May 17, 2000

The camera panned away from a garbage fire in the middle of the street and followed the young men who had set it. The men were calling to a nearby band of demonstrators. “The people are afraid they might be provocateurs, under orders from Castro,” said the television announcer. “This is rowdier than most Miami traffic jams, but it isn’t a riot; it’s the beginning of a catharsis.”

South Africa has the world’s second largest AIDS epidemic (in gross numbers). Its neighbor, Zimbabwe, ranks first. During the past ten years, while AIDS has come under control in central African countries with far fewer resources, the disease has gone out of control in South Africa, in the richest, most cosmopolitan nation in the whole sub-Saharan region. An estimated 10 million South Africans, out of a population of approximately 40 million, will die of AIDS during the next ten years.

The aids epidemic is so widespread in some countries that U.S. officials fear it could undermine economies, destabilize governments, threaten military establishments and create other regional problems. Here are a few indications of the magnitude of the problem—with a particular focus on sub-Saharan Africa, where the epidemic is worse that anywhere else in the world:

When Sister Raphaela Händler arrived in Namibia in 1996 to coordinate the country’s Roman Catholic hospitals and health-care clinics, she realized that AIDS was a “time bomb” about to burst. She had worked previously in Tanzania, and had seen the AIDS pandemic spread there. Although Namibia was years behind Tanzania in the spread of this disease, the pattern was similar. Namibia was heading for disaster.