AIDS
and Violent Conflict in Africa
Timothy Docking
http://www.usip.org/pubs/specialreports/sr75.html
Summary
-
In
sub-Saharan Africa there are more than 25 million Africans
infected with HIV/AIDS (70 percent of the world's cases) and
17 million dead; on its current trajectory, by 2010 the
disease will decrease life expectancy on the continent to
levels found at the beginning of the last century.
-
Many
governments, international organizations, and NGOs have
joined a UN-led movement to address the causes and effects
of AIDS in Africa. It now appears that the international
community is fully conscious of the need to commit resources
to turn the tide against this plague.
-
The
decade of the 1990s witnessed a steady climb in violence
across sub-Saharan Africa, with the number of states at war
or with significant lethal conflicts doubling from 11 in
1989 to 22 in 2000.
-
The
relationship of the AIDS pandemic to violent conflict in
Africa is far too complex to be expressed in simple
cause-and-effect terms. Instead it must be addressed in
terms of: (1) how the explosion of HIV/AIDS may contribute
to further instability and conflict on the continent in
coming years, and (2) how instability and violence encourage
conditions favorable to the spread of the HIV virus.
-
AIDS
most frequently strikes at the most productive members of
society, those 15-45 years old that are critical to the
development of the African state and the stability of the
African family.
-
As AIDS
advances in a society it weakens the state's economic
capacity, stealing away its human capital, cutting into its
tax base, and drying up foreign investment. Power struggles
over the state's limited resources increase the likelihood
of violent conflict.
-
The
disease leaves in its wake an explosion of the orphan
population, thereby increasing the ranks of poverty-stricken
children in Africa.
-
Warfare
is an amplifier of disease, creating ideal conditions for
its spread, including poverty, famine, destruction of health
and other vital infrastructure, large population movements,
and the breakdown of family units and thus protective
networks for women.
-
The
prevalence of HIV infection in a number of African
militaries is extraordinarily high, perhaps up to 60 percent
in Angola and the Democratic Republic of the Congo.
-
Sexual
harassment and exploitation of mobile populations by
soldiers and others is commonplace while refugees often have
no recourse to legal or social protections.
AIDS in Africa
The December 2000 report "AIDS
Epidemic Update" (United Nations AIDS Fund/World Health
Organization) described the stark human tragedy caused by the
HIV/AIDS pandemic: 36 million people infected worldwide, 22
million dead since the identification of the disease some 20
years ago, indications of exponential growth of HIV infection in
the Russian Federation, and an escalating AIDS epidemic in Asia.
However, nowhere is the picture as
bleak as in sub-Saharan Africa: more than 25 million Africans
infected with HIV/AIDS (70 percent of the world's cases) and 17
million dead; on its current trajectory, by 2010 the disease
will decrease life expectancy on the continent to levels found
at the beginning of the last century. These most recent data far
surpass the most pessimistic predictions about the effects of
the disease in Africa made just five years ago (C. J. L. Murray
and A. D. Lopez, eds., The Global Burden of Disease,
World Health Organization and the World Bank, 1996).
Moreover, new reports are beginning
to describe the full extent of this African tragedy. One study
("AIDS Poverty Reduction and Debt Relief: Implications for
Poverty Reduction" by UNAIDS and the World Bank, March 2001) has
found that HIV-induced declines in gross domestic product (GDP)
levels in sub-Saharan Africa are severely undermining poverty
reduction efforts in developing countries. According to the
report, the pandemic is shaving off up to two percent of annual
economic growth in the worst affected countries. Some countries
will see their gross national product (GNP) shrink by up to 40
percent within 20 years. On the whole, the study suggests,
Africa's income growth per capita is being reduced by about 0.7
percent per year because of HIV/AIDS. Another study concludes
that by 2010, per capita income in South Africa, Africa's most
robust economy, will drop by 7-10 percent while the GDP will be
17 percent lower than it would have been without AIDS (Jeffrey
D. Lewis and Channing Arndt, "The Macro Implications of HIV/AIDS
in South Africa: A Preliminary Assessment," Africa Region
Working Paper no. 9, December 2000).
Two African states struggling to
cope with the disease are Botswana and
Zimbabwe.
