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Africa's AIDS Crisis in Context: 'How the Poor Are Dying'

Nana K. Poku

Third World Quarterly

, Vol. 22, No. 2. (Apr., 2001), pp. 191-204.

Stable URL:http://links.jstor.org/sici?sici=0143-6597%28200104%2922%3A2%3C191%3AAACIC%27%3E2.0.CO%3B2-7

Third World Quarterly

is currently published by Taylor & Francis, Ltd..Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available athttp://www.jstor.org/about/terms.html. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtainedprior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content inthe JSTOR archive only for your personal, non-commercial use.Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained athttp://www.jstor.org/journals/taylorfrancis.html.Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printedpage of such transmission.The JSTOR Archive is a trusted digital repository providing for long-term preservation and access to leading academic journals and scholarly literature from around the world. The Archive is supported by libraries, scholarly societies, publishers,and foundations. It is an initiative of JSTOR, a not-for-profit organization with a mission to help the scholarly community takeadvantage of advances in technology. For more information regarding JSTOR, please contact support@jstor.org.http://www.jstor.orgThu Jan 24 18:12:01 2008

Third World Quarterly, Vol22, No 2, pp 191-204, 2001

Africa's

AIDS

crisis in context: 'howthe poor are dying'

NANA

K

POKU

ABSTRACT

The 13th International Conference on

AIDS

held in Durban, SouthAfrica, highlighted the social catastrophe unfolding on the African continent. Themeeting took place in the country with the largest number of people infected byHIV-the virus that causes AIDS-on the continent that is home to 70% of theworld's HIV-infected opulation. The cruel irony of the unfolding human tragedyis that Africa is also the least equipped region in the world to deal with the multi-plicity of challenges posed by the

HIV

virus. Drawn from ongoing research insouthern Africa, this article charts the relationship between poverty,

HIV

preva-lence and the politics of global response.

Of the 30 new viruses that emerged during the last quarter of the 20th century, 20still remain immune to standard chemotherapeutical control and mutation ratesare such that any synthetic antidote rapidly becomes obsolete.' With 35 millionpeople infected worldwide, the Human Immunodeficiency Virus(HIV) s by farthe most prevalent of these new incurable viruses. Despite two decades of intenseresearch, its origins remain obscure.' What is accepted, however, is that

HIV

is azoonosis; that is, it is a human disease acquired from animals. The virusevidently evolved from a Simian Immunodeficiency Virus (srv): a type of slowvirus found naturally in monkeys and apes which, while not harming its host,produces diseases in other primates. Amid the usual wild allegations and implicitracism-wide tribal sexual practices with monkeys (the suggestion of aCambridge virologist) or some magical practices involving blood drinking-howthe virus crossed the species barrier remains unclear. Although the historicalepidemiology poses 'daunting difficulties', the political ramifications are evenmore imposing. Identifying an origin automatically means pointing an accusingfinger and who would accept being stigmatised as the group or nation that gaveHIV-the cause of Acquired Immune Deficiency Syndrome (AIDS)-to the world?As a consequence, the biological and geographical origins of the

HIV

virus remainobscure. This notwithstanding, the virus now represents the gravest threat tohuman life in the developing world, where

90%

of all infected persons re~ide.~Nowhere is

HIV

more firmly established than in sub-Saharan Africa, where anestimated 23.5 million people infected with the virus live (see Table

I).

The cruelirony, of course, is that Africa is the least equipped region in the world to dealwith the multiplicity of challenges posed by this deadly virus. Infection levels are

Nana

K

Poku

is

at

the

Department

of

Politics at the

University of

Southampton,

Highfield,

Southampton

SO1

7

I

BJ, UK.

ISSN

0143-6597 print; 1360-2241 online/01/020191-14

0

2001

Third

World

Quarterly

DOI:

10.1080/01436590120037027

191

NANA

K

POKU

TABLE



Regional

HIVIAIDS

tatistics and features, June

2000

Region Epidemic Adults and Adults and Adult Percent of Main mode(s)started children children prevalence HIV-positive of trartsmissionliving with newly rate adults who for adultsHIV/AIDS infected

(%)I

are women living withwith

HIV

(%)

HIV/AIDS~

Sub-Saharan late 1970s- 23.3 million 3.8 million HeteroAfrica early 1980sNorth Africa and late 1980s 220 000 19 000

IDU,

HeteroMiddle EastSouth and late 1980s6 million1.3 million HeteroSoutheast AsiaEast Asia and late 1980s 530 000 120 000

IDU,

Hetero,Pacific

MSM

Latin America late 1970s-1.3 million150 000

MSM, IDU,

early 1980s HeteroCaribbean late 1970s-360 000 57 000Hetero,

MSM

early 1980sEastern Europe early 1990s 360 000 95 000

IDU, MSM

and Central AsiaWestern Europe late1970s-52000030 000

MSM. IDU

early 1980sNorth America late 1970s- 920 000 44 000

MSM, IDU,

early 1980sHeteroAustralia and late 1970s- 12 000 500

MSM. IDU

New Zealand early 1980s

TOTAL 33.6 million 5.6 million

Source:

WHO~UNAIDS.

'

The proportion of adults (15 to 49 years of age) living with

HIVIAIDS

n 1999, using 1998 population numbers. 

MSM

(sexual transmission among men who have sex with men),

IDU

(transmission through injecting drug use), Hetero (heterosexual transmission). 

highest, access to care is lowest, and social and economic safety nets that mighthelp families cope with the impact of the epidemic are badly frayed-in partbecause of the epidemic itself. There are already signs that

HIV

is threatening towipe out the fragile development gains achieved over many decades. A newmeasure published by the United Nations Development Programme

(UNDP)

calculates the percentage of the population currently alive that can expect to liveto celebrate their 60th birthday. Fewer than

50%

of Africans currently alive areexpected to reach the age of 60, compared with an average of 70% for alldeveloping countries and

90%

for industrialised countries.Wrawn from fieldresearch this paper details the impact of the

HIV

virus on African societies.Specifically, the paper is divided into three sections: the first section draws oncommunity-based research to explore the relationship between poverty and the

of 00

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