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How the U. S. Has Slept through the Global AIDS Pandemic, the Greatest Humanitarian Catastrophe of Our Time
by Greg BehrmanPreface
A Feeble Beginning (1983-1990)
Quiescence (1990-1996)
An Awakening of Sorts (1996-1999)
Opportunities Squandered (1998-2000)
A Great Awakening? (2001-2003)
A Note on Sources I am an invisible man .... I am invisible, understand, simply because people refuse to see me.
Notes
Acknowledgments
Index
Ralph Ellison,
The Invisible Man, 1952
Invisible graves line the fields of faraway lands. Therein lie invisible people -- 25 million of them -- all laid to rest by one of the most lethal scourges in the history of mankind. Hundreds of millions of empty graves await those who may follow.
Over the past two decades, 65 million people have become infected with HIV, the virus that causes AIDS. Approximately 25 million people -- more than the aggregate battle deaths of the twentieth century combined -- have lost their lives to this plague. More than 40 million are currently infected. Every day, 8,000 people (nearly three times 9/11's death toll) die of AIDS.
Since the first century, the world's wars have exacted approximately 149 million deaths. It is projected that by 2010, more than 100 million will have been infected with HIV. There will be as many as 250 million new HIV infections by 2025.
Beyond the ineffable human toll, the pandemic is refashioning the social, economic, and geopolitical dimensions of our world.
Even as the virus's shadow looms, poised to explode on other continents, AIDS has been decimating sub-Saharan Africa, home to almost 70 percent of those infected worldwide. Approximately 40 percent of adults in Botswana are HIV positive. More than 20 percent of those in South Africa are infected. Life expectancy in Botswana has decreased from seventy-one to thirty-nine years, and in Zimbabwe, from seventy to thirty-eight years. Four other countries in the region have life expectancies below forty. By 2010, several African countries are expected to have life expectancies of thirty years or less. "We are threatened with extinction," Botswana's president, Festus Mogae, has said.
Most ominously, the pandemic is creating an entire generation of orphans. By 2010, Africa will be host to 20 million of the world's 25 million AIDS orphans. Reared in abject poverty and without moral guidance, Africa's AIDS orphans, it has been said, constitute an army in search of a leader.
Suffering almost endemic poverty, Africa's economies will be pulverized by the pandemic. It is commonplace for businesses to train two or three workers for every one job. Such are the chances that workers will become infected and die. AIDS will shrink many economies by 15 to 20 percent or more by decade's end. Within several generations, the World Bank predicts, economic collapse is a possibility.
The disease will have grave consequences for U.S. and global security. 9/11 demonstrated the danger of a failed state. In Africa, the world confronts nothing less than the potentiality of a failed continent. The disease is eviscerating national militaries (some have infection rates, it is believed, as high as 50 percent) and generating social and economic pressures that will threaten the very viability of many African states, in some cases begetting disintegration or implosion. The debris, without drastic action, will be the fodder upon which terrorists and transnational criminal elements will find refuge and sustenance. The pandemic -- with surreptitious but undeniable force -- is shaking some of the fault lines upon which tomorrow's wars will be fought.
Southern Africa is the canary for the rest of the world. By 2010, the National Intelligence Council predicts, China, India, Russia, Nigeria, and Ethiopia will have between 50 to 75 million infections, and possibly more (overtaking the 30 to 35 million projected in central and southern Africa).
By 2025, one expert estimates, AIDS will cripple China's, India's, and Russia's economies, such that they will only be able to produce flat to nominal annual economic growth. The aftershock will generate seismic reverberations throughout the global economy.
Already facing serious economic challenges and a chilling demographic crisis -- Russia's population is expected to decline from 145 million by as many as 30 million in the next several decades -- Russia faces the additional possibility of 8 million HIV infections in the next ten years. AIDS will imperil Russia's tenuous democratization, and will precipitate instability in a power already struggling to safeguard thousands of nuclear weapons and large quantities of nuclear materials. Poised to explode in India and China, the disease threatens to destabilize these other nuclear states as well, possibly contributing to internal, or even regional instability and conflict.
These "next wave" countries comprise roughly 40 percent of the world's population. The pandemic's near-term incursion heralds only the beginning. The toll taken thus far is merely a harbinger of what is still to come.
The longest journey of any person is the journey inward
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