It is projected that, at current rates, more than 100 million people worldwide will have been infected with HIV by 2005. Where the epidemic has hit hardest, Sub-Saharan Africa, experts believe AIDS will eventually kill one in four adults. Seven countries already have adult prevalence rates above 20 per cent of the population.
Yet this pandemic may only be at its beginning. Infection rates are still rising in most African nations, and the strongest effects are only now beginning to be felt. Elsewhere, infection rates are rising at steep rates, in patterns disturbingly similar to those observed in Sub-Saharan Africa five to ten years ago. HIV infections are believed to be doubling every year in Russia and increasing rapidly across the Commonwealth of Independent States, India, China and Southeast Asia. For a growing number of states, AIDS can no longer be understood or responded to as primarily a public health crisis. It is becoming a threat to security.
ICG was founded to help prevent and end conflict in and between nations. But where it reaches epidemic proportions, HIV/AIDS can be so pervasive that it destroys the very fibre of what constitutes a nation: individuals, families and communities; economic and political institutions; military and police forces. It is likely then to have broader security consequences, both for the nations under assault and for their neighbours, trading partners, and allies.
AIDS does not itself cause wars. But it is a security issue in all the following ways:
AIDS is a personal security issue. As 5, 10, 20 per cent or more of adults become fatally ill, gains in health, longevity and infant mortality are wiped out. Agricultural production and food supply become tenuous; families and communities break apart; and surviving young people cease to have a viable future. Divisions among ethnic and social groups may be exacerbated. Economic migration and refugee seekers increase.
AIDS is an economic security issue. It threatens social and economic progress, worsening trends that we know contribute strongly to the potential for violent conflict and humanitarian catastrophe. A World Bank study suggests that even an adult prevalence rate of 10 per cent may reduce the growth of national income by up to a third. At infection levels above 20 per cent, studies show that a nation can expect a decline in GDP of 1 per cent per year.
AIDS is a communal security issue. It directly affects police capability, and community stability more generally. It breaks down national institutions that govern society and provide public confidence that the people's interests are being served. It strikes hardest at the educated and mobile - civil servants, teachers, health care professionals, police. In South Africa, as many as one in seven civil servants were thought to be HIV-positive in 1998.
AIDS is a national security issue. In Africa, many military forces have infection rates as much as five times that of the civilian population. The weaknesses it creates in militaries as well as in the pillars of economic growth and institutional endurance can make nations more vulnerable to both internal and external conflict.
AIDS is an international security issue - both by its potential to contribute to international security challenges, and by its ability to undermine international capacity to resolve conflicts. A military analyst with South Africa's Institute of Strategic Studies has warned that unless the spread of AIDS among African armies is stopped soon, it is possible that many countries, including South Africa, will soon be unable to participate in peacekeeping operations.
Countries such as Uganda, Senegal, Thailand have succeeded in slowing and even reversing the rate of infection, keeping AIDS' consequences at far lower levels than neighbouring countries. They have accomplished this through extensive education and prevention programs; by providing care and support; and above all by mobilizing national political leadership to stress that AIDS presents a challenge to the nation going far beyond its health dimensions.
Over the past year, UNAIDS has worked with global health and economic experts to define a level of resources and structure of response that will allow for an effective worldwide response. UN Secretary General Kofi Annan has now called for a "war chest" with the support of World Bank President James Wolfensohn and others. A comprehensive response will require funding this commitment at $10 billion per year. This would include preventive measures that could cut the rate of HIV prevalence among young people in Africa by 25 percent by 2005; life-extending antiretroviral therapy to 3 million people worldwide; and prophlyaxis and treatment for opportunistic infections for nearly 6 million more people with AIDS.
The international community has the opportunity to mobilise the leadership and resources to meet this goal now, with the UN General Assembly Special Session on AIDS in late June 2001, and a meeting of the G-8 industrial powers slated to focus on HIV/AIDS in July 2001. With increased international attention to the disease, and infections in many countries rising fast but not yet out of control, this is a window of opportunity that the international community, donor and recipient nations, and the business community cannot afford to miss. But the history of the AIDS crisis tells us that window will not stay open long.