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HIV and AIDS Scenarios for South Africa in 2025
A rigorous process was followed when developing the scenarios. This section highlights the main points that informed the scenarios and provides a summary of the four scenarios in order to outline the context, effect and responses in each. The scenarios include demographic and financial projections. Further information is contained in the Live the Future - Information Pack.
Abbreviations
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The season autumn has been used in the name of the scenario as it visually captures the essence of the scenario: in autumn the trees continue to grow taller, while the leaves die and are shed. In this
scenario, sectors of the economy continue to grow and thrive, while other parts shrivel. The Autumn of Limited Opportunity looks at what our society and economy could look like in 2025 if all the role players (government, business, labour, communities and individuals) take, or fail to take,
certain actions. [read more] |
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The season winter has been used in the name of the scenario as it visually captures the essence of the scenario: in winter the world seems bleak and hopeless, nothing grows, and life retreats. So too, in
this scenario. The economy is stagnant, and social circumstances are depressed. The Winter of Discontent looks at what our society and economy could look like in 2025 if all the role players (government, business, labour, communities and individuals) take, or fail to take, certain
actions. [read more] |
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The season spring has been used in the name of the scenario as it visually captures the essence of the scenario: in spring, the world is full of hope and optimism as the world comes back to life after
the cold and hardship of winter. Spring is alive with possibility, new beginnings and the possibility of a brighter future. So too in this scenario. Greater cooperation and coordination improves economic and social conditions for increasing numbers of people. The Spring of Hope looks at what our society and economy could look like in 2025 if all the role players (government, business, labour, communities and individuals) take, or fail to take, certain actions. [read more] |
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The season summer has been used in the name of the scenario as it visually captures the essence of the scenario: summer is a symbol of life. During summer the trees are green, flowers bloom, and
the birds sing. The scenario depicts a society which is blooming. Through collaboration the economy and society are thriving in a way that everyone is able to reap the fruits. South Africa is now indeed a better place for all. The Summer for All People looks at what our society and economy could look like in 2025 if all the role players (government, business, labour, communities and individuals) take, or fail to take, certain actions.[read more] |
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The Key Question that informed
the Scenarios
How will HIV and AIDS and our responses
shape the future of South Africa by 2025? The answer lies in understanding what
the key driving forces are, how they interact and how they are likely to play
out in the future.
Key Driving Forces
There are two kinds of key driving
forces, namely:
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Inescapables: These are
elements that are a given. They will form part of any future scenario, e.g.
the epidemic is with us for the next 20 years. Based on our research we will
still be dealing with the burden of the epidemic on our country in 20 years’
time.
-
Uncertainties: These are
elements that are likely to influence the scenarios, but how they play out
is uncertain. Depending on future developments they could go either way,
e.g. today we may believe that we will not find a cure for HIV and AIDS in
the next 20 years, but in five years from now there may well be a cure that
will change our beliefs and the course of the epidemic.
Based on the synthesis of existing
scenario studies, and further discussions, the following key driving forces were
identified:
Inescapables
-
The epidemic is with us for
the next 20 years.
-
Some poverty, inequality and
unemployment remain.
-
Government resources have
limits.
-
Increased demand on and
depletion of natural resources.
-
People on the move.
-
Climate change.
-
Activist energy.
-
Orphans.
-
Other diseases.
Uncertainties
-
Will there be a ‘magic
bullet’?
-
Who has the power? What kind?
How will it be used?
-
How do we respond to
inequality and with what effect?
-
What do we believe about
HIV and AIDS? What works? Traditional versus modern medicine? Prevention?
Treatment? Care?
-
What will the South African
and global economy be?
-
What is happening on the
African continent?
-
What human and natural
resources will we have?
-
Can we all work together?
