Summary

AIDS is a new disease that was first recorded in 1981. In the 1980s and early 1990s, there were concerns that it would decimate populations; prevention was slow to take hold, and there was no cure. By the mid-1990s it was clear, in the developed world, that it would be mostly contained to specific populations. Effective but expensive treatment was unveiled in 1996. However, in Africa there were fears of a continent-wide epidemic. AIDS emerged in central Africa (HIV1) and west Africa (HIV2) and spread from there. In the 1990s it reached southern Africa, the current epicenter.

It has become evident that AIDS has not meant the collapse of economies and nations or the hollowing out of populations. Treatment options mean people can live normally provided they adhere to the drug regime, but they are costly. The worst epidemic is in the southern cone of Africa. Here it continues to have political consequences, although causality is hard to ascribe.

Unique features of the disease are that the modes of transmission include its geographic location and the excessive involvement of donors in the response; the lack of African ownership makes it a global political problem. At the moment the lives of millions of Africans depend on the generosity of the West, and that future is uncertain. AIDS is a greater challenge to southern and eastern African states than anywhere in Africa and indeed the world. The international engagement particularly in the provision of treatment means the disease has global political ramifications.