Volume 9 Number 5 and 6
`Break the silence’ was the theme for the 13th International AIDS conference, held in Durban in July. Durban, in the province of KwaZulu-Natal, was an appropriate setting for the conference. In 1999, almost a third of pregnant women attending public antenatal clinics in the province tested HIV-positive: the highest of all South African provinces. The national picture is not better. With an estimated 4.2 million infected people, South Africa has the largest number of people living with HIV/AIDS in the world.
While the HIV/AIDS epidemic is widespread in South Africa, the fact is that the whole of sub-Saharan Africa is disproportionately affected by it. According to the latest annual UNAIDS report, 34.3 million people were living with HIV/AIDS at the end of 1999. Of these, 24.5 million (or 71%) were living in sub-Saharan Africa, even though only a tenth of the world’s population reside in the region.
Altogether, at the end of 1999, there were 16 countries (all in sub-Saharan Africa) where more than a tenth of the adult population aged 15-49 years were infected with HIV. In seven countries (all in Southern Africa), at least one adult in five tested positive for HIV.
As UNAIDS points out: "AIDS is now the leading cause of death in Africa. In 1998 alone, two million people died of AIDS in the African countries south of the Sahara, and millions of new HIV infections occur there every year, foreshadowing even greater losses in the future. In the world’s nine most affected countries (all of them located in Africa), life expectancy for a child born in 2000 – 2005 will drop to 43 years from the pre-AIDS expectation of 60 years of life."
Given the magnitude of the epidemic in Africa and the insecurity that plagues most regions of sub-Saharan Africa, it was surprising that none of the almost 5 000 papers and abstracts that were made available to delegates at the Durban conference dealt with the likely impact of the epidemic on human security.
A January 2000 US government National Intelligence Council report concluded that there is a definite link between infectious disease epidemics (in particular HIV/AIDS) and security. For example, the report found that:
- The impact of HIV/AIDS is likely to aggravate and even provoke social fragmentation and political polarisation in the hardest hit countries in the developing world.
- The deaths resulting from the HIV/AIDS epidemic will weaken the military capabilities of countries — as well as international peacekeeping efforts — as the armies and recruitment pools experience HIV infection rates ranging from 10% to 60% in many sub-Saharan countries.
- By 2010, an estimated 22 million orphans in sub-Saharan Africa are expected to comprise a ‘lost orphaned generation’. Such societies will be at risk of increased crime and political instability as these young people become radicalised or are exploited by various political groups for their own ends.
The impact of HIV/AIDS will be with Africa and its peoples for some decades to come. It is becoming clear that much of the potential impact of the epidemic is as yet either unknown, or has not been sufficiently explored. The link between HIV/AIDS and human security could provide invaluable insights into the impact of HIV/AIDS in Africa.
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