-
Will the goodwill continue? |
| Issue |
ASSA2003 estimates for 2005 |
Winter of Discontent by 2025 |
Autumn of Limited
Opportunity by 2025 |
Spring of Hope by 2025 |
Summer for All People by 2025 |
| Adult HIV prevalence
(20-64) |
19% |
18% |
13% |
11% |
7% |
| People living with HIV and
AIDS (millions) |
5.2m |
5.4m |
4.2m |
3.4m |
2.4m |
| New infections p.a. |
539 000 |
491 000 |
312 000 |
275 000 |
111 000 |
| Cumulative new infections
2005-2025 |
N/a |
8 738 000 |
5 926 000 |
5 165 000 |
2 864 000 |
| Cumulative infections
averted 2005-2025 |
N/a |
(used as baseline) |
2 812 000 |
3 573 000 |
5 874 000 |
| AIDS sick p.a. |
529 000 |
786 000 |
530 000 |
500 000 |
339 000 |
| AIDS deaths p.a. |
326 900 |
445 000 |
303 000 |
292 000 |
201 000 |
| Cumulative AIDS deaths
2005-2025 |
N/a |
8 160 000 |
6 708 000 |
6 790 000 |
5 672 000 |
Cumulative AIDS deaths
averted
2005-2025 |
N/a |
(used as baseline) |
1 452 000 |
1 370 000 |
2 488 000 |
| People on ART p.a. |
124 000 |
439 000 |
1 255 000 |
771 000 |
1 127 000 |
| Life expectancy at birth |
51 |
50 |
55 |
56 |
59 |
| AIDS orphans – maternal
(millions) |
0.8m |
1.7m |
1.4m |
1.4m |
1.0m |
| Cumulative programme costs
(2005 – 2025 in R billions)* |
N/a |
144b |
261b |
207b |
284b |
* Cumulative programme costs are the costs that
the public health sector are likely to incur in managing the effects of HIV and
AIDS. These costs exclude various social grants. |
| Issue |
Winter of Discontent |
Autumn of Limited
Opportunity |
Spring of Hope |
Summer for
All People |
| Magic bullet? |
No cure and no effective and widely used
vaccine or microbicide for HIV or AIDS |
No cure and no effective and widely used
vaccine or microbicide for HIV or AIDS |
No cure and no effective and widely used
vaccine or microbicide for HIV or AIDS |
No cure and no effective and widely used
vaccine or microbicide for HIV or AIDS |
| Status awareness by 2010 |
One in five |
One in three |
One in three |
40% of all
60% of HIV positive |
| Condom usage |
Youth: 40%
Adults: 25% |
Youth: 70%
Adults: 40% |
Youth: 70%
Adults: 40% |
Youth: 90%
Adults: 60% |
| Partner change |
Very frequent |
Frequent |
Less frequent |
Less frequent |
| VCT take-up p.a. in 2010 |
6% |
16% |
22% |
25% |
| ART access by 2025 |
15% |
68% |
40% |
95% |
| AIDS deaths p.a. |
445 000 |
303 000 |
292 000 |
201 000 |
| Cumulative AIDS deaths
2005-2025 |
8 160 000 |
6 708 000 |
6 790 000 |
5 672 000 |
Cumulative AIDS deaths
averted
2005-2025 |
(used as baseline) |
1 452 000 |
1 370 000 |
2 488 000 |
| People on ART p.a. |
439 000 |
1 255 000 |
771 000 |
1 127 000 |
| Life expectancy at birth |
50 |
55 |
56 |
59 |
| AIDS orphans – maternal
(millions) |
1.7m |
1.4m |
1.4m |
1.0m |
Cumulative programme costs
(2005 – 2025 in
R billions)* |
144b |
261b |
207b |
284b |
* Cumulative programme costs are the costs that
the public health sector are likely to incur in managing the effects of HIV and
AIDS. These costs exclude various social grants. |
In developing the different Live the Future - HIV and AIDS Scenarios, we had to ask a few key questions to determine the scenario content.The leading question was: How will HIV and AIDS and our responses shape the future of South Africa by 2025?
To answer this question, we in turn asked the following questions for each of the scenarios: 1. Will there be a magic bullet? 2. What do we believe about HIV and AIDS? 3. What kind of leadership is there? 4. How does government, business, civil society and the donor community respond? 4.1. Government response 4.2. Business sector response 4.3. Civil society response 4.4. Donor community response 5. What condition is the South African economy in? 6. How is business affected by HIV and AIDS? 7. What is the medical response? 8. What are the socio-economic issues? 9. What are the underlying psychosocial issues fuelling the HIV epidemic? 10. What about the children? 11. What has happened to the legal system? 12. What natural resources will be available? 13. What is happening on the African continent? 14. What is happening in terms of media / communications? 15. What are some critical time frames and events?
Download the responses |
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