by Norman Lowe
Why was the epidemic so much worse in southern Africa?
HIV was able to spread more quickly in conditions of poverty, where there was very little access to information and education about the virus and how to prevent it spreading. Widespread hunger reduced resistance to the disease and accelerated the progress from HIV to AIDS. Nor were any of the expensive anti-retroviral drugs available for Africans. The large number of civil wars in Africa produced thousands of refugees, who were often cut off from their normal healthcare services. In emergency situations like these, there was a greater danger of the HIV virus being spread through contaminated blood. Most African governments took a long time to acknowledge what was happening, partly because of the stigma attached to the disease: the belief that it was caused by homosexual sex and the general reluctance to discuss sexual habits. South Africa itself was one of the slowest to take action, mainly because President Mbeki refused to accept the link between HIV and AIDS.
(c) What is being done to combat AIDS?
The experts know what needs to be done to bring the AIDS epidemic under control: people must be persuaded to have safe sex and use condoms; and somehow governments must be able to provide cheap ARV treatment. Brazil is one country where the campaign has slowed down the spread of the disease. In Africa, governments have concentrated on the so-called ‘ABC’ message: ‘Abstain from sex. Be faithful to one partner, and if you cannot, use a Condom.’ Uganda provides the great African success story; the government admitted to the WHO in 1986 that they had some AIDS cases, and President Museveni personally took charge of the campaign, travelling round from village to village to talk about the problem and what should be done. Uganda was the first country in Africa to launch the ABC campaign and provide cheap condoms for its people. People were encouraged to come forward voluntarily for testing. The programme was financed jointly by the government, by aid agencies and by religious organizations and churches. Uganda’s meagre resources were strained to the limits, but the campaign worked, even though very few people had access to ARV drugs: Uganda’s HIV prevalence rate had peaked at 20 per cent in 1991, but by the end of 2003 it had fallen to about 5 per cent. The epidemic had passed its acute stage, but the problem of orphaned children was just reaching its height.
Elsewhere in Africa and China, governments were slow off the mark and the epidemic took a firmer hold, reaching crisis proportions in 2003. Some African countries were beginning to follow Uganda’s example. In Malawi, President Muluzi set up an AIDS commission and appointed a special minister to deal with the problem. But huge sums of money are needed to finance the necessary three-pronged attack on HIV/AIDS across Southern Africa:
ABC campaigns or some equivalent;
anti-retroviral drugs – these are much cheaper now, since pharmaceutical companies gave way to political pressure and allowed drugs to be supplied more cheaply to poorer countries;
healthcare systems and infrastructures, which in most poor states need modernizing in order to cope with the magnitude of the problem; more doctors and nurses are required.
There are several international agencies trying to deal with the disease, the most important being the UN’s Global Fund to Fight AIDS, TB and Malaria; the World Health Organization (WHO); and UNAIDS. In December 2003, UN secretary-general Kofi Annan complained that he was ‘angry, distressed and helpless’; 1 December was World AIDS Day, but the outlook was bleak. Reports from all over the Third World showed that the war against the disease was being lost; the virus was still spreading and 40 million people were living with HIV. The UN Fund said it would need £7 billion by 2005 and the WHO wanted £4 billion. Many wealthy countries have given generously; the USA, for example, has promised $15 billion over the next five years, but insists that the money be spent in the way it specifies. The Bush administration favoured programmes which promoted abstinence against those that advocated the use of condoms. The Roman Catholic Church also continues to oppose the use of condoms, even though scientists have shown that it is the best means of prevention available. No wonder Kofi Annan was angry; ‘I am not winning the war’, he said, ‘because I don’t think the leaders of the world are engaged enough.’
