By Alexander Rose

The National Post (Canada) 4 May 2000

President Bill Clinton decided to list AIDS as a "threat to U.S. national security" on the very same weekend that a massive Gay Pride parade assembled at the Washington Monument to cheer Al Gore's candidacy. The backscratching paid off. On Sunday, the vice-president obediently said he wants to expand the definition of "national security" to include health and education issues.

First among these is the epidemic of HIV/AIDS ravaging sub-Saharan Africa, which might spread to these shores. It is reported that nearly 70% of the world's HIV and AIDS victims live (and die) there, while a quarter of the population is expected to die of AIDS in the next decade.

These figures are dubious. If there is an epidemic, why is it confined to sub-Saharan Africa while North African (i.e., Muslim) Egypt has recorded a "mere" 215 AIDS-related deaths since the early 1980s? Even within sub-Saharan Africa, why is it that Nigeria and Cameroon report very few cases while Rwanda, Uganda, Zaire and Kenya are apparently stricken with the virus? Why is the disease thought to be afflicting men and women of all backgrounds and locales in sub-Saharan Africa while North American cases are almost exclusively promiscuous homosexuals and drug addicts?

Some have suggested that the sub-Saharan angle appeals to liberal Westerners imbued with colonialist instincts towards the "heart of darkness." We've all heard the story about the philandering truck driver ploughing his way through hordes of teenage girls, a neo-Victorian image that reminds us of rubber-lipped savages ravishing the village strumpet with her National Geographic-breasts. As Tom Bethell of the American Spectator pithily says: it's "Beverly Hills morals imputed to African villagers."

But the most important question is: Are we sure that the millions of victims in sub-Saharan Africa are suffering from HIV/AIDS? Some, like Africa veteran Charles Geshekter at the California State University, aren't so sure. He points out that in North America, AIDS patients are certified as HIV positive and suffer from any one or more of 30 diseases or conditions.

To qualify as an AIDS victim in sub-Saharan Africa, however, there is no need to test positive to HIV, let alone undergo a test at all. As a result, the narrow North American definition of AIDS has been swept aside, and we're using in its stead a sprawling catch-all. If some unfortunate soul contracts malaria or tuberculosis, or even succumbs to a "prolonged fever, weight loss of 10% or greater, and prolonged diarrhoea," he or she will probably be catalogued as an AIDS victim.

It's easy to see how the numbers, especially in the absence of rigorous surveillance, can balloon into an "AIDS epidemic" of Black Death proportions. As even a paranoiac CIA report linking infectious diseases with national security circumspectly acknowledged: Agencies "are often forced to extrapolate or build models based on relatively small samples, as in the case of HIV/AIDS." In Africa, accurate record-keeping is virtually non-existent, forcing researchers to make guesstimates.

This is not to say that nobody in Africa is dying of AIDS. But the figures seem to have been distorted and exaggerated out of all proportion. The tragedy is that blaming mortality rates on a sexually transmitted disease is a convenient fiction that avoids addressing the real problems afflicting sub-Saharan Africa, where political and economic instability is endemic. Nearly a third of the region's 42 countries are currently at war. Misgovernment is rife, as is misapplication of development funds. Basic medical services are chronically hard to find, just as basic sanitation is in short supply.

Their absence has led to 900,000 deaths from malaria in 1998 alone in sub-Saharan Africa, and more than 1.5-million cases of tuberculosis. All of these are either easily preventable or curable. As a "national security" threat, it's unlikely African HIV/AIDS can even begin to compare with malaria, TB, measles, tetanus, pertussis or even diptheria.

Proper North American-style diagnoses, in combination with clean water, protein nutrition, immunization and other such preliminary steps, could cut the inflated HIV/AIDS figure overnight.

Then we could start doing something about the real African problems.