The aids pandemic an update on the numbers and needs
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The AIDS Pandemic: an Update on the Numbers and Needs. What are the numbers for 2002? What are the global and regional trends? Where do all these numbers come from? How are the estimates made? Can we look into the future?. What are the numbers for 2002?.

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The aids pandemic an update on the numbers and needs

The AIDS Pandemic: an Update on the Numbers and Needs

  • What are the numbers for 2002?

  • What are the global and regional trends?

  • Where do all these numbers come from?

  • How are the estimates made?

  • Can we look into the future?


What are the numbers for 2002

What are the numbers for 2002?


Global estimates for adults and children end 2002

Global estimates foradults and childrenend 2002

  • People living with HIV/AIDS

  • New HIV infections in 2002

  • Deaths due to HIV/AIDS in 2002

42 million

5 million

3.1 million


Adults and children estimated to be living with hiv aids as of end 2002

Adults and children estimated to be living with HIV/AIDS as of end 2002

Eastern Europe & Central Asia

1.2 million

Western Europe

570 000

North America

980 000

East Asia & Pacific

1.2 million

North Africa

& Middle East

550 000

South

& South-East Asia

6 million

Caribbean

440 000

Sub-Saharan Africa

29.4 million

Latin America

1.5 million

Australia

& New Zealand

15 000

Total: 42 million (3.2 mln children)


Global distribution of 42 million people living with hiv in 2002

Global Distribution of 42 million People Living with HIV in 2002


Hiv prevalence of adults 15 49 by sex and region in 2002

HIV Prevalence (% of adults 15-49) by Sex and Region in 2002


Estimated number of adults and children newly infected with hiv during 2002

Estimated number of adults and childrennewly infected with HIV during 2002

Eastern Europe & Central Asia

250 000

Western Europe

30 000

North America

45 000

East Asia & Pacific

270 000

North Africa

& Middle East

83 000

South

& South-East Asia

700 000

Caribbean

60 000

Sub-Saharan Africa

3.5 million

Latin America

150 000

Australia

& New Zealand

500

Total: 5 million(0.8 mln children)


Global distribution of 5 million newly hiv infected people in 2002

Global Distribution of 5 million Newly HIV Infected People in 2002


The aids pandemic an update on the numbers and needs

The Global Distribution of Prevalence (Old +New) is still very similar to the Global Distribution of Incidence (New)

Prevalence

Incidence


Estimated adult and child deaths from hiv aids during 2002

Estimated adult and child deathsfrom HIV/AIDS during 2002

Eastern Europe &

Central Asia

25 000

Western Europe

8 000

North America

15 000

East Asia & Pacific

45 000

North Africa

& Middle East

37 000

South

& South-East Asia

440 000

Caribbean

42 000

Sub-Saharan Africa

2.4 million

Latin America

60 000

Australia

& New Zealand

<100

Total: 3.1 million


Global distribution of 3 1 million adult and child deaths from hiv aids in 2002

Global Distribution of 3.1 million Adult and Child Deaths from HIV/AIDS in 2002


About 14 000 new hiv infections a day in 2002

About 14 000 new HIV infections a day in 2002

  • More than 95% are in developing countries (70% are in Africa)

  • 2000 are in children under 15 years of age (9 out of 10 are in Africa)

  • About 12 000 are in persons aged 15 to 49 years, of whom:

    • almost 50% are women

    • about 50% are 15–24 year olds


What are the global and regional trends

What are the global and regional trends?


Comparing 2001 and 2002

Comparing 2001 and 2002

  • Modest increase in people living with HIV from 40 to 42 million, new infections still about 5 million, deaths about 3 million

    • 0.9 mln increase in Africa,

    • 0.8 mln South, Southeast, East Asia

    • 0.2 mln Eastern Europe and Central Asia


Trends in number of people living with hiv infection 1980 2002 by who region

Trends in Number of People Living with HIV infection 1980 - 2002 by WHO Region


Trends in number of people living with hiv infection 1980 2002 by who region1

Trends in Number of People Living with HIV infection 1980 - 2002 by WHO Region


Trends in number of people living with hiv infection 1980 2002 by who region2

Trends in Number of People Living with HIV infection 1980 - 2002 by WHO Region


Where do all these numbers come from

Where do all these numbers come from?


