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Last Updated: Thursday, 14 June 2007, 12:44 GMT 13:44 UK
Africa's Aids epidemic 'slowing'
Aids orphan with grandmother
Rwanda recognised the seriousness of Aids early on
The spread of Aids is slowing down in some parts of Africa, a World Bank report has suggested.

Urban areas in Rwanda, Zambia and Ethiopia were singled out as places where infection rates were lowering.

The World Bank's Miriam Schneidman told the BBC that Rwanda had done an "exceptional job" in recognising the HIV problem and taking strong action.

Figures from the World Bank put the prevalence of Aids in Rwanda at about 3%, down from 11% seven years ago.

Aids stole into Africa like a thief in the night
World Bank's Joy Phumaphi

"The mobilisation of empowered 'grassroots' communities, along with delivering condoms and life-saving treatments, are beginning to slow the pace of the ... epidemic," the report said, without giving detailed statistics.

But it says southern Africa remains the epicentre of the epidemic.

In Francistown, a city in Botswana bordering Zimbabwe, 70% of women in their early 30s were found to be HIV-positive, according to a 2004 household survey.

Last year, the epidemic killed more than 2m people in Africa.

Mixed picture

Rwanda's success is put down to understanding the seriousness of the problem early on and taking quick action.

Population: 8.6m
2002: One of countries worst hit by HIV
2000: 11% of adults HIV-positive
2007: 3% of adults HIV-positive
2003-6: $30.5m grant to fight Aids:
  • 12m condoms distributed
  • 500,000 tests and counselling provided
  • 5,000 patients received ARVs
  • School fees paid for 27,000 orphans or vulnerable children
  • Health insurance schemes subsidised for 52,000 homes
  • 100,000 participated in income-generating activities
  • "Prevention messages, early testing, prevention of mother-to-child transmission - it's been this holistic approach that we think has really provided the strong results that we're seeing," Ms Schneidman told the BBC's Network Africa programme.

    Treatment is seen as key to addressing stigma and fears and about the disease.

    "The availability of lifesaving ARV drugs is providing hope to people who are desperately ill, and also is leading to greater acceptance of people living with HIV/Aids," a Rwandan nurse at Butare Hospital says in the report.

    In Rwanda's case, education at a grassroots level has also helped.

    "My son Oliver was born HIV-positive. My husband died in 1996 and I was not aware it was from Aids. I always feared to get tested," 34-year-old Gloriose Murebwayire said.

    This changed in 2004 after encouragement from her church pastor - subsequent counselling has helped her deal with the disease and get help.

    The epidemic shows signs of slowing in Uganda, Kenya, and Zimbabwe, and in urban Ethiopia, Rwanda, Burundi, Malawi, and Zambia, the report says.

    In East Africa, the picture is mixed with significant numbers of new infections originating in the commercial sex trade, it says.

    "Aids stole into Africa like a thief in the night, and all these years later, we still must stay vigilant against this terrible disease," Joy Phumaphi, of the World Bank's Human Development Network, a former health minister of Botswana.

    "Even when it seems that infections are starting to fall and more and more people are being saved with treatment."

    Global funding for HIV more than quadrupled between 2001 and 2005, from less than $2bn to more than $8bn, but falls short of what countries need, Ms Phumaphi says.

    The reports says there is no single ideal Aids programme and each country must design their own, based on what drives the epidemic in that region.


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