By 2012 well over 30 million people had died from AIDS since the first cases were identified in 1981. An estimated 1.8 million of them died in 2010 alone, two-thirds of them in southern Africa, where nearly 15 million children were left orphaned. In the same year around 2.7 million people became infected with HIV. According to the WHO, the attempts to control the epidemic have been intensified; from 2002–8 spending on the campaign in low- and middle-income countries increased sixfold. Since 2008 spending has not increased, but at least the level has been maintained. In May 2012 the WHO published a plan of priority action for the next two years: focusing on HIV prevention, encouraging people who might be at risk to get themselves tested regularly, providing even wider access to cheap ARV drugs and improving and modernizing healthcare systems, especially in southern Africa. There were some encouraging signs: more people than ever before were receiving ARV treatment, the annual number of AIDS deaths had declined and the global percentage of people infected with HIV seemed to have stabilized. However, the UN agencies warn that recent achievements should not lead to complacency; on no account should efforts be relaxed. In fact in eastern Europe infection rates were still rising; and in the USA in June 2012 more than one million people were living with HIV, but probably 20 per cent of them didn’t know they were infected.
FURTHER READING
Baker, R., ‘Degrading Democracy: American Empire, Islam and Struggles for Freedom in the Arab Islamic World’, in S. Shehata, S. (ed.), Islamic Politics in the Middle East (Routledge, 2012).
Berman, P., Terror and Liberalism (Norton, 2004 edition).
Connelly, M. J., Fatal Misconception: The Struggle to Control World Population (Harvard University Press, 2008).
Barnett, D. and Whiteside, A., AIDS in the 21st Century: Disease and Globalisation (Palgrave Macmillan, 2002).
Epstein, H., The Invisible Cure: Africa, the West, and the Fight Against AIDS (Viking, 2007).
Fassin, D., When Bodies Remember: Experiences and Politics of Aids in South Africa (University of California Press, 2007).
Liotta, P. H. and Miskel, J. F., The Real Population Bomb: Megacities, Global Securities and the Map of the Future (Potomac Books, 2012).
QUESTIONS
Explain the causes and consequences of the rapid growth in the world’s population during the twentieth century.
What methods were used to try to control population growth in the second half of the twentieth century, and why did some of them arouse criticism?
Why was it that in the second half of the twentieth century the rate of population growth in Europe slowed down, while in Africa and other Third World areas it accelerated?
There is a document question about the HIV/AIDS epidemic on the website.
Index
Abacha, Sani 569
Abbas, Mahmoud 239, 250, 252, 253–4
Abdelazia, Mohamed 556
Abdullah, King of Saudi Arabia 282, 291
Abiola, Mashood 569
Abubakar, General Abdulsalam 568, 569
Abu Nidal Organization (ANO) 262
Abyssinia see Ethiopia
Acerbo Law (1923) 300
acid rain 646
Acheampong, Ignatius 566
Adenauer, Konrad 188–9
Afghanistan 161–2, 208, 258–9, 264, 267–9, 277–9
Africa 4, 8, 9, 35, 37, 73–5, 118
decolonization 529–30, 541–4, 555–7, 559–61
pan-Africanism 533
problems in 563–606
