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(Applause)

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AIDS was discovered 1981; the virus, 1983.

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These Gapminder bubbles show you

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how the spread of the virus was in 1983 in the world,

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or how we estimate that it was.

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What we are showing here is --

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on this axis here, I'm showing percent of infected adults.

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And on this axis, I'm showing dollars per person in income.

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And the size of these bubbles, the size of the bubbles here,

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that shows how many are infected in each country,

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and the color is the continent.

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Now, you can see United States, in 1983,

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had a very low percentage infected,

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but due to the big population, still a sizable bubble.

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There were quite many people infected in the United States.

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And, up there, you see Uganda.

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They had almost five percent infected,

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and quite a big bubble in spite of being a small country, then.

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And they were probably the most infected country in the world.

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Now, what has happened?

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Now you have understood the graph

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and now, in the next 60 seconds,

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we will play the HIV epidemic in the world.

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But first, I have a new invention here.

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(Laughter)

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I have solidified the beam of the laser pointer.

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(Laughter)

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(Applause)

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So, ready, steady, go!

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First, we have the fast rise in Uganda and Zimbabwe.

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They went upwards like this.

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In Asia, the first country to be heavily infected was Thailand --

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they reached one to two percent.

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Then, Uganda started to turn back,

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whereas Zimbabwe skyrocketed,

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and some years later South Africa had a terrible rise of HIV frequency.

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Look, India got many infected,

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but had a low level.

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And almost the same happens here.

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See, Uganda coming down, Zimbabwe coming down,

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Russia went to one percent.

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In the last two to three years,

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we have reached a steady state of HIV epidemic in the world.

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25 years it took.

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But, steady state doesn't mean that things are getting better,

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it's just that they have stopped getting worse.

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And it has -- the steady state is, more or less,

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one percent of the adult world population is HIV-infected.

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It means 30 to 40 million people,

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the whole of California -- every person,

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that's more or less what we have today in the world.

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Now, let me make a fast replay of Botswana.

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Botswana -- upper middle-income country in southern Africa,

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democratic government, good economy,

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and this is what happened there.

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They started low, they skyrocketed,

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they peaked up there in 2003,

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and now they are down.

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But they are falling only slowly,

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because in Botswana, with good economy and governance,

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they can manage to treat people.

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And if people who are infected are treated, they don't die of AIDS.

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These percentages won't come down

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because people can survive 10 to 20 years.

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So there's some problem with these metrics now.

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But the poorer countries in Africa, the low-income countries down here,

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there the rates fall faster, of the percentage infected,

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because people still die.

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In spite of PEPFAR, the generous PEPFAR,

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all people are not reached by treatment,

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and of those who are reached by treatment in the poor countries,

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only 60 percent are left on treatment after two years.

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It's not realistic with lifelong treatment

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for everyone in the poorest countries.

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But it's very good that what is done is being done.

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But focus now is back on prevention.

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It is only by stopping the transmission

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that the world will be able to deal with it.

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Drugs is too costly -- had we had the vaccine,

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or when we will get the vaccine, that's something more effective --

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but the drugs are very costly for the poor.

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Not the drug in itself, but the treatment

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and the care which is needed around it.

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So, when we look at the pattern,

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one thing comes out very clearly:

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you see the blue bubbles

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and people say HIV is very high in Africa.

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I would say, HIV is very different in Africa.

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You'll find the highest HIV rate in the world

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in African countries,

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and yet you'll find Senegal, down here --

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the same rate as United States.

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And you'll find Madagascar,

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and you'll find a lot of African countries

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about as low as the rest of the world.

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It's this terrible simplification that there's one Africa

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and things go on in one way in Africa.

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We have to stop that.

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It's not respectful, and it's not very clever

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to think that way.

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(Applause)

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I had the fortune to live and work for a time in the United States.

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I found out that Salt Lake City and San Francisco were different.

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(Laughter)

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And so it is in Africa -- it's a lot of difference.

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So, why is it so high? Is it war?

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No, it's not. Look here.

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War-torn Congo is down there -- two, three, four percent.

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And this is peaceful Zambia, neighboring country -- 15 percent.

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And there's good studies of the refugees coming out of Congo --

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they have two, three percent infected,

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and peaceful Zambia -- much higher.

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There are now studies clearly showing

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that the wars are terrible, that rapes are terrible,

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but this is not the driving force for the high levels in Africa.

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So, is it poverty?

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Well if you look at the macro level,

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it seems more money, more HIV.

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But that's very simplistic,

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so let's go down and look at Tanzania.

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I will split Tanzania in five income groups,

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from the highest income to the lowest income,

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and here we go.

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The ones with the highest income, the better off -- I wouldn't say rich --

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they have higher HIV.

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The difference goes from 11 percent down to four percent,

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and it is even bigger among women.

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There's a lot of things that we thought, that now, good research,

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done by African institutions and researchers

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together with the international researchers, show that that's not the case.

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So, this is the difference within Tanzania.

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And, I can't avoid showing Kenya.

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Look here at Kenya.

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I've split Kenya in its provinces.

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Here it goes.

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See the difference within one African country --

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it goes from very low level to very high level,

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and most of the provinces in Kenya is quite modest.

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So, what is it then?

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Why do we see this extremely high levels in some countries?

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Well, it is more common with multiple partners,

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there is less condom use,

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and there is age-disparate sex --

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that is, older men tend to have sex with younger women.

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We see higher rates in younger women than younger men

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in many of these highly affected countries.

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But where are they situated?

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I will swap the bubbles to a map.

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Look, the highly infected are four percent of all population

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and they hold 50 percent of the HIV-infected.

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HIV exists all over the world.

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Look, you have bubbles all over the world here.

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Brazil has many HIV-infected.

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Arab countries not so much, but Iran is quite high.

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They have heroin addiction and also prostitution in Iran.

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India has many because they are many.

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Southeast Asia, and so on.

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But, there is one part of Africa --

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and the difficult thing is, at the same time,

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not to make a uniform statement about Africa,

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not to come to simple ideas of why it is like this, on one hand.

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On the other hand, try to say that this is not the case,

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because there is a scientific consensus about this pattern now.

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UNAIDS have done good data available, finally,

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about the spread of HIV.

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It could be concurrency.

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It could be some virus types.

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It could be that there is other things

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which makes transmission occur in a higher frequency.

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After all, if you are completely healthy and you have heterosexual sex,

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the risk of infection in one intercourse is one in 1,000.

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Don't jump to conclusions now on how to

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behave tonight and so on.

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(Laughter)

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But -- and if you are in an unfavorable situation,

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more sexually transmitted diseases, it can be one in 100.

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But what we think is that it could be concurrency.

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And what is concurrency?

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In Sweden, we have no concurrency.

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We have serial monogamy.

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Vodka, New Year's Eve -- new partner for the spring.

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Vodka, Midsummer's Eve -- new partner for the fall.

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Vodka -- and it goes on like this, you know?

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And you collect a big number of exes.

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And we have a terrible chlamydia epidemic --

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terrible chlamydia epidemic which sticks around for many years.

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HIV has a peak three to six weeks after infection

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and therefore, having more than one partner in the same month

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is much more dangerous for HIV than others.

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Probably, it's a combination of this.

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And what makes me so happy is that we are moving now

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towards fact when we look at this.

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You can get this chart, free.

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We have uploaded UNAIDS data on the Gapminder site.

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And we hope that when we act on global problems in the future

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we will not only have the heart,

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we will not only have the money,

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but we will also use the brain.

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Thank you very much.

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(Applause)