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date: 25 April 2019

HIV/AIDS epidemic

A Dictionary of African Politics

Nicholas Cheeseman

HIV/AIDS epidemic 

The outbreak of the human immunodeficiency virus and acquired immune deficiency syndrome that is estimated to have killed over 15 million people in Africa by 2011. It is now believed that the virus spread to humans from chimpanzees in west-central Africa in the early twentieth century. This could have happened when humans hunting chimpanzees for meat came into contact with blood infected with simian immunodeficiency virus (SIV). It is thought that at this point, the virus mutated into HIV, which can be spread in humans when the blood, semen, vaginal fluids, or breast milk of someone who is infected enters the bloodstream of someone who is not, for example through sexual intercourse or blood transfusions. Although AIDS was first clinically observed in the United States in 1981, the earliest known case of HIV infection was found in a blood sample from a man in Kinshasa in what is now the Democratic Republic of Congo in 1959. Explanations of the devastating impact of HIV/AIDS in Africa are numerous and have often proved to be highly contentious. Early suggestions by some Western researchers that the high prevalence of HIV was related to promiscuous sexual practices were subsequently challenged both on the grounds of their empirical accuracy and on the basis that they propagated racist assumptions about the continent. Alternative explanations have included the fact that the outbreak began in Africa well before the virus was identified and understood, the weak and underfunded nature of African public health systems, patterns of labour migration, and the emergence of social taboos that militate against talking about the disease. Political factors also contributed to the crisis, with some leaders failing to respond quickly or effectively. Most famously, South African President Thabo Mbeki adopted a policy of AIDS denialism from 1999 to 2008, which rejected Western scientific explanations of the onset of the illness. Mbeki’s decision to search for alternative medicines and to deny the use of antiretroviral drugs to South African citizens—including mothers who risked passing on the virus to their children—is estimated to have led to 330,000 unnecessary deaths according to a Harvard University study. Although considerable progress was subsequently made in both treating the disease and preventing the transmission of HIV, the World Health Organization estimates that as of 2016 nearly one in every twenty-five adults on the continent was living with HIV—some two-thirds of those living with the disease worldwide. Given this, it is important to note that the impact of HIV/AIDS has been found to be both shaped by and to reinforce gender inequalities. For example, it is estimated that in the 15–24 age group in eastern and southern Africa, women are twice as likely to be infected with HIV as men.