New York - AIDS, the disease which in Africa kills ten times more people than war, will be in the spotlight here today as the United Nations Security Council begins its first ever meeting on a health issue. In another first, an American vice president, Al Gore, will chair the meeting, designed to focus attention on African issues.
The 15-member Security Council’s decision to address AIDS underscores the rapid evolution of the epidemic, which is fast becoming sub-Saharan Africa’s number one human security issue.
"By overwhelming the continent’s health and social services, by creating millions of orphans, and by decimating health workers and teachers, AIDS is causing social and economic crises which in turn threaten political stability," UN Secretary-General Kofi Annan told the Security Council.
"In already unstable societies, this cocktail of disasters is a sure recipe for more conflict. And conflict, in turn, provides fertile ground for further infections," Mr. Annan said.
AIDS is now the leading killer in sub-Saharan Africa, where 23.3 million people have HIV or AIDS; 90% of the world’s 11 million AIDS orphans are in Africa; in 1998, 200,000 African died from war - but 2.2 million died from HIV/AIDS. Though it has just a tenth of the world’s population, sub-Saharan Africa is home to two-thirds of the world’s HIV-positive population. In Africa’s most affected regions, as many as one person in four are estimated to carry HIV, the virus that causes AIDS.
About half of HIV infections occur before the age of 25, and these young men and women typically die of AIDS before 35. The disease is killing people in their most productive years and destabilizing all walks of African life: health, education, industry, agriculture, transport. This dual devastation of debilitating disease and early death is turning back decades of development and reversing economic growth across the continent.
"Visibly, the epidemic is eroding the social fabric of many communities," said Dr Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). "In its demographic, social and economic impact, the epidemic has become more devastating than war, in a continent where war and conflict appear to be endemic."
The destabilizing effect of AIDS in Africa was also driven home in a statement by Mark Malloch Brown, Administrator of the United Nations Development Programme (UNDP), who spoke to the Security Council. "HIV/AIDS is undermining the security of southern Africa because it eats at social and economic structures as well as taking a huge human toll," he said. "Richard Holbrooke is to be congratulated for taking this initiative." Mr. Malloch Brown was referring to US Ambassador Holbrooke, the Security Council’s new president, who pushed to make long-neglected African issues a theme of his month-long presidency.
In Africa, the impact of the AIDS epidemic is magnified by the fragility and complexity of geo-political systems. Eleven of the world’s 27 conflicts are in Africa; 15 sub-Saharan countries face food emergencies; drought in East Africa threatens to exacerbate food scarcity; a generation of orphans brought up in poverty may give rise to a generation of disaffected youth. These emergencies pose real threats to social and political stability in Africa. AIDS has a disproportionate impact on vulnerable populations such as displaced persons and refugees - women are six times more likely to get HIV in refugee camps than populations outside.
The epidemic is also affecting armed forces and the civilians who interact with them, either through commercial sex or rape as a weapon of war. The use of rape in war has already been documented. Soldiers involved in conflicts in the Great Lakes Region of Africa reportedly raped women of "the enemy side" with the stated intent of infecting them with HIV.
"In fact, a military and police force, well-trained in HIV prevention and behaviour changes, can be a tremendous force for prevention if it is made one of their priorities," Dr Piot said.
Despite the magnitude of the emergency, resources remain scarce. "The resources available to address HIV/AIDS are entirely disproportionate to the size of the problem," warned Dr Piot. In 1997, approximately US$165 million were spent on AIDS prevention in the worst affected countries, compared with the US$1-3 billion now required for effective prevention programmes across sub- Saharan Africa.
Still, Dr Piot said, we are far from powerless against AIDS in Africa. "In countries where strong political leadership, openness about the issues, and broad, cross-cutting responses come together, the tide is turning and clear success is being demonstrated," he said. "Many African leaders have spoken out in unprecedented ways, breaking the silence and the stigma surrounding the epidemic." In Uganda, where the top leadership has been outspoken about AIDS, new infections among pregnant women in towns has dropped by more than half from 37% to around 15%.
"Internationally, too, the tide is turning," Dr Piot added. The special session in 1999 of the UN General Assembly set a new target to reduce new infections by 25% in 15 to 24-year olds in the most-affected countries by 2005. To form a united front and alter the course of the epidemic, an International Partnership Against AIDS in Africa - composed of African governments, donor countries, UN bodies, civil society and the private sector - is being established.
For more information please contact: Anne Winter, , Geneva (+41 22) 791 4577, Andrew Shih, UNAIDS, New York (+1 212) 584 5024, Richard Delate, UNAIDS ICT/ESA, Pretoria, (27 12) 338 5294 or (27) 82 375 7594. You may visit the UNAIDS Home Page for more information about the programme (http://www.unaids.org). This document is also at http://www.unaids.org/whatsnew/press/eng/seceng2000.html.
January 10, 2000
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