Hivaids State Capacity and National Security Lessons from Zimbabwe1

The HIV/AIDS pandemic continues to spread inexorably throughout the developing countries, proliferating from its established base in sub-Saharan Africa to infect millions in India, Eastern Europe, and East Asia. In 2005 the pandemic claimed 2.8 million lives and generated 4.1 million new infections, bringing the number of people currently infected to 38.6 million.2 Despite the increasing production of anti-viral therapies, access to them remains limited in the developing countries, and resistant strains of HIV have begun to proliferate.

According to UNAIDS' 2006 Report on the Global AIDS Epidemic, the contagion is showing signs of slowing as increases in incidence begin to plateau in certain countries. However, a deeper analysis of UNAIDS' annual data on incidence and prevalence suggests otherwise. Specifically, while there may be selected geographically specific pockets of stabilization (and even amelioration) of HIV, the larger story is one of a pandemic that continues to expand into new geographical domains even as it remains entrenched within its epicenter in sub-Saharan Africa. UNAIDS' interpretation of the data is unusual, as UNAIDS prefers to emphasize the point that the epidemic appears to have slowed its expansion (in terms of prevalence as a percentage of population). However, this is a function of both aggregate population growth and the fact that mortality from HIV/AIDS now equals or exceeds the rate of new infections. Thus, stabilized prevalence does not necessarily equate with an epidemic that has reached an epidemiological equilibrium or "plateau"; it is simply killing more people faster than ever before. (See figure 4.1.)

Globally, the HIV/AIDS pandemic resulted in 4.3 million new infections in 2006, and over 39.5 million people are now HIV positive.3 Using UNAIDS data on incidence of HIV, I have calculated the rate of vo o

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