Continued high rates of AIDS-related illness and death in some of the world’s poorest countries could impose unprecedented changes in their population age structures, stunt their economic development and retard their demographic transition—the change from a population characterized by short lives and large families, to one with long lives and small families. These impacts promise to leave the most seriously AIDS-affected countries even more vulnerable to political instability and civil conflict. How the world responds to the HIV/AIDS pandemic in this decade could bear heavily upon the future of global security.
Destroying the social fabric
Ninety percent of HIV-associated fatalities occur among people of working age. Like no other disease, AIDS debilitates and kills people in their most productive years. People in these age groups have largely completed formal education, and most are building or maintaining a family. Thus, the costs to social investment and social cohesiveness can be devastating in the most seriously AIDS-affected societies.
Projections suggest the disease’s most destructive period is still to come. Four trends induced by HIV/AIDS pose threats to civil stability: 1) extremely high proportions of young adults; 2) the loss of trained teachers, technicians and professionals; 3) the weakening of police units and the undermining of military readiness; and4) the staggering number of orphaned children.
|Working Age Deaths, 2000 – 2005
Death as a proportion of the working-age population over a five year period
Source: United Nations Population Division, 2003
The AIDS-induced age structure
Deaths from AIDS lead to an ominous, bottle-shaped population age structure, with very high proportions of young people in the virtual absence of older adults. Studies conclude that youthful population age structures tend to be much more vulnerable to political unrest and civil conflict than older age structures.
AIDS is consuming household savings and diminishing human capital in southern Africa.Unlike the birthrate-driven slowing of population growth that proved economically beneficial to east and southeast Asian states in the 20th century, slowed population growth in southern Africa due to AIDS deaths threatens to have the opposite effect.
A projected 10 percent to 18 percent of the working-age population will be lost in the next five years in Botswana, Zimbabwe, Swaziland, Lesotho, Namibia, Zambia, South Africa, Mozambique and the Central African Republic, primarily due to AIDS-related illness. Such high levels of adult mortality exceed those experienced in recent civil wars (such as the Afghan, Sudanese and Sri Lankan civil wars), where working-age mortality ranged from 4 percent to 6 percent in five years.
Loss of key professionals
Countries in sub-Saharan Africa are experiencing debilitating rates of illness and death among teachers, technicians and professionals in the private sector and in public services. Technicians and professionals who travel on the job appear doubly at risk of contracting HIV. Studies show that sexually transmitted HIV often spreads first through employed and educated groups, though its prevalence often plateaus at lower levels than in poorer communities.
Public agencies and private firms that provide health benefits and employ trained technicians and professionals are among the hardest hit in heavily AIDS-affected countries. In South Africa, for example, employers experience an “AIDS tax”—the sum of added expenditures for training new employees, providing health care benefits and burial fees, and frequent sick leave.
Unprecedented numbers of orphans
There are currently 14 million AIDS orphans globally and 11 million in sub-Saharan Africa alone, due to the combination of high levels of HIV infection, high fertility and the lack of access to proven anti-retroviral therapies. By 2010, the number of orphans is projected to be 30 million.
AIDS orphans are substantially augmenting the population of children on city streets.Urban street children were a concern for the public health and criminal justice systems in many developing countries even before HIV/AIDS reached epidemic proportions. Lacking in the formal education and skills to secure formal-sector employment, street children often find themselves recruited into organized crime or used as child soldiers by insurgencies or state-financed militias.
HIV/AIDS in the military
Data suggest that more than 15 percent of military personnel in as many as 20 developing countries are HIV-positive, threatening the operational readiness of their armed forces. In a few sub-Saharan African countries, more than half of the force strength is believed to be infected. AIDS-related illness and death have forced military leaders in Malawi, Nigeria, Rwanda, South Africa, Zambia and Zimbabwe to modify operational schedules or downgrade their assessment of the operational strength or readiness of units under their command.
High HIV prevalence rates hinder peacekeeping commitments and threaten the communities with which they come in contact. Without effective HIV-prevention education and affordable condoms, peacekeepers can influence the course of the epidemic in the countries to which they are deployed, in their home communities and throughout their own country. Likewise, without concerted HIV prevention, testing and treatment programs, demobilization and reintegration of combatants almost anywhere in sub-Saharan Africa is seen as a potential public health crisis.
Securing a future
International health organizations recommend a coordinated effort of HIV prevention and AIDS treatment programs in each of the seriously AIDS-affected countries. The most cost-effective preventive strategy for most communities is likely to be the “ABC approach”—promoting Abstinence or Being faithful to a single partner, and promoting and supplying Condoms to all who can benefit from their use.
A few HIV/AIDS education and prevention programs in the armed forces of developing countries have produced measurably positive results, notably in Uganda, Senegal, Morocco, Tanzania and Thailand. Such efforts should be multiplied by increasing funds to international military-to-military and civilian-to-military programs that combat the proliferation of HIV/AIDS.
- Cincotta, RP, R Engelman, and D Anastasion. 2003. The Security Demographic: Population and Civil Conflict after the Cold War. Washington, DC: Population Action International.
- International Crisis Group. 2001. HIV/AIDS as a Security Issue. Brussels: ICG.
- U.S. National Intelligence Council. 2002. The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, India, and China. Washington, DC: NIC.
- Yeager, R, CW Hendrix, and S Kingma. 2000. International Military Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Policies and Programs: Strengths and Limitations in Current Practice. Military Medicine 165: 87-92