In Sierra Leone, the WHO World Health Report (2004) indicates an adult mortality²⁴ rate per 1000 population of 682 for males and 569 for females. Life expectancy for males is 32.4; for females 35.7. Healthy life expectancy is 27.2 for males; 29.9 for females.²⁵

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.

The global pandemic of HIV/AIDS is at catastrophic levels in sub-Saharan Africa, while the need for research and treatment initiatives throughout the developing world remains critical. The West African country of Sierra Leone is representative of both of these facts.²⁶

Sierra Leone ranks bottom of the global World Bank Development Index based on multiple health and economic indices, and lacks the resources to even purchase HIV diagnostic kits.²⁷ Estimates of HIV/AIDS prevalence in Sierra Leone fluctuate significantly. The preliminary findings of a survey conducted by the Centers for Disease Control and Prevention in April 2002 suggest an overall national HIV prevalence rate of 4.9 per cent. HIV/AIDS awareness is generally low, even among medical staff, and hospitals do not have adequate testing facilities. Blood donors are tested, but, in general, are not informed if found to be HIV-positive because of a lack of counselling capabilities and support networks. The government, previously criticised for its poor response to the epidemic, has now qualified for a World Bank Specific Investment Loan of $15 million for HIV/AIDS.²⁸

The 2004 Report of the global AIDS epidemic was unable to estimate the prevalence of HIV/AIDS in Sierra Leone as sufficient data for the previous six years was unavailable. However, in 2001 it was estimated that the prevalence rate of HIV/AIDS amongst the adult population (15-49 years) was approximately 7 per cent, the number of people living with HIV/AIDS was approximately 170,000, and the number of HIV/AIDS deaths per year was approximately 11,000.²⁹

Available data regarding antenatal clinic attendees in Sierra Leone indicates a steadily worsening HIV epidemic. Nationally, less than one per cent of pregnant women tested positive for the virus in 1989. By 1996, 7 per cent were infected with the virus. A 1995 sero-survey conducted among sex workers in Freetown found 27 per cent tested positive for HIV-1. In an unspecified locale outside of major urban areas, 70 per cent of sex workers were HIV positive in 1997. Outside major urban areas, 9 per cent of police officers were HIV positive in 1996. In 1997, 12 per cent of security forces were infected.³⁰