Chapter 3

The Roots Of The Crisis

AIDS is about more than just facts and statistics. But we need a basic understanding of the available facts in order to be informed about the nature and scope of the HIV/AIDS crisis.

To better understand the enemy we face in this struggle, it will be useful to have answers to some basic questions. And as you will see, the very nature of the sources cited in the following pages validate the ongoing seriousness of the issue and the international effort to respond to it.

WHAT IS HIV/AIDS?

According to the Mayo Clinic:

AIDS is a chronic, lifethreatening condition caused by the human immunodeficiency virus (HIV). By damaging or destroying the cells of your immune system, HIV interferes with your body’s ability to effectively fight off viruses, bacteria, and fungi that cause disease. This makes you more susceptible to opportunistic infections your body would normally resist, such as pneumonia and meningitis, and to certain types of cancers. The virus and the infection itself are known as HIV. The term AIDS (acquired immunodeficiency syndrome) is used to mean the later stages of HIV infection. But both the terms HIV and AIDS refer to the same disease.1

That statement reveals an often misunderstood reality: People don’t die directly from HIV/AIDS. The disease merely weakens the body’s ability to fight other diseases. When those other diseases attack, the weakened defense systems of an HIV/AIDS-infected body have no resources with which to fight off that attack.

This is part of what makes HIV/AIDS so dangerous. It doesn’t merely attack a person’s body, it acts as a sort of viral artillery that weakens the body’s defenses, making a person more vulnerable to almost anything else that might come along.

WHERE DID IT COME FROM?

This is an issue that causes great frustration. In response to this question, About AIDS/HIV reports:

We do not know [where it came from]. Scientists have different theories about the origin of HIV, but none have been proven. The earliest known case of HIV was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggests that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.

We do know that the virus has existed in the United States since at least the mid- to late- 1970s. From 1979–1981, rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of gay male patients. These were conditions not usually found in people with healthy immune systems.

In 1982 public health officials began to use the term “acquired immunodeficiency syndrome,” or AIDS, to describe the occurrences of opportunistic infections, Kaposi’s sarcoma, and pneumocystis carinii pneumonia in previously healthy men. Formal tracking (surveillance) of AIDS cases began that year in the United States.2

Any wise military leader will confirm that one of the keys to success on the battlefield is to know your enemy—who they are, how they fight, and even where they come from. In the war on AIDS, much of this basic information simply is not available to us. We face an enemy we struggle to define.

It does seem, however, that the ultimate source of the AIDS-causing virus was the sub-Saharan African continent—and that part of the world continues today to be the region most deeply ravaged by the disease.

HOW IS IT CONTRACTED?

AIDS.org, one of dozens of AIDS/HIV-related Web sites, responds to this question with further helpful insight:

You don’t actually “get” AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who’s infected, even if they don’t look sick, and even if they haven’t tested HIVpositive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

• Having sex with an infected person. • Sharing a needle (shooting drugs) with someone who’s infected.

• Being born when the mother is infected, or drinking the breast milk of an infected woman.

Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.3

The sad fact is that HIV/AIDS is truly no respecter of persons. It pays little attention to factors like age, respectability, or lifestyle. Although some might argue that certain lifestyles are more susceptible to this disease, the global reality is that the growing majority of its victims are truly helpless victims.

Newborn children, victimized women, and many others form the body of those infected by HIV and AIDS— and the situation is not improving.

As we will see, newborn children, victimized women, and many others form the body of those infected by HIV and AIDS—and the situation is not improving.

WHO IS AFFECTED?

We cannot escape the fact that the entire world is affected. The United Nations, in its efforts to respond to the crisis, has set its own considerable resources to the task of understanding the magnitude of the global crisis. UNAIDS research says that worldwide there are approximately 47.3 million people who have been infected with HIV since the start of the epidemic. Part of what makes this staggering number so disturbing is that 4.4 million of those people are children under the age of 15.

The human toll is heartbreaking on every level. UNAIDS estimates that since the disease was discovered, about 13.9 million people have died with AIDS-related complications—and 3.2 million of those fatalities have been children under 15. This is truly an international human tragedy.

