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In Sub-Saharan Africa, the region of the world that has been worst affected by the global AIDS epidemic, HIV and AIDS have caused vast amounts of human suffering. Nearly two-thirds of all HIV positive people live in this area, although it contains little more than 10% of the world's population. The most obvious effect of this crisis has been illness and death, but the impact of the epidemic has certainly not been confined to the health sector; households, education, workplaces and economies have been significantly affected, along with other sections of society.

During 2005 alone, an estimated 2 million adults and children died as a result of AIDS in Sub-Saharan Africa. Since the beginning of the epidemic more than 15 million Africans have died from AIDS.

The Impact on the Health Sector

In all affected countries the AIDS epidemic is bringing additional pressure to bear on the health sector. As the epidemic matures, the demand for care for those living with HIV rises, as does the toll among health workers. In sub-Saharan Africa, the direct medical costs of AIDS (excluding antiretroviral therapy) have been estimated at about US$30 per year for every person infected, at a time when overall public health spending is less than US$10 per year for most African countries.
The Effect on Hospitals
As the HIV prevalence of a country rises, the strain placed on its hospitals is likely to increase. In Sub-Saharan Africa, people with HIV-related diseases occupy more than half of all hospital beds. Government-funded research in South Africa has suggested that, on average, HIV-positive patients stay in hospital four times longer than other patients. It is predicted that patients affected by HIV and AIDS will soon account for 60-70% of hospital expenditure in South Africa.
Hospitals are struggling to cope, especially in poorer African countries where there are often not enough beds available. This shortage results in people being admitted only in the later stages of illness, reducing their chances of recovery. As the epidemic worsens, more complex cases of HIV and AIDS are likely to arise, taking up more hospital time and further reducing the standard of care provided.
Health Care Workers
While AIDS is causing an increased demand for health services, large numbers of healthcare professionals are being affected by the epidemic. Botswana, for example, lost 17% of its healthcare workforce due to AIDS between 1999 and 2005. A study in one region of Zambia found that 40% of midwives were

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