In these countries life expectancy is expected to fall by as
much as 30 years, and as much as one-quarter of the respective
populations could die by 2010, according to the U.S. Census
Bureau. The increase in mortality effectively strips families of
breadwinners, field labor, and parents and is already producing
a huge group of "AIDS orphans" (David Gordon, "National
Intelligence Estimate: The Global Infectious Disease Threat and
Its Implications for the United States," National Intelligence
Council, January 2000, p. 35).
Although it has taken two decades
since the virus was identified in the United States, it now
appears that the magnitude of the disease--its impact on Africa
and the risk it poses to the rest of the world--has been
accepted by a wide array of governments and international
bodies. Indeed, over the past year the HIV/AIDS crisis has
received significant and sustained attention both in the United
States and on the international stage. Many governments,
international organizations, and NGOs (non-governmental
organizations) have joined a United Nations-led movement to
address the causes and effects of AIDS in Africa. It now appears
that the international community is fully conscious of the need
to commit resources to turn the tide against this plague.
The recent coalescence of the
international community on the AIDS issue, most notably
represented at the June 2001 United Nations General Assembly
Special Session (UNGASS) on HIV/AIDS convened at the urging of
UN secretary general Kofi Annan, gives cause for optimism. Yet
doubts remain concerning the level of financial commitments to
the recently established UN AIDS Fund (now called the Global
AIDS and Health Fund), which is designed to attract
international financial support in the fight against HIV/AIDS,
tuberculosis, and malaria while strengthening health care
systems and infrastructure. Meanwhile the discourse about
priorities in treatment and prevention is still taking shape.
Conflict in Africa
The decade of the 1990s witnessed a
steady climb in violence across sub-Saharan Africa, with the
number of states at war or with significant lethal conflicts
doubling from 11 in 1989 to 22 in 2000 (S. Mullen and J. Woods,
Cohen and Woods International, Washington, D.C., January 2001).
Full-blown regional wars grew out of conflicts in Liberia,
Rwanda, and Zaire in the mid-'90s; simmering tensions boiled
over between Ethiopia and Eritrea and led to a major interstate
war; decades-old civil wars in Angola and Sudan continued to
claim hundreds of thousands of lives; and ethnopolitical hatred
in Rwanda led to the genocide of nearly one million people.
Currently, over one-quarter of sub-Saharan African states are
engaged in either civil or interstate conflict, or both. Several
more (including Nigeria and Ivory Coast) are threatened by
imminent political, religious, or ethnic division that could
erupt into violent conflict at any time. The post-Cold War
decade, which held out the promise of an "African renaissance,"
deteriorated rapidly into severe instability across the
continent that shows no sign of abating.
The AIDS-Conflict Continuum
While recent fora and reports like
those stemming from the June UNGASS meeting have rightly pointed
to poverty, the lack of education, and gender inequality as
important factors in the AIDS pandemic, few have linked AIDS in
Africa to violent conflict.
In the light of these two
disturbing trends--the spread of HIV/AIDS and increases in
violent conflict--which are dominant features of today's Africa,
the United States Institute of Peace brought together a panel of
specialists in May 2001 to examine an often overlooked aspect of
the pandemic: the nexus between conflict and AIDS.
The Institute event explored the
multiple and cross-cutting connections between the incidence of
HIV/AIDS and violent conflict on the continent. The panel also
attempted to develop a set of broad policy recommendations for
the U.S. government and the international community.
The panelists were in agreement
that the relationship of the AIDS pandemic to violent conflict
in Africa was far too complex to be expressed in simple
cause-and-effect terms. Instead the panel addressed the
"AIDS-conflict continuum" in discussing: (1) how the explosion
of HIV/AIDS may contribute to further instability and conflict
on the continent in coming years, and (2) how instability and
violence encourages conditions favorable to the spread of the
HIV virus.
The AIDS Epidemic and National
Security
A major theme addressed by the
panel is the linkage between AIDS and American strategic
interest. The devastation associated with the pandemic has
prompted both the Bush and Clinton administrations to treat the
AIDS epidemic as a national security issue with the potential to
threaten the United States and American interests worldwide.
By far the most outspoken Bush
administration official on the threat of AIDS has been Secretary
of State Colin Powell who quickly made the pandemic one of the
centerpiece issues of the State Department. Indeed, during his
week-long trip to Africa in May, Powell returned to the theme of
AIDS repeatedly and underscored the pandemic's threat to the
African continent and global security. While touring one health
center outside of Nairobi, Powell stated, "There is no war
causing more death and destruction, there is no war on the face
of the earth right now that is more serious, that it is more
grave, than the war we see here in sub-Saharan Africa against
HIV/AIDS."
