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• W2122935863 abstract "The contemporary AIDS epidemic can be compared with the other major visitations of pestilence. In Europe 20 million or more people probably died during the Black Death in 1347-1351, and globally perhaps 20 million died during the 1917-1919 influenza epidemic. By the end of 1996 the world estimates for the AIDS epidemic were over 6 million dead and a further 23 million seropositive and nearly all certain of death. In numbers dying, the AIDS epidemic will certainly far exceed both other historic epidemics, although no-one knows the total mortality in Europe and Asia for the Black Death. The reason for the inevitability of greater mortality from AIDS is the open-endedness of the present epidemic. Both the previous epidemics just cited were over in three or four years, and it is this relatively short duration which was thought to characterize epidemics. In contrast, the first AIDS cases were identified in 1981, the result of infection mostly over the previous decade. Thus, the AIDS epidemic is already a quarter of a century old, and the level of infection is still climbing both globally and in the Third World. There is no evidence as yet about its likely duration or even whether it will become endemic in some parts of the world. There are, however, contrasting aspects of the disease. World population is now three times its level in the early twentieth century and ten times that of the fourteenth century. Population growth rates in most of the Third World are now so high that even a huge rise in mortality may not cancel them out, and we are not yet certain that any country will experience a decline in population size because of AIDS. In comparison, the Black Death ravaged a nearstationary population, reducing Europe’s numbers by perhaps one-third. The high population growth rates of the developing world have come about because of continuing high fertility together with declining mortality which has raised life expectancy even in sub-Saharan Africa to almost 50 years. Thus, the most pessimistic projection of the present epidemic does not show the expectation of life at birth falling to as low a level as 30 years in any sub-Saharan African country, while the influenza epidemic reduced India’s expectation of life for the whole intercensal decade, 1911-1921, to 18.5 years. Nevertheless, there is in Africa a contemporary AIDS epidemic which in its intensity and in its impact on the population can be likened to the plague. In its intensity it is quite unlike anything experienced by national populations outside sub-Saharan Africa, although some sectors of other populations, such as homosexuals in the United States, may have comparable experiences. This severe epidemic is identified in Table 1 and Map 1. The affected population is found in a long belt stretching from the Central African Republic and southern Sudan through Uganda, Rwanda, Burundi, Kenya and Tanzania to Malawi, Zambia, Zimbabwe, Botswana, South Africa and Namibia. The map, but not the table, identifies southern Sudan, which has been omitted from the table both because it is not a national population and because HIV testing is so poor as to be suggestive rather than definitive. In South Africa, KwaZuluNatal has been disproportionately affected (and the major city in the table is not Johannesburg * In this concluding chapter, other chapters are referenced by providing only the author’s name and no date. All other publications are referenced with the year of publication. Assistance has been provided by Jeff Marck, Wendy Cosford and Pat Goodall of the Australian National University’s Health Transition Centre." @default.
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• W2122935863 date "1997-01-01" @default.
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• W2122935863 title "The impact of the African AIDS epidemic" @default.
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