A Look at the Future: The ASSA 2003 Model
The Actuarial Society of South Africa has developed an often-cited model capable of projecting AIDS infection, mortality and a range of other indicators a decade into the future.
The latest reiteration of this model is the ASSA2003 version which was issued in November 2005. This revised model also incorporates several interventions, including antiretroviral treatment, and their likely effect on the epidemic.
Some ASSA2003 Key Findings
The 2006 report based on the ASSA2003 model made the following projections for 2010:
- The total number of people living with HIV in South Africa is estimated to be 5.8 million in 2010.
- HIV Infection rates appears to be decreasing as the model predicts 0.8% in 2005, 0.6% in 2010 and around 0.4% in 2015.
- The model predicted that without adequate rollout of ARVs, the AIDS death toll would have reached around 505 000 in the year 2010. However, given the recent scale-up in treatment, cumulative AIDS deaths are closer to 388 000 in 2010.
- Furthermore, the report estimated that AIDS deaths in 2010 could be as low as 291 000 if 90% of the population in need of treatment were receiving it.
- The ASSA2003 model also predicts that the total number of HIV infections in South Africa will increase slightly, from 5.2 million in 2006 to 5.8 million by 2010 and by the year 2015 this number is expected to have reached around 6.0 million.
- The annual number of new HIV infections is likely to remain at close to half a million over the next few years, with a slight drop in the new infection rate.
ASSA2003 Model Projections
The ASSA2003 model makes projections up to 2025. The full model is available for download from the ASSA website after free registration. Below are projections on key HIV/AIDS indicators for 2006, 2007, 2010 and 2015, using the ASSA default assumptions and rounded to the nearest whole number.
| Calendar Year starting 1 July | 2006 | 2007 | 2010 | 2015 |
| Total population | 47,866,985 | 48,218,209 | 49,147,178 | 50,328,901 |
| Total HIV infections | 5,372,474 | 5,511,749 | 5,813,088 | 6,027,508 |
| Births infected perinatally | 38,429 | 38,592 | 38,504 | 37,416 |
| Babies newly infected by mother's milk | 25,624 | 25,786 | 25,816 | 25,134 |
| AIDS sick | ||||
| New AIDS sick (over the past year ending on 30 June) | 465,126 | 492,779 | 524,857 | 490,175 |
| Total AIDS sick (in the middle of year) | 599,298 | 633,931 | 701,508 | 797,003 |
| Adults on ART | 200,457 | 313,420 | 709,021 | 1,126,299 |
| Adults with AIDS, not on ART | 510,804 | 510,514 | 456,452 | 426,352 |
| Children on ART | 25,318 | 38,069 | 81,980 | 111,168 |
| Children with AIDS, not on ART | 26,955 | 27,289 | 26,807 | 25,432 |
| Deaths: | ||||
| Male AIDS deaths (in the year starting 1 July) | 163,016 | 167,357 | 175,358 | 187,217 |
| Female AIDS deaths (in the year starting 1 July) | 191,363 | 199,643 | 218,420 | 242,645 |
| AIDS deaths (in the year starting 1 July) | 354,379 | 367,000 | 393,777 | 429,862 |
| Accumulated Aids Deaths (to middle of the year) | 1,814,457 | 2,168,835 | 3,293,012 | 5,351,660 |
| Adult AIDS deaths (15+) | 309,715 | 320,893 | 341,106 | 373,145 |
| Child AIDS deaths (0-14) | 44,663 | 46,107 | 52,671 | 56,717 |
| Prevalence rates | ||||
| Antenatal clinics | 28.3% | 28.7% | 29.2% | 29.1% |
| Youth aged 15-24 | 10.4% | 10.4% | 10.5% | 10.4% |
| Male population | 10.1% | 10.2% | 10.5% | 10.7% |
| Female population | 12.3% | 12.6% | 13.1% | 13.2% |
| Total population | 11.2% | 11.4% | 11.8% | 12.0% |
| Incidence rates | ||||
| Women aged 15 — 19 | 4.23% | 4.22% | 4.20% | 4.22% |
| Youth 15-24 | 2.85% | 2.85% | 2.84% | 2.86% |
| Adults (ages 20 — 64) | 1.68% | 1.63% | 1.49% | 1.38% |
| Total population | 1.23% | 1.20% | 1.14% | 1.09% |
| Total new infections (in the year starting 1 July) | 521,607 | 512,931 | 492,244 | 481,471 |
| Life expectancy at birth | 50.7 | 50.5 | 50.4 | 50.3 |