The nexus between AIDS and U.S.
national security was identified in government circles as far
back as 1994. Writing of the risks AIDS poses to state stability
and prosperity, then Undersecretary of State for Global Affairs
Timothy Wirth wrote: "HIV/AIDS has potentially devastating
impacts on whole sectors of societies. In the most vulnerable
nations, these trends could have devastating consequences for
sustainable development and contribute to conflict and
instability. We must understand the pandemic for its ability to
affect the social, economic, and political fabric of many
nations and thus, its implications for U.S. foreign policy,
American leadership, and global cooperation. Viewed in the
context of national security interests, many countries are today
waging (and losing) a war with this infectious disease"
(foreword to K. Hamilton, Global HIV/AIDS, CSIS, 1994, p.
vii).
President Clinton subsequently
appointed the National Science Council on Emerging and
Re-Emerging Infectious Diseases to determine the direct and
indirect threat that pathogens posed to U.S. national security
and prosperity. In January 2000, Vice President Al Gore placed
the issue on the U.S. national security agenda when he stated at
the special UN Security Council Session on AIDS in Africa: "When
10 people in sub-Saharan Africa are infected every minute; when
11 million children have already become orphans, and many must
be raised by other children; when a single disease threatens
everything from economic strength to peacekeeping--we clearly
face a security threat of the greatest magnitude."
Also in 2000 the National
Intelligence Council (NIC) produced its "National Intelligence
Estimate: The Global Infectious Disease Threat and Its
Implications for the United States." The report was an important
milestone in the policy discussion about AIDS and other
infectious diseases in systematically linking them to U.S.
national security. It further described the catastrophic set of
circumstances confronting the hardest hit states in sub-Saharan
Africa, which may be replicated in Asia and other areas as the
AIDS pandemic continues to spread.
Linking AIDS and Conflict
At the core of this important
report is the link between contagion and socioeconomic
instability. At the Institute briefing David Gordon, the author
of the NIC report, explained the linkage between national
security and infectious diseases. He suggested four areas of
concern about the HIV/AIDS virus: the impact on U.S. public
health; the effect on U.S. and international troops and
peacekeeping operations; the slowing of economic development in
states where the United States has significant strategic and
economic interests; and the destabilization of African
societies.
A closer examination of these
points illustrates the rationale behind Gordon's argument. AIDS
is not just Africa's health crisis. Diseases don't respect
national borders, be they flu, tuberculosis, or evolving strains
of AIDS. As a writer in the New York Times Magazine
recently said, "The strains of HIV running rampant in Africa, if
left unchecked, are sure to gain novel malevolence that would
allow them to spread elsewhere and overwhelm whatever resources
we have devoted to defeating our western-bred strains" (Natalie
Angier, "Together, in Sickness and in Health," May 6, 2001).
Moreover, AIDS has the potential to
weaken U.S. and foreign militaries and make mobilization of
international forces difficult. It has been estimated that 40
percent of the military in South Africa and up to 60 percent in
Angola and the Democratic Republic of the Congo (DRC) are
HIV-positive, as are many soldiers serving in African peace
operation forces. Richard Holbrooke, then U.S. ambassador to the
United Nations, warned last year that peacekeepers need better
education about AIDS. "It would be the cruelest of ironies," he
said, "if people who had come to end a war were spreading an
even more deadly disease."
Finally, in highly affected
regions, HIV/AIDS also places huge strains on state institutions
and the economy. AIDS most frequently strikes at the most
productive members of society, those 15-45 years old. It is also
a disease that often strikes teachers and other wage earners
that are critical to the development of the African state and
the stability of the African family. Therefore, Gordon
maintains, acute impact of the AIDS pandemic may result in the
widespread economic and political destabilization of societies,
states, and entire regions.
Gordon's analysis thus portends a
spiral of destabilization resulting from the impact of HIV/AIDS.
Families become impoverished as breadwinners sicken and die.
With the spread of disease and death, social bonds within and
between families are weakened. The disease leaves in its wake an
explosion of the orphan population. This and the shortage of
teachers due to AIDS contribute to the disruption of education
patterns and increase the likelihood that children will leave
school early. Erosion of all the elements of civil society is
inevitable in the face of the epidemic, weakening one of the
main brakes on governmental excesses in Africa. With the loss of
population, the economy languishes and growth becomes
impossible. Finally, power struggles over the state's limited
resources increase the likelihood of violent conflict.