That UN data goes on to report: “As of December 1998, there were an estimated 33.4 million people living with HIV infection or AIDS (32.2 million adults and 1.2 million children under 15).” 4

Some other estimates are even more grim. Wess Stafford, president of the Christian relief organization Compassion International, says:

Every day 6,000 people die of AIDS. AIDS is the fourth leading cause of death in the world. Since it began in the early 1980s, 20 million people have died from AIDS and about 42 million people are living with it. Approximately 14 million children have been orphaned by AIDS. Last year alone, 5 million new people were infected.5

As distasteful as it may seem to dwell on these numbers, it is imperative that we get a sense of the magnitude of this crisis. The crisis is not going away. In fact, it is getting worse. The same UN report cited earlier states, “An estimated 5.8 million new HIV infections occurred in 1998. This represents almost 16,000 new cases per day. During 1998, HIV-associated illnesses caused the deaths of an estimated 2.5 million people, including 900,000 women and 510,000 children under 15.” 6

The numbers are overwhelming even if taken as nothing but numbers. But they are not merely numbers. When we allow ourselves to recognize that the numbers are actual human beings killed by AIDS, it is heartbreaking. Over half of the worldwide victims of AIDS in 1998 were women and children. Recent statistics released as part of “World AIDS Day 2003” indicated that 5 million new HIV infections were recorded in 2002, and 3 million more deaths occurred.7 Think about it—3 million more human lives lost!

Implicit in those statistics is one of the most startling things about the impact of AIDS. This fact is made clear by the Mayo Clinic— AIDS is an epidemic that is becoming increasingly universal, both in terms of gender and geography. Whereas this disease once predominantly affected men, its onslaught has now become pandemic— attacking human life across previously unbreached lines. The Mayo staff points out:

What’s more, the face of AIDS has changed—for the first time, as many women as men are now living with the disease worldwide. In Africa, 58 percent of those infected are women, raising concerns that more babies may contract the virus from their mothers.8

For obvious and urgent reasons, much of the world’s attention has been drawn to Africa, as it continues to bear the greatest weight of this. But Africa is not the only region devastated by AIDS.

AIDS is an epidemic that is becoming increasingly universal, both in terms of gender and geography.

Some of the largest increase in the spread of HIV and AIDS in recent years has been in the Russian Federation, where approximately 1 million people are now living with the HIV virus. China, India, and Eastern Europe also face growing epidemics.

Who is affected? Once again, we must recognize the fact that the entire world is staggeri ng under the weight of HIV/AIDS and its impact on human life.

ARE THERE OTHER RESULTS?

Admittedly, HIV/AIDS is first and foremost a health problem and the human toll is unmistakably the most critical impact of the disease. It must also be understood, however, that the world has come to realize that AIDS jeopardizes all aspects of human welfare. The effects of the disease on a nation have a number of devastating results, perhaps most notably the impact on the country’s potential for advancement.

We see some of the greatest impact of HIV/AIDS in countries that are sometimes referred to as “third world,” “developing,” or “emerging” nations. These are societies that are in the process of attempted advancement in the global economy. They are trying to make their way into the international competition for industrial and economic growth, and for the prosperity that often accompanies it. How does AIDS slow that advancement?

Diverted Resources. At the heart of any economic advancement is the investment of financial resources. The old expression “You have to spend money to make money” rings particularly true when a country is trying to grow its young economy. In a developing country that is being ravaged by the AIDS epidemic, all available monetary resources are drained away in an attempt to combat the disease. Because the disease consumes everything in sight, that leaves very little with which to try to stimulate economic progress.

Diminished Workforce. This element of the human cost of this epidemic is extremely troubling. Though it may seem inhumane to think in such terms, government leaders and economic advisors are faced with these very issues. The Mayo Clinic staff expressed the nature of this concern very well: “In the hardest-hit regions, nearly 20 million children are expected to lose one or both parents to AIDS within the next 8 years, and some countries could lose up to a quarter of their workforce by the year 2020.” 9 With such a diminished workforce, it will become increasingly difficult for emerging nations to attract industrial and economic investments from other countries. Without the investment of money to build industry, there are fewer resources with which to fight the disease. It becomes a self-defeating vicious cycle of despair.

Desperate Decision-making. With existing resources being consumed by attempts to fight the AIDS epidemic, and the prospects of lost opportunities for economic growth, leaders in affected countries find themselves caught in a scissors action. They often find themselves forced to make decisions out of desperation that can continue the downward spiral of economic devolution.

At the end of the day, the impact of AIDS is twofold. On the one hand is the microcosm of the very personal sense of loss and grief that brings pain and heartache to individual lives and hurting families. On the other hand is the macrocosm of the blow this disease deals to an entire nation—particularly w hen it seems that the countries most deeply affected are the ones with the least amount of resources with which to combat it.

WHAT IS THE FUTURE?

As of this writing, the human, medical, political, and economic futures are admittedly grim. Though some forms of medical treatment have shown limited success in controlling the impact of HIV and AIDS, there is no full-fledged cure in hand, nor does there appear to be one on the horizon.

While the medical community continues