Fatal Destiny

The venue for this week's 13th International Aids Conference is tellingly close to the cutting edge of a continental apocalypse. Outside Durban, in some parts of rural KwaZulu-Natal, the hiv-aids infection figures are among the highest in the world. South Africa, the most developed economy in the subcontinent, is facing a devastating onslaught of the disease, with 4.2 million people infected 10% of the population. In the space of five days, during which more than 10,000 delegates will discuss the subject, there will be at least 9,000 new hiv infections in South Africa, 2,600 progressions from hiv to aids, and 1,800 deaths.

Researchers and medical experts say that the situation is worse than a disaster because most disasters have a foreseeable end. There is none in sight to the advance of aids across Africa. With areas of high population density, extreme poverty, migrant labor and dysfunctional family life, South Africa is a microcosm of the way aids can spread and the socioeconomic fallout of the pandemic. According to a recent survey by ING Barings, the international corporate and investment bank, one third of the country's semiskilled and unskilled work force will be HIV-positive in 2005. Apart from the immediate human cost, researchers say productivity could slump by 50%. "aids will define the future structure and shape of society and the business environment in Africa," says Alan Whiteside, one of the country's leading aids experts.

The approach to the problem in South Africa has become sadly snared in controversy and bureaucratic red tape. Last month, when the South African government announced a five-year strategic plan against aids, many skeptics were asking whatever happened to a similar initiative drawn up in 1994. President Thabo Mbeki, always an eloquent campaigner for aids awareness, added to the mixed signals by inviting onto his aids advisory panel scientists who question the link between hiv and aids. Such a dispute in a country standing "on the cusp of a horror," says University of Pretoria researcher Hein Marais, is tantamount to telling firemen to put down their hoses and argue about the causes of the fire.

Last week, in advance of the Durban conference, some 5,000 doctors and scientists from aids research centers around the world signed a declaration saying that the evidence that aids is caused by hiv is "clear-cut, exhaustive and unambiguous" and that the battle against aids needs "research, not myths."

A spokesman for the office of President Mbeki, who was due to open the Durban conference at the weekend, described the doctors' declaration as rubbish. While the debate rages, so too does the plague that is laying waste the homelands of Africa.