The state of the epidemic at the beginning of 2001.

According to the 2000 Joint UN Programme on HIV/AIDS (UNAIDS) AIDS Epidemic Update there were 36.1 million people living with HIV/AIDS globally 5.3 million with new infections and 3 million deaths over the year. Of significance is that sub-Saharan Africa continues to dominate the epidemic; the region has 70% of total infections and 72% of new ones. Much of the UNAIDS report is concerned with the impact of the disease including the orphaning of children which makes them vulnerable to malnutrition dropping out of school and living in increased poverty. UNAIDS also recognizes the impact AIDS is having on investment and macroeconomic growth prospects; labor impacts that may mean increase capital intensification; labor shortages especially of skilled workers; changes in income distribution; and government budgets being adversely affected with decreased revenue and increased demand for expenditure. AIDS is the major development challenge for southern Africa. It is also raising a number of important questions about citizens rights in terms of care and treatment. These questions call for a particular response around issues of equity expectations and treatment affordability.