Unaids who classification of epidemic states

UNAIDS/WHO Classification of epidemic states

  • LOW LEVEL:

    • HIV prevalence has not consistently exceeded 5% in any defined sub-population (surveillance: high risk group focus)

  • CONCENTRATED

    • HIV prevalence consistently over 5% in at least one defined sub-population but below one percent in pregnant women in urban areas (surveillance: high risk groups + bridgers)

  • GENERALISED

    • HIV prevalence consistently over 1% in pregnant women nation-wide (surveillance: general population + high risk groups)


Hiv prevalence among women attending antenatal clinics uganda 1989 2001

HIV Prevalence among Women Attending Antenatal Clinics, Uganda 1989-2001


The aids pandemic an update on the numbers and needs

HIV prevalence in blood donations

in Indonesia: 1992 - 2001

0.016

0.014

0.012

0.010

Percentage HIV-positive

0.008

0.006

0.004

0.002

0.000

1992 –

1993

1993 –

1994

1994 –

1995

1995 –

1996

1996 –

1997

1997 –

1998

1998 –

1999

1999 –

2000

2000 –

2001

Source: National AIDS Programme, Indonesia


The aids pandemic an update on the numbers and needs

Source: Sentinel Serosurveillance, Division of Epidemiology, Ministry of Public Health.

Remark: Switching from bi-annually (June and December) to annually in June since 1995

Conscript data in November of each year since 1995 were not shown here

HIV Prevalence Among Pregnant Women,

Male Conscripts, and Donated Blood

Thailand 1989-2000

%

Conscripts (age 21)

Pregnant women

Donated blood

Month/Year


Hiv prevalence among sex workers in selected provinces in china 1993 2000

HIV prevalence among sex workers in selected provinces in China: 1993-2000

12

Guangxi

Guangzhou

Yunnan

9

% HIV-positive

6

3

0

1993

1994

1995

1996

1997

1998

1999

2000

Source: National AIDS Programme, China (1993-2000). Data compiled by the US Census Bureau


The aids pandemic an update on the numbers and needs

90

80

70

Myitkyina

60

Taunggyi

50

Percent (%)

40

30

20

10

0

94M

92M

99M

94S

95M

95S

96S

97M

98M

98S

99S

00M

92S

93S

96M

97S

93M

01m

Sentinel Year

HIV prevalence among injecting drug users in

selected sentinel sites in Myanmar: Mar 1992 – Mar 2001

100

INDIA

Myitkyina

l

CHINA

l

Taunggyi

LAOS

THAILAND

Source: Myanmar National AIDS Programme


How are the estimates made

How are the estimates made?


Epidemic model

Epidemic model

New entrants

At risk (susceptible)

Not at risk

Non-AIDS death

Non-AIDS death

Infected

Non-AIDS death

AIDS deaths


Epidemic model1

Epidemic model

New entrants

fo

At risk (susceptible)

Not at risk

r

Non-AIDS death

phi

Non-AIDS death

Infected

Non-AIDS death

AIDS deaths


Model epidemic curve

Model epidemic curve

f0

phi

r

t0


Can we look into the future

Can we look into the future?


Population distribution in 2005 6 4 billion people

Population distribution in 2005 (6.4 billion people)


How bad can the asian epidemic become

How bad can theAsian epidemic become?

  • Growth in size of Risk groups -

  • IDU, MSM,sex workers

  • Chances of mixing with general population - people’s movement, socio-political and economic developments

  • Response: behaviour change, vaccine, STD control etc.


Trends asia lessons learned

Trends - Asia: Lessons Learned

  • Asian epidemics spread through specific, identifiable behaviors & populations

  • Asian epidemics are vulnerable to focused prevention efforts

  • Prevention in Asia produces huge benefits (Thailand averted over 5 million infections)


Global prevention focus young people percent of population aged 15 24 in 2000 and 2010

Global Prevention Focus: Young People(Percent of population aged 15-24 in 2000 and 2010)


Care projected number of aids deaths 2001 2010

Care Projected Number of AIDS Deaths 2001-2010


Estimated number of people needing treatment by 2005

Estimated Number of People Needing Treatment by 2005

Number depends on:

- accuracy of the numbers of

deaths projections

- decisions on when to start

treatment (clinical, lab)

- how many people are already on

treatment in preceding years

- children

Need 6-9 million by 2005


Global goals ungass and mdg

Global Goals: UNGASS and MDG

  • In terms of global numbers and needs the epidemic will be driven by Africa and Asia

  • UNGASS Target: 25% reduction globally by 2010 in prevalence among young people (15-24 years) (25% by 2005 in most severely affected countries)

  • MDG Target: turn around the epidemic by 2015


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