HIV/SIDA en Africa

Since the WHO-led “3 by 5” Initiative began in 2003 (1),
the world has witnessed an unprecedented expansion in
access to selected health-sector interventions and services
for HIV prevention, treatment, care and support in lowand-
middle-income countries (2). This expansion has also
taken place in many of the 46 Member States of the WHO
African Region (3), all but one of which are located in sub-
Saharan Africa, the region that still bears the brunt of the
global HIV burden. By the end of 2010, an estimated 22.5
million adults and children were living with HIV in sub-
Saharan Africa. This represents 68% of the global total of
33.3 million adults and children living with HIV, although
an estimated 12% of the total world population lives in
sub-Saharan Africa.

The last update on the HIV epidemiological situation in the
WHO African Region (5) was published in 2008, and the
latest update on global progress towards achieving universal
access to priority HIV interventions in the health sector was
published in 2010 (2). This report updates the empirical data
generated by HIV surveillance systems and reviews the
progress made so far in expanding access to HIV prevention,
treatment, care and support services in the African Region.
This is in accordance with the strategic directions of WHO
in the African Region 2010–2015 (6) and responds to the
WHO core function of monitoring the health situation and
assessing health trends.

Given its focus on the African Region, the report builds on
and complements the global report Towards universal access
– scaling up priority HIV/AIDS interventions in the health sector
(2) by providing a more detailed regional and subregional
perspective on progress made towards achieving universal
access to HIV prevention, treatment, care and support.
It focuses on interventions that are especially relevant
to the epidemiological situation in countries of the
Region, some of which are predominantly implemented
in the Region. These include HIV testing and counselling,
providing treatment and care, preventing mother-to-child
transmission, carrying out male circumcision and ensuring
blood safety. The report also identifies enabling factors
and challenges in achieving universal access and the
Millennium Development Goals and proposes specific
actions that will help countries accelerate progress towards
achieving these targets and goals.

Political commitment to halt and reverse the HIV epidemic
continues to grow in the African Region. The United
Nations General Assembly Political Declaration on HIV/
AIDS in 2006 (7), the declaration of 2006 as a Year ofAIDS-related deaths are also decreasing in the Region. In
2009, 16 countries had declines in AIDS-related mortality,
ranging from 11% in Congo to 72% in Rwanda (4). These
declines reflect the increased availability of antiretroviral
therapy and improved quality of care and support for
people living with HIV. More deaths are expected to be
averted when people living with HIV start treatment
earlier according to the 2010 WHO recommendations on
antiretroviral therapy.

The data used in describing the HIV epidemiological
situation are based on the most recent reports of HIV
surveillance systems in the African Region, primarily
from 2005 to 2009. These systems include surveillancesuch, statistical aggregates and averages may vary slightly
as a result. In some sections, the Eastern Africa subregion
and Southern Africa subregion are reported separately to
illustrate the specific features of the HIV epidemic in these
subregions. The countries in the subregions are as follows:
• Eastern Africa subregion: Eritrea, Ethiopia, Kenya,
Rwanda, Seychelles, Uganda and United Republic of
Tanzania;
• Southern Africa subregion: Comoros, Lesotho,
Madagascar, Malawi, Mauritius, Mozambique, Namibia,
South Africa, Swaziland, Zambia and Zimbabwe;
• Central Africa subregion: Angola, Burundi, Cameroon,
Central African Republic, Chad, Congo, Democratic
Republic of the Congo, Equatorial Guinea, Gabon and
Sao Tome and Principe; and
• Western Africa subregion: Algeria, Benin, Burkina Faso,
Cape Verde, Côte d’Ivoire, Gambia, Ghana, Guinea,
Guinea-Bissau, Liberia, Mali, Mauritania, Mauritius,
Niger, Nigeria, Senegal, Sierra Leone and Togo