Gordon concluded that the AIDS
pandemic threatens to overwhelm already fragile structures and
will exacerbate all of the conditions that have made Africa
extraordinarily vulnerable to violent conflict in the past. "If
national security is defined as protection against threats to a
country's population, territory, and way of life, then AIDS
certainly presents a clear and present danger to much of
sub-Saharan Africa, and a growing threat to the vast populations
of Asia and Eurasia, which have the world's steepest HIV
infection curves."
Empirical research attributing
violent conflict to the AIDS pandemic is scanty. However, there
is a strong correlation between environmental stress and
conflict. The research of Professor Thomas Homer-Dixon, a
leading scholar in this field, has established a relationship
between conflict and decreasing levels of water, fuel wood,
food, and arable land. Homer-Dixon suggests that the
epidemiological stress created by AIDS will have similar
deleterious ramifications. At the Institute briefing he applied
his model of environmental stress and conflict to the new
analysis of conflict and AIDS.
In his book, Environmental
Scarcity and Violence (Princeton University Press, 1999),
Homer-Dixon found that stress on the environment leads to a
series of intermediate social effects that have an indirect
causal relationship to conflict. These include declining
agricultural and economic production throughout the society,
weakened state capacity to deal institutionally with internal
divisions, increasing migration rates, and deepening social
cleavages exacerbating ethnic/class divisions.
Homer-Dixon sees clear parallels
between the effects of environmental scarcity and the unfolding
AIDS crisis in Africa. In particular, he predicted that
declining economic productivity and weakening state institutions
would be two of the most prominent conditions that emerge in
AIDS-ravaged societies. "AIDS," he suggested, "will drain off
human capital while simultaneously increasing the need for
innovation, scientific capacity, economic structures, political
systems, and collective actions initiatives." "Indeed,"
Homer-Dixon continued, "the [most severely infected] societies
we are looking at in Africa are entering a downward spiral [as
concerns] human capital." And this result will be compounded, he
argued, by "synergistic factors" that affect social development
and increase the likelihood of conflict, such as longstanding
ethnic divisions, corruption, the abundance of light weapons,
and market failure. The strength of these socio-economic
factors, he concluded, will ultimately determine if the pandemic
is associated with an outbreak of violence.
Therefore, Homer-Dixon pointed out,
it will be difficult to establish a direct correlation between
disease and conflict: "Disease is not going to lead directly to
violence, it is going to have indirect effects," principally, he
argued, through its "tremendous capacity to weaken the state."
Thus, as the pandemic degrades
human capital the state's ability to make rational decisions
will decline, so too will the state's fiscal capacity from lost
tax revenues. Yet fiscal pressure on the state will be met with
increased fiscal demand to confront the malady, which will
further exacerbate the problem. Similarly, Homer-Dixon points
out that just as the crisis posed by AIDS heightens the
imperative for African innovation and ingenuity, the disease
diminishes the intellectual capacity of society. Together, he
maintained, these factors illustrate the perverse socio-economic
effects of AIDS and suggest why the disease must be seen as a
deeply destabilizing threat on the continent.
One of the few scholars examining
the connection between AIDS and conflict, Professor Andrew
Price-Smith is the author of the forthcoming book, The Health
of Nations: Infectious disease, Environmental change, and Their
Effect on National Security and Development (MIT Press,
2001). Like Gordon, Price-Smith argued persuasively that there
is linkage between AIDS-related deaths among the 15-45 year olds
(the most heavily infected and most productive segment of a
population), the commensurate loss of human capital, and
resultant falling GDP levels in Africa. He reasoned that, as
AIDS skims off the doctors, teachers, parents, lawyers,
entrepreneurs, judges, and policymakers, it leads to
institutional and societal fragility. This point illustrates the
stress that AIDS places on social systems and suggests why poor
countries often with low levels of education and a small
professional class will be more greatly affected than more
affluent nations.
He went on to suggest that
AIDS-induced poverty will further increase the risk of ethnic
violence as individuals and groups blame others and scapegoat
minorities for their increasing economic deprivation. The net
effect of an AIDS-depleted society, Price-Smith argued, is a
hollowing out of the state and social networks that are already
under pressure from poverty and sundry other concomitant
variables.
Furthermore, in heavily
AIDS-affected societies increasing levels of poverty coupled
with increasing weakness of the state produce greater incentive
and opportunity for political violence, as challenging elites
seek to replace those in power and capture diminishing economic
resources. This dynamic, Price-Smith concluded, poses a grave
threat to nascent democracies and could lead to more
authoritarianism and even state failure in heavily affected
African states.
The macroeconomic costs of AIDS and
other associated infectious diseases thus pose an extra burden
on societies. As the sickness strikes at the labor force it
takes a toll on productivity, profitability, and foreign
investment in the future. As David Gordon points out, some
senior officials within the World Bank consider AIDS to be the
single biggest threat to economic development in sub-Saharan
Africa (Gordon, "National Intelligence Estimate," p. 57).
As AIDS advances in a society it
thus weakens the state's economic capacity, stealing away its
human capital, cutting into its tax base, and drying up foreign
investment. This confluence of economic factors further limits
state capacity to respond to the epidemic through health and
education programs. Furthermore, as families lose breadwinners
and more adults die, children are often the worst affected.
Panel moderator Princeton Lyman cautioned at the Institute
briefing that the increasing ranks of orphaned and
poverty-stricken children in Africa increases the risk that more
of Africa's vulnerable youth will be forced to take up arms as
child soldiers.
Exacerbating the disease-induced
decline of some African economies and the concomitant fall in
African living conditions has been a trend among Western nations
to scale back foreign development aid to the continent. Aid from
rich countries to the 28 countries with the highest adult HIV
prevalence rates (excluding South Africa) have fallen by nearly
one-third since 1992, from U.S. $12.5 to U.S. $8.6 billion
(Integrated Regional Information Network, "New Figures on
Development Costs of HIV/AIDS," June 28, 2001).
Other factors compounding the
impact of the epidemic on the African continent over the past
decade include the failure of many leaders to acknowledge the
problem and take decisive action to stop its spread. Indeed, in
some of the worst infected areas, for example in South Africa,
Zimbabwe, and Kenya, Presidents Mbeki, Mugabe, and Moi have at
times been slow to even accept the link between the HIV virus
and AIDS, let alone to promote preventive measures against it
within their societies. The vital importance of such leadership
can be seen in cases where leaders took up the challenge, for
example in Uganda, Thailand, and Brazil, and significantly
reduced the infection rates.
The picture painted above leaves a
dire image: HIV/AIDS is ravaging the African continent, causing
enormous human suffering and undermining state capacity and
stability at an alarming rate. Yet, while the AIDS pandemic can
be linked to the development of a conflict-inducing
socio-economic climate, we cannot at this time directly
correlate the dreadful conditions left in the wake of the
disease to war. Indeed, none of the experts foresee the outbreak
of violence in the world's most stricken nation, Botswana.
Again, the experts on the panel agreed that while AIDS has a
tremendous capacity to weaken the state and to otherwise
establish the conditions for violent conflict, the ultimate
effects of the disease will be non-linear and difficult to
predict.
Conflict as a Vector
Although some might question the
significance of AIDS as a contributor to conflict, no one denies
the role of conflict in the spread of the virus. As Andrew
Price-Smith points out, warfare is an amplifier of disease,
creating ideal conditions for its spread: poverty, famine,
destruction of health and other vital infrastructure, large
population movements, and the breakdown of family units and thus
protective networks for women. In a recent article, Helen
Epstein illustrates this point when she describes how the course
of the AIDS epidemic in Uganda has paralleled the country's
passage from chaotic conflict in the 1980s, when HIV incidence
began to rise dramatically, to the impressive decline of AIDS
cases in the relatively calm early and mid-1990s, to a new
upsurge of both violence and infection in recent years ( "AIDS:
The Lessons of Uganda," New York Review of Books, July 5,
2001).
At the Institute seminar, Millicent
Obaso pointed out that soldiers have been identified as a
principal vector of the AIDS epidemic in Africa. Indeed, this
group is one of the most highly infected on the continent. A
1999 Defense Intelligence Agency study estimated that the
prevalence of HIV infection in a number of African militaries is
extraordinarily high, perhaps up to 60 percent in Angola and the
DRC. Indeed, in a recent interview Nigeria's president Olusegun
Obasanjo explained that one of the watershed events for his
government's approach to the epidemic came when tests of the
Nigerian military revealed a high incidence of the disease:
"When I took over the reins of government in Nigeria, HIV/AIDS
had not been given the type of attention it should be given. It
was still a sort of hush-hush affair. What really spurred me on
was when I got back some of our soldiers from Sierra Leone, . .
. we found that they were, on average, about 11 percent infected
(a rate twice the national average). That really gave me cause
for alarm" (Barbara Crossette, New York Times, June 28,
2001, p. A-10).
No one has accurate figures on the
infection rates of various rebel groups (such as the
Revolutionary Unity Front in Sierra Leone) or the numerous
militias that so often circulate in war-torn settings on the
continent, but there can be little doubt that such groups of
insurgents are important vectors spreading the disease in
conflict zones.
Obaso further pointed out that
there are millions of refugees in Africa today, including
internally displaced persons in 18 sub-Saharan states. Many of
these refugees have been displaced by war or ethnic conflict and
face grievous daily circumstances. While population movement is
not necessarily a risk factor for HIV/AIDS transmission,
displaced people are often highly marginalized while in transit
or at destination. Sexual harassment and exploitation of mobile
populations by soldiers and others is commonplace while refugees
often have no recourse to legal or social protections.
In conflict situations, law
enforcement, judicial, religious, and other state systems that
protect individual rights break down. Within this set of
circumstances the vulnerability of women to sexual intimidation
is greatly increased. Social controls, vital to the maintenance
of peace and order in weak state settings, also suffer.
Incidence of rape and other forms of sexual coercion skyrocket
in such conflict settings. A recent UNAIDS publication
("Population Mobility and AIDS," February 2001) concludes that
war and forced migration promote increased sexual intimidation
of women: "As physical, financial, and social security erode in
the refugee setting, women are often forced into high-risk
sexual behavior, . . . by trading or selling unprotected sex for
goods, services, and cash in order to survive and/or continue
their travel."
The impact of this sexual
victimization of women on the spread of AIDS is compounded by
the general absence of condoms in areas affected by war. The
collapse of educational systems associated with war further
exacerbates problems and has the double effect of curtailing
prevention efforts taught in the classroom and pulling children
away from their studies, often into a chaotic and predatory
environment.
Finally, as Obaso pointed out at
the Institute, soldiers and other combatants are not only
responsible for spreading the disease within conflict situations
but also for contaminating communities and villages upon
returning to their home villages. Ironically, demobilization
thus spreads AIDS infection to previously unaffected areas.
Conclusion
The twin scourges of conflict and
AIDS are tearing apart entire regions of sub-Saharan Africa.
However, although alarm bells have been sounded on both of these
problems, analysis of their interrelationship is incomplete. As
expert opinion cited in this report shows, the links between
violent conflict and the AIDS pandemic in Africa are becoming
more clear. And the risks associated with the plagues of
conflict and disease--to U.S. national security, economic
development, and regional stability, as well as the livelihoods
of more than 700 million Africans--are serious.
The experts gathered together at
the U.S. Institute of Peace to address this issue provided a
number of recommendations for the United States and the
international community as they begin to address these daunting
problems:
Policy Recommendations
1.
Experts at the forum agreed that the West should provide more
funds to strengthen the ability of poor governments to address
their growing AIDS crises, as well as technical assistance to
help highly affected governments bolster their own institutions
to confront the problem.
2.
Panelists warned, however, that an increase in funding for the
fight against HIV/AIDS in Africa must not come at the expense of
already decreasing Western (especially U.S.) development
budgets, lest such underlying factors as poverty, poor
education, and weak infrastructure undermine whatever AIDS
effort is undertaken.
3.
Panelists also recommended that the international community,
which has been focused on non-state actors and their fight
against the pandemic, should again think about engaging with the
African state. Failure of donors to recognize the long-term
consequences of the weakening state could have major
consequences for both stability and development.
Non-governmental organizations, while pressing for programs
outside of government and for the strengthening of civil
society, need to recognize this factor as well.
4.
Women, often excluded in the decision-making process on the
continent, must be involved in the battles against both AIDS and
war. Furthermore, all sides in the fight against AIDS must
continue to fight for the economic empowerment and human rights
of African women.
5.
The multitude of policies aimed at HIV prevention, both at the
national and international level, need to be harmonized and
actors involved in the struggle against AIDS must search for
avenues to collaborate and to create synergies. Indeed, UNAIDS
has only been partially successful in coordinating the UN
effort, and the introduction of a new, separate, global fund for
addressing the problem, welcome as it is, poses new issues of
coordination that should be addressed at the outset.
6.
Peacekeepers involved in missions to Africa need to be educated
on the risks of contracting/spreading the disease, lest they
become part of the problem rather than the solution.
7.
The AIDS orphans problem urgently needs to be addressed by the
international community. Communities need to be helped to adapt
traditional extended family arrangements to the larger and more
demanding dimensions of the orphan problem. This can be done
through strengthening local NGOs and community organizations
that share a common concern for orphaned children, increasing
funds for scholarships and other support to orphans, and helping
parents prepare for this situation when they learn of their
positive HIV status. Innovative training and educational
programs will also be necessary to capture this generation of
orphans before they become street children or recruits as child
soldiers. Like other aspects of the problem, the orphan problem
must be considered integral to the overall strategy of
prevention, care, and treatment.
8.
Political leadership in the fight against AIDS is key. While the
recent summit in Abuja, Nigeria (May 2001)--where African
leaders pledged to devote 15 percent of their annual public
spending to AIDS and other public health priorities--and the
June 2001 UNGASS meeting--where agreement was reached on a
comprehensive platform for addressing the pandemic--are hopeful
signs of progress on this issue, much more needs to be done.
Africa's leaders (especially in the southern African region)
should be encouraged to publicly acknowledge the problem and
spearhead efforts to implement effective counter-measures
against the sickness. The initiative should spur the spread of
AIDS education programs and prevention campaigns similar to
those that have partially contained the rampant spread of the
pandemic in Brazil, Thailand, and Uganda.
9.
South Asia and Eurasia deserve new and concerted attention from
the international community. The experts agreed that the vast
populations of India, the former Soviet Union, and China
currently have the steepest HIV infection rate curves.
International health organizations recently estimated that 1.25
million people in China are infected with the AIDS virus, and
these organizations projected that by 2010 that figure could
balloon to 20 million. The panelists felt strongly that these
alarming new data warrant a proactive response from the
international community so that outbreaks of the disease are
confronted through early intervention, lest the malady ravage
these lands as it is doing in Africa.
About the Report
In light of two disturbing
trends--the spread of HIV/AIDS and increases in violent
conflict--which are dominant features of today's Africa, the
United States Institute of Peace brought together a panel of
specialists in May 2001 to examine an often overlooked aspect of
the pandemic: the nexus between conflict and AIDS. This report
is a synthesis of the most salient points broached during this
briefing combined with pertinent supporting information. It
concludes with nine policy recommendations.
Participating in the panel were
David Gordon, national intelligence officer for economic and
global issues, National Intelligence Council; Thomas
Homer-Dixon, director of the Peace and Conflict Study Program,
University of Toronto; Princeton Lyman (moderator), formerly
U.S. ambassador to South Africa and currently executive
director, Global Interdependence Initiative, Aspen Institute;
Millicent Obaso, manager of the Africa Initiative, American Red
Cross; and Andrew Price-Smith, assistant professor of government
and international affairs, University of Southern Florida.
The panel was organized by
Institute staff members Timothy Docking and Joseph Klaits,
Jennings Randolph Program
for International Peace, and Sheryl Brown and Burton Edwards,
Office of Communications. The report was written by
Timothy Docking.
The views expressed in this report
do not necessarily reflect those of the United States Institute
of Peace, which does not advocate specific policies.
Additional Resources
-
"AIDS
and the Military." New York: UNAIDS, May 1998. Also check
the UNAIDS website (www.unaids.org)
-
Carballo, Manuel, et al. "Demobilization and Its
Implications for HIV/AIDS." Geneva: International Centre for
Migration and Health, October 2000 (www.certi.org/publications/Publications.htm).
-
"HIV/AIDS as a Security Issue." Washington/Brussels:
International Crisis Group, June 19, 2001.
-
"Plague
upon Plague: AIDS and Violent Conflict in Africa." Current
Issues Briefing transcript, United States Institute of
Peace, Washington, D.C., May 8, 2001 (www.usip.org/events/pre2002/plague_cib.html).
-
Price-Smith, Andrew, ed. Plagues and Politics: Infectious
Disease and International Policy. London: Palgrave
Publishers, 2001.
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