HIV/AIDS has been with us for decades. Most of us have had friends sicken and die, wasted and frail. We have seen it move from being spoken of in hushed, shamed voices to being bill-boarded and featured in Tony Award winning plays and TV dramas. Global clothing companies take it on as a cause celebre. In some ways, in the wealthy countries, it is under control – not stopped, no cure, but not threatening with explosive growth.
In Africa life is different. Without western wealth, medicine, infrastructure the disease is long past individual, and even community, tragedy. Entire societies are riven, and unlike the body itself, societies do not simply lie down and die.
The epidemic accounts for seven out of ten military deaths in South Africa and kills more Ugandan soldiers than any other cause, including a brutal twenty-year insurgency and two wars in Congo. AIDS deaths have reduced Malawi’s forces by 40 percent. Mozambique can’t train police officers fast enough to replace those dying of the disease. “As we fight the enemy, the HIV is also fighting us,” John Amosa, a forty-five-year-old AIDS-afflicted Ugandan sergeant, told me. “We have two front lines.”
When the status quo of life expectency is replaced by death, rapid, mysterious and painful all other expectations begin to collapse as well. Friendships, families, neighborliness collapse. When the elite of the countries — and the ranks of the military are surely among them — is stricken in large numbers, brutality and violence, random and organized, begin to rule; messiahs with apocalyptic answers, with scapegoats to be sacrificed, with weapons to be used, appear and sow their own ghastly strife and ruin.
As long ago as April of 2000, the Clinton Administration understood the implications of AIDS as a security threat both within and between countries; even the National Security Council was engaged. It is encouraging to read that early initiatives bear fruit.
The Navy—whose Naval Health Research Center is a leader in military research on behavioral issues—oversees and funds prevention and treatment programs in sixty-seven countries. In Vietnam, U.S. forces teach AIDS prevention to the army they once fought. In Ukraine, they’re setting up testing and counseling centers. In India, they’re providing clinical training and lab support. “We can’t just sit back and wait until the crisis is fully blown and treat every problem like it’s the nail and we’re the hammer,” says Wald.
Of course it is sad commentary that it takes fear for our own skins to bring us to help others. But somehow we learn. Security is not at base a matter of having the biggest guns. It is always about health, food, shelter, habitat and mutual aid. That the Department of Defense is participating is a very good sign.
For more on this from the Public Library of Science, an on-line peer reviewed medical research journal go here.