Report on the Global HIV/AIDS epidemic

Waking up to devastation

Waking up to devastation
Since the early 1990s, it has been clear that HIV would help undermine development
in countries badly affected by the virus. Warnings about falling life expectancy,
increasing numbers of orphans, extra costs for business and the destruction of family and community structures are not new.
These effects are becoming increasingly visible in the hardest-hit region of all, subSaharan Africa, where HIV is now deadlier than war itself: in 1998, 200 000 Africans
died in war but more than 2 million died of AIDS. AIDS has become a full-blown
development crisis. Its social and economic consequences are felt widely not only
in health but in education, industry, agriculture, transport, human resources and the
economy in general. This wildly destabilizing effect is also affecting already fragile
and complex geopolitical systems.
As a result, AIDS is rapidly becoming the key issue for human security in subSaharan Africa. AIDS in Africa was chosen as the theme for the United Nations
Security Council meeting on 10 January 2000 - the first time that body had dealt
with a development issue.
The demographic impact of AIDS
The population chimney
It is now clear that the population structures of badly affected countries will be radically altered by HIV. And that can only mean massive changes in the way societies
organize themselves, make a living and care for the needy.
In developing countries, population structure is generally described as a pyramid,
reflecting the demographer's traditional depiction of populations according to age
group, with men on one side of a central axis and women on the other. The shape
of the pyramid is determined by both birth and death rates. When both are high, the
pyramid has a wide base and tapers off steadily with increasing age. As health
improves and fertility falls, the older age groups grow larger than the younger age
groups, and the pyramid becomes more of a column.

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