In Ethiopia, the WHO World Health Report (2004) indicates an adult mortality¹⁵ rate per 1000 population of 487 for males and 422 for females. Life expectancy for males is 46.8; for females 49.4. Healthy life expectancy is 40.7 for males; 41.7 for females.¹⁶

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

Ethiopia has been severely affected by the HIV/AIDS epidemic. Estimates suggest that in Ethiopia, between 950,000 and 2.3million people were living with HIV/AIDS at the end of 2003. In the same year, up to 190,000 adults and children are thought to have died from the disease (Table 2).

Table 2 Ethiopia HIV and AIDS estimates, end 2003

Source: 2004 Report of the global AIDS epidemic

UNAIDS reports:

Ethiopia has a total population of 67 million people and is one of the poorest countries in the world. Antiretroviral therapy is accessible on payment in most regions. Guidelines for preventing mother-to-child transmission have been developed, and the implementation is underway. The National Monitoring and Evaluation Framework, Communication Guidelines and HIV/AIDS Behavioural Surveillance Survey have been developed. The National AIDS Council (NAC) is chaired by the president of the country and includes all stakeholders; the HIV/AIDS Prevention and Control Office (HAPCO) was legally established in 2002, both at federal and regional levels; and district (woreda) and lower district (kebele/community level) coordination mechanisms were established in 262 woredas (44% of the total districts). The National Strategic Framework (NSF) for 2000–2004 is now being updated after the joint midterm review of the National Response. The Country Coordinating Mechanism (CCM) Ethiopia has submitted the fourth round proposal to the Global Fund for US$ 139 million over two years, of which the HIV/AIDS component of US$ 108 million focuses on treatment and care.¹⁷

WHO report the severity of the problems caused by stigmatisation:

No prominent Ethiopian is willing to stand up, acknowledge infection and urge others to discuss the issue on a personal and public basis. Health professionals emphasis the unwillingness of Ethiopians to come forward for voluntary testing, even when kits are available. Because HIV/AIDS is correlated with promiscuity, many believe that only immoral people get AIDS. Death certificates, even when AIDS is highly suspected, routinely cite other causes of death, such as TB. When testing proves that AIDS was the cause of death, friends and relatives are usually not told. In fact, Ethiopian doctors are usually reluctant to pass along bad news to patients on any health matter, especially now with AIDS. When donated blood is found to be HIV+ the blood is destroyed and the donor not told. People with or suspected of having HIV are afraid they will be turned away from health care services, employment, or refused entry to a foreign country. Fear of discrimination often prevents many Ethiopians from seeking treatment for AIDS. In numerous cases, those with AIDS have been evicted from their homes by their families and rejected by their friends and colleagues. Infected children, and those who have parents infected by HIV, are often orphaned or abandoned. In Ethiopia, HIV?AIDS-related stigma, characterised by silence, fear, ignorance, intolerance, discrimination ans denial are fuelling the spread of HIV/AIDS and are creating immense barriers to effective responses to the epidemic.¹⁸