Second World War in 89, 94–5, 100
underdevelopment of 564
African National Congress (ANC) 263, 585–6, 588–91
Agadir Crisis 7, 9
Agricultural Adjustment Administration (USA) 494–5
Ahmadinejad, Mahmoud 280–2
AIDS/HIV 174, 654, 667, 671, 679–82
<
br /> in South Africa 590–1
in southern Africa 573, 598, 680
Ai Weiwei 455
Akufo, General Fred 566
Albania 75, 94
since 1945 204, 211
Albright, Madeleine 519
Alexander, King of Yugoslavia 61
Algeciras Conference (1906) 8
Algeria 282
struggle for independence 550–3
Alia, Ramiz 211
Allende, Salvador 155–7, 672
Alliance for Progress 611
allied air offensive 102–4, 109
alphabet agencies 498
al-Qaeda 262, 266–70
Alsace-Lorraine 4
America see Latin America, South America, United States of America
American Federation of Labor (AFL) 481–2
American International Group (AIG) 655–8
American Railway Union (ARU) 482–3
Amin, Idi 573
Andropov, Yuri 402
Anglo-German Naval Agreement (1935) 69, 73, 77
Anglo-Japanese Alliance (1902) 4
Angola 557, 577–9
Annan, Kofi 184, 605
Anschluss 70
anti-ballistic missiles (ABMs) 521
Anti-Comintern Pact (1936) 69, 75
anti-communism (USA) 511–13
Anzacs 22
apartheid 584–90
end of 587–90
introduced 584–5
opposition to 585–7
appeasement 78–80
April Theses (Lenin) 357
Arab League 227
‘Arab Spring’ 259, 282–91, 675
causes of 283
Arabs 172, 225–56
Arafat, Yasser 234, 238–40, 247, 262
Arbenz, Jacobo 619
Arévalo, Juan José 618–19
Argentina 608, 610, 622, 626–7
Aristide, Jean-Bertrand 611
Armenia 164, 382, 406
Arusha Declaration (1967) 572–3
Ashmun, Jehudi 593
Assad, Bashar 283
Assad, Hafez 243
Assange, Julian 630
Association of South-East Asian Nations (ASEAN) 456
Atlantic Charter (1941) 532
Attlee, C.R. 126, 534–5
Australia 22, 650
Austria (since 1918)
between the wars 64–5
since Second World War 134, 194, 198
union with Germany (1938) 77
Austria-Hungary (before 1918) 3, 4, 7–11
break-up of 31, 38–9
during First World War 18, 20–1, 23, 25, 29, 30
peace settlement 38–9
responsibility for First World War 12–16
autocracy, meaning 4
Axis, Rome–Berlin (1936) see Rome–Berlin Axis
‘axis of evil’ 266
Azerbaijan 164, 382, 400
Azikiwe, Nnamdi 543, 567
Babangida, Major-General Ibrahim 569
Bachelet, Michele 622, 627
Baghdad Pact (1955) 229
Bahrain 282
Balewa, A.T. 567–8
Balfour Declaration (1917) 230
Balkan Wars 7, 9–11
Banda, Dr Hastings 546
Bangladesh 670, 673
Ban Ki-moon 651
Bantu Self-Government Act (1959) 585
Barak, Ehud 248
Barthou, Louis 80
battles
Adowa (1896) 73
Arnhem (1944) 107
Atlantic (1942–3) 102
Britain (1940) 93–4
‘Bulge’, the (1944) 107
Cambrai (1917) 27
Caporetto (1917) 27
Dien Bien Phu (1954) 150, 455, 550
El Alamein (1942) 100
Falkland Islands (1914) 25
Jutland (1916) 26
Marne (1914) 19–20
Masurian Lakes (1914) 20
Midway Island (1942) 99–100
Monte Cassino (1944) 104
Passchendaele (1917) 27
Somme (1916) 24
Stalingrad (1942) 101
Tannenberg (1914) 20
Verdun (1916) 23–4
Vittorio Veneto (1918) 30
Ypres (1914) 19 (1915) 20 (1917) 27
Bay of Pigs 137, 148
Bear Stearns Bank 655
Begin, Menachem 237–8
Beijing (formerly Peking) 70, 162
Belgium 3, 11, 89, 91, 192–3, 197
and decolonization 555–6
Belize 537–9
Belorussia 407
Ben Bella 551–2
Beneš, Edvard 62, 81, 131
Bengal 536, 560
Berlin 107
blockade and airlift 131–2
divided after Second World War 126
wall 135–6, 210
Berlusconi, Silvio 190
Bernanke, Ben S. 654–5
Betancourt, Romulo 614
Bethmann-Hollweg, Theobald von 14–16
Beveridge Report (1942) 119
Bevin, Ernest 191, 534
Biafra 543, 568
Biko, Steve 587
bin Laden, Osama 258, 262, 266–70, 278
Bizimungu, Pasteur 582
Black Muslims 509–10
Black Panthers 489, 510
Black Power 510
Blair, Tony 271–2, 596
Blitzkrieg 90, 96, 109
Blum, William 260, 265
Boers 583
Boko Haram 571
Bolivarian Alternative for the Americas (ALBA) 630–1
Bolívar Plan (Venezuela, 2000) 623
Bolivia 608, 610, 622, 627–9
Bolsheviks 51–8, 354, 360, 361–8
seize power 60, 357–9
bombing 89–91, 93–4, 96, 99–100, 102–4, 153, 345
Bosnia 7, 8–9, 176, 212, 214–15
Botha, P.W. 587–88
Botswana 680
Boutros-Ghali, Boutros 582
Boxer Rebellion (1899) 421
Bo Xilai 445–6
Bo Zhiyue 446
Bracher, Karl Dietrich 111, 318
Brandt, Willi 189
Brandt Report (1980) 638–43
Brazil 608, 612–14, 622, 624–5, 643, 662–3
Brezhnev, Leonid 396
Brezhnev Doctrine 206
Briand, Aristide 54
BRIC nations, meaning 661
Britain, Great 132, 145, 169
and China 4
and decolonization 529–32, 534–48
economy 3
and the European Community 192–6, 197–9, 218
and First World War 18–32
foreign policy between the wars 50–5, 57–9, 74, 77–83
and Germany before 1914 4, 8–9, 12–13
and India 534–7
and the League of Nations 47–8
and the Middle East 172, 227–34
and the peace settlement 32–3
and Russia 7–8, 58–9, 365
and Second World War 89–91, 93–4, 100–10
and South Africa 583–91
and Suez 172, 232–4
and the war against terrorism 268–9, 271–9
British Expeditionary Force (BEF) 19–20
British Honduras see Belize
Broszat, Martin 76, 332
Brown, Gordon 656
Brusilov, General 25, 355
Brussels Defence Treaty (1948) 132
Bukhari, Major-General 569
Bukharin, Nikolai 373–5, 380, 394
Bulgakov, Mikhael 399
Bulgaria 9–10
and the Peace Settlement 39–40
since 1945 204, 211
Bullock, Alan 116
Burma 89
Burundi 580–1
Bush, George 246–7, 518, 624
Bush, George W. 170, 260–1, 453, 520–3, 650, 652, 656
and Afghanistan 266–9, 271–5
and Iraq 270–7
Busia,
Kofi 566
Cambodia (Kampuchea) 158, 175, 457–62
Cameron, David 255, 278
Camp David 237–8, 515
Campaign for Nuclear Disarmament (CND) 139–40
Canada 19, 132, 145
capitalism, meaning and nature of 123
Capone, Al 450
Cárdenas, Lázaro 616
Cardoso, Francesco 613–19
CARICOM (Caribbean Community and Common Market) 539
Carmichael, Stokeley 510
Carnegie, Andrew 477
Carter, Jimmy 237, 515, 621
Castro, Fidel 137, 147–9
Ceauşescu, Nicolae 211
Central African Federation 546
Chamberlain, Austen 54
Chamberlain, Neville 70, 82
Chamorro, Violeta Barrios de 662
Charter 77 207
Chávez, Hugo 608–9, 615, 622–4, 630
Chechnya 411–12, 414–18
Chernenko, K.U. 402
Chernobyl 403, 646–7
Chiang Kai-shek 420, 423–9
Chile 155–7, 608, 610, 622, 627
China 420–46
before 1949 4, 420–9
becomes communist 425–9
communist rule in 431–46
economic advance 662
and Japan 69, 70–2, 118, 336–8, 421–2
and Korea 142–6
and Latin America 609, 623, 624
and population control 674
and USA 142–6, 162–3, 514
and Vietnam 152–5
Chirac, Jacques 187–8, 219
chlorofluorocarbons (CFCs) 646
Chomsky, Noam 261, 265, 628, 631
Chongqing 445
Churchill, Sir Winston 13, 22, 82, 126, 129, 191, 233
Civilian Conservation Corps (CCC) 495
‘civilization struggle’ 269–70
Civil Rights Movement (USA) 486–9, 505–11
Civil Rights Acts (USA) 506, 509
civil wars
Angola 557, 577–9
Congo 574–5, 576–7