9 - A disaster with no name: the HIV/AIDS pandemic and the limits of governance

Summary

In the end, everyone agreed that they should do one thing: Wait and see what happens. The situation would clarify itself and then they would move.

Randy Shilts, commenting on the United States' Government's debate on how to respond to AIDS at the end of 1982.

So here I am, in the middle way, having had twenty years, twenty years largely wasted …

TS Eliot, The Four Quartets.

This is a very, very different crisis than anything we've seen before.

James Morris, Executive Director of the World Food Programme, in Southern Africa, September 2002.

Introduction

For more than a decade, for those who cared to look, it has been clear that the HIV/AIDS pandemic would inevitably cause major problems for African governance. The loss of human resources in the institutions of government, the private sector and civil society, would inexorably cause grievous economic harm, famine, declining governance capacity and risks to peace and security. To date, almost nothing has been done to address this imminent crisis. This chapter is concerned with some of the reasons for this, and what they tell us about the nature of African governance and international public policy.

Among myriad examples of lack of pace in responding to the implications of HIV/AIDS, let us select just two. The first indications of a major negative impact of the pandemic on an agrarian economy emerged in the mid-1980s, and the first studies were completed a few years later.