS can still meet them
in the conjugal bedroom, regardless of their willingness to protect themselves. Thus,
there is a pressing need for an effective, comprehensive response to the disease in
Africa.
The Commission on HIV/AIDS and Governance in Africa (CHGA), which was
launched in 2003 by United Nations Secretary-General, Kofi Annan, aimed at bringing back a sense of urgency to HIV prevention. Its final report contains important
findings on this pandemic and gives useful recommendations (box 2.3).
23 Social Development II Economic Report on Africa 2007 - To learn more about this author, visit United Nations Economic Commission for Africa's Website.
Like this article? Share it with your friends
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John BrennanJohn Brennan Ed.D. Dr. Brennan is President of Interpersonal Development, LLC, a training and development firm. Interpersonal Development has provided sales training and coaching to more than 3,000 sales reps from over 100 companies. A native of Australia, Dr. Brennan received his doctorate from the University of Rochester. His dissertation researched the effectiveness of Behavioral Modeling Technology in training people in interpersonal skills. While he has spent most of his career designing or delivering training, he was also a Vice-President of Sales of a training and development franchise with operations in 25 markets. Dr. Brennan has designed and delivered sales training in North America, Asia, Europe, Australia and the Middle East. He has been a guest speaker at numerous national and regional professional conferences. When Microsoft wanted Best Practices articles on sales for their web site, they called Dr. Brennan. The results are at http://office.microsoft.com/en-us/FX011387391033.aspx His firm’s clients have included Volvo, The Prudential, Merrill Lynch, Eastman Kodak, Gannett, Equifax Europe, the Economist Group and countless small businesses. - Visit John Brennan's Website |
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Dave KurlanDave Kurlan is the founder and CEO of Objective Management Group, Inc., the industry leader in sales assessments and sales force evaluations, and the CEO of David Kurlan & Associates, Inc., a consulting firm specializing in sales force development. Dave has been a top rated speaker at Inc. Magazine's Conference on Growing the Company, the Sales & Marketing Management Conference and the Gazelles Sales & Marketing Summit. He has been featured on radio and TV, including World Business Review with General Norman Schwarzkopf, in Inc. Magazine, Selling Power Magazine, Sales & Marketing Management Magazine and Incentive Magazine. He is the author of Mindless Selling and Baseline Selling – How to Become a Sales Superstar by Using What You Already Know about the Game of Baseball. He created and wrote STAR, a proprietary recruiting process for hiring great salespeople, and he writes Understanding the Sales Force, a popular business Blog and is a contributing author to The Death of 20th Century Selling and 101 Great Ways to Improve Your Life, Volume 2. - Visit Dave Kurlan's Website |
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John PowerJohn Power, founder of Biltmore Franchise Consulting, has extensive experience developing and marketing franchises and business opportunities. He has been in and around franchising for over twenty years. From 1980 through 1990 he conceptualized, organized, and developed the American Video Association. He grew AVA to 2,000 national members, before selling the company it 1990. It was later merged into another home video marketing company. From 2000 to 2005 he worked as a contract marketing and human resources consultant to several local and national companies. In 2005 Mr. Power began working as a franchise development consultant on a full-time basis. Since that time he has helped more than three dozen companies initiate and develop their franchising program. He notes that there are many companies interested in developing a franchise program, and who need his specialized assistance. Mr. Power is a “hands-on” franchise consultant. He said, “I am the ‘nuts and bolts’ person who tends to the details for my clients.” Mr. Power holds a B.S. degree with a major in Marketing. See: www.biltmorefranchise.com You may contact Mr. Power at: jpower@biltmorefranchise.co - Visit John Power's Website |
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David AchesonDavid Acheson is the founder of DCJA Consultancy. DCJA Consultancy is a management consultancy business specialising in B2B sales consultancy. They offer bespoke and packaged sales consultancy including Sales Optimisation Review, Interim Sales Management, Sales & Marketing Review, 1:1 Sales & Management Staff Analysis, Management Training, Solution Sales Training, Creation of New Pay Plan, KPI's, run Customer Feedback Campaigns, assist with Recruitment, Coaching, Appraisals and set up Strategic Marketing Campaigns. David spent his early career in accountancy and then moved into sales in 1982, working in Office Equipment, IT, Advertising, Training, Outsourcing and Consultancy. He has held many Senior Positions in SMBs and Global Organisations including Head of Sales Operations & Head of Business Development. His knowledge, skills and great experience of the Sales Industry has led to David making keynote speeches and running educational sessions to key businesses through organisations including The Chamber of Commerce and Business Link. - Visit David Acheson's Website |
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Linda RichardsonLinda Richardson is the Founder and Executive Chairwoman of Richardson, a global sales training and performance improvement company. As a recognized leader in the industry, she has won the coveted Stevie Award for Lifetime Achievement in Sales Excellence and she was identified by Training Industry, Inc. as one of the “Top 20 Most Influential Training Professionals.” Ms. Richardson is credited with the movement to Consultative Selling and is the author of ten books on selling and sales management, including Sales Coaching — Making the Great Leap from Sales Manager to Sales Coach, and Stop Telling, Start Selling. She teaches sales and management at the Wharton Graduate School of the University of Pennsylvania and the Wharton Executive Development Center. Linda is a frequent speaker at industry and client conferences, has been published extensively in industry and training journals, and has been featured in numerous publications, including The Wall Street Journal, Forbes, Nation’s Business, Selling Power, Success, and The Conference Board Magazine. Learn more about Richardson's sales training and performance improvement solutions at http://www.richardson.com web - Visit Linda Richardson's Website |
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