Five years ago, the Clinton Administration identified AIDS as a national and global security threat, declaring that it has the potential to destabilize governments. Today, the threat has grown as governments across sub-Saharan Africa teeter on the brink of collapse while those in developed and developing states differ greatly in their reactions to the devastating disease from denial to the suggestion of aggressive action.

The human and economic toll of HIV/AIDS on the African continent is reaching disastrous levels, undermining and perhaps dooming the region’s future. In some countries erasing all progress made over the past half century. The effects of the epidemic also threaten India, Russia, and China, as the disease undermines economic growth and may well lead to political instability. The threat to U.S. national security interests presented by the African epidemic would be trumped by epidemics in Russia, India, and China that would carry global consequences.

President George W. Bush, at the Inter-American Development Bank in March 2002, proposed a five-year emergency plan with a stated aim of bringing treatment to two million people in 100 countries living with HIV/AIDS. The White House is cognizant of the affects of failed states. In his speech, Bush stated, “Persistent poverty and oppression can lead to hopelessness and despair. And when governments fail to meet the most basic needs of their people, these failed states can become havens for terror.”

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Africa

According to the UNAIDS Report on the Global AIDS Epidemic 2002, in Sub-Saharan Africa alone there are 28.5 million cases of HIV/AIDS, with a prevalence rate as high as 20 percent, as compared with the U.S. where it is less then one percent. The results of the disease, and its spread represent the most serious crisis facing Africa today.

The human cost of HIV/AIDS on Africa is astounding. In Sub-Saharan Africa, life expectancy for both men and women declined from 62 years in 1990 to 47 in 2002. Rather then progressing into the 21st century, the region is sliding back to the 19th century. HIV/AIDS has created more than 13 million orphans across the region, with an expected tripling of that figure to 42 million by 2010. It is these orphans who make up the majority of street gangs in urban centers.

The epidemic has also decimated the ranks of the educated workforce, such as civil servants and teachers. According to a 1999 Center for Strategic and International Studies (CSIS) report on Global AIDS, 860,000 African teachers died from HIV/AIDS. These critical members of the workforce are not being replaced. In the country of South Africa, one in seven civil servants are believed to have HIV/AIDS, along with a military where estimates of the HIV/AIDS rate go as high as 25 percent. The deaths and infections of these members of society undermine the social structure of the state. The paucity of teachers had led a staggering number of uneducated and impressionable youth that wind up in street gangs, like the ones seen in Johannesburg, South Africa where a large percentage of the street crime is committed by the some 800,000 AIDS orphans in the area. These orphans are more prone to contract the disease themselves and exacerbate the infection cycle.

Military and police forces with high infection rates also strains African society by creating a vacuum where gangs and terrorists can operate. In nations that send peacekeepers for stability throughout the continent, those soldiers are five times as likely to contract HIV/AIDS and as result spread the disease. South Africa, a traditional provider of continental peacekeepers, may soon be unable to send its troops abroad because of its own infection rate. A lack of peacekeepers is likely to threaten regional security, as stability in many African states is dependent upon peacekeeping forces.

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Losses Measured In Macro-Economic Terms

As HIV/AIDS destroys the financial underpinnings of millions of families, it is felt on a national scale. A World Bank Study of HIV/AIDS in 2002 found that family income drops between 40 and 60 percent when the disease strikes a family member. Often other family members will leave their jobs to care for those who are ill. At the national level, the percent of the population with HIV/AIDS is directly proportional to economic growth and in turn economic development. Models created by the World Bank demonstrate that when infection levels rise above five percent national growth slows dramatically; when the infection rate reaches 10 percent growth ceases, and; in the cases when the infection rate reaches 20 percent, roughly one percentage point of GDP drops per year. The UNAIDS report suggests that this relationship may be exponential, and that the results of an infection rate above 20 percent may be dramatically worse than modeled.

The UN Food and Agriculture Organization (FAO) estimated that in the 27 hardest hit nations in Sub-Saharan Africa, seven million agricultural workers have died since 1985, and that by 2020, 16 million will have died. In some African countries, close to 25 percent of the agricultural work force will die in the next 15 years. There is potential for massive food shortages and famine across an already stricken continent, which would further impoverish and malnourish the population that is further destabilizing.

African State Collapses Threaten U.S. Security

The complete disintegration of Sub-Saharan Africa caused by HIV/AIDS is not beyond the realm of possibility. The chaos that results from state failure, as seen in Somalia, boosts radicalization of the population creating a fertile ground for terrorist recruitment. Regional stability and sustainable development are goals of the U.S. National Security Strategy and the HIV/AIDS explosion poses a formidable roadblock to both of them.

Large scale African state failure due to HIV/AIDS, in a region that is ripe to be radicalized, could pose a serious threat to U.S. security. The embassy bombings in Kenya and Tanzania show that terrorism already has an African face. With 42 million orphans potentially on the streets in the next five years, terrorist and extremist groups will have no shortage of recruits. Al Qaeda and its affiliated organizations have a proven proficiency at recruiting disaffected youth and can be expected to draw from this dramatically expanded pool.

Command and control of state armies and even rebel groups is jeopardized when a large percentage of the force believe they are “walking dead” due to their HIV/AIDS infection. A lack of discipline among the soldiers, who increasingly partake in risky behavior, or outright disobey orders, such the rapes UN peacekeepers have been recently reported to be committing in the Congo.

Russia, China, and India: HIV/AIDS in Major Regional Powers.

While the immediate results of HIV/AIDS in Africa are far and away worse than in the three largest threatened developed or developing states, the African states play but a minimal role on the global stage. The onset of an epidemic in Russia, India or China could dramatically alter the balance of power on a near global basis.

Official Russian government figures state that currently 300,000 people are living with HIV/AIDS. However, a recent study by USAID and the Woodrow Wilson Center puts the actual number at close to 900,000. However, unlike in the West where on average 70 percent the affected population is over 30, the report claims, “Over 80 percent [or Russian AIDS suffers] are under the age of 30.” The Federal Center for HIV/AIDS Treatment in Russia’s Ministry of Health estimates that five to 10 million 15-20-year-olds will have contracted the virus by 2007. The Russian military consequently has been hit hard with high infection rates.

HIV/AIDS in Russia has grown since the fall of communism. The most common form of transmission has been through intravenous drugs. The Federal Center estimates that each drug user infects, on average, two other people per year. The number of intravenous drug users in Russia is thought to be some 2.5 to 3 million. The number climbs five percent per year. The combination of an estimated one million intravenous drug users in Moscow is coupled with a flourishing sex industry spells disaster. Another breeding ground for the disease is within the Russian prison system. A pattern has been observed whereby released convicts, infected during their incarceration, bring the disease to their small towns upon release. The deadly effect of HIV/AIDS with an already decreasing Russian population, rampant alcoholism, along with declining birthrates means that Russia’s population may shrink by as much as 30 percent by 2050.

The economic effects of HIV/AIDS in Russia is much the same as in Africa, but is compounded by the country’s decreasing population. Even in African countries where HIV/AIDS is 20 percent there is still positive population growth; this is not the case for Russia. According to a 2002 World Bank study of the economic effects of HIV/AIDS in Russia, if current infection rates hold constant then Russian GDP could be up to 10.5 percent lower by 2020.

Domestically, the Russian government spends but $6 million annually on HIV/AIDS programs. In a perplexing allocation of funds, it pledged $20 million to fight the disease globally in the summer of 2002 at a UN Conference on HIV/AIDS. The government then blocked the implementation of a World Bank program in Russia to reduce tuberculosis, which often accompanies HIV/AIDS. As a result, foreign charitable organizations are the primary caregiver for Russians suffering with HIV/AIDS.

Dr. Murray Feshbach, an economist and demographer, is an expert on the HIV/AIDS crisis in Russia and authored The Woodrow Wilson Center report. He said; “If the [Russian] leadership continues to pay only lip service to the issue, the consequences in the very near term of two to three years, and certainly a decade from now, will be devastating to the society, to family formation, to the military, to productivity of labor, to continued growth of the gross domestic product and to the polity.”

Until recently, China was reluctant to admit it had an HIV/AIDS problem. UNAIDS estimated about one million Chinese suffer from HIV/AIDS, and that by 2020 that number could exceed 20 million. In seven of China’s 22 provinces strong epidemics rage, along with pockets of HIV/AIDS on the southern border where an underground drug market flourishes. Poor governmental blood transfusion techniques have complicated the matter, with a large number of new infections arriving from the widespread use of non-sterile needles during the early 1990s.

It seems the Beijing government, however, now understands the implications of the HIV/AIDS epidemic and its potential impact on the economics and investment. The Chinese government has set a series of benchmarks to reduce of the infection rate by 10 percent by 2005, along with increased education and care for half those infected by the disease.

With a population second only to China, India has the highest number of HIV/AIDS infections in the world. India’s bustling truck routes, where drivers utilize a growing sex industry, is where the majority of HIV/AIDS infections first arise and then is spread throughout the country when the drivers return to their far-flung homes. One of the signs that the general population is at risk is the astounding fact that, at any one time, as many as three percent of pregnant women are infected. Due to a large percentage of its vast population living in squalid and cramped urban areas, India could be ripe for an HIV/AIDS pandemic.

New Delhi’s response to HIV/AIDS, much like Russia’s, has been a mixture of reluctance and unachievable goals such as an April 2002 proclamation that the target infection rate for 2007 was “zero.” According to Dr. Nicholas Eberstadt, a demographer and health issue expert at the American Enterprise Institute, “this only raises questions about the seriousness of the effort overall.” The U.S. has several vital national interests related in India, China, and Russia, and could ill afford for a sub-Saharan level of the crisis in these countries. In the case of Russia, the shrinking population, combined with a massive nuclear arsenal, along with the relatively slow response to the growing issue of HIV/AIDS should be cause for concern, according to the Woodrow Wilson report. If HIV/AIDS caused a massive collapse of Russia’s economy it is highly probable that Moscow would initiate a fire sale of its weapons, especially its highly desired weapons of mass destruction and their delivery vehicles.

By JINSA Editorial Assistant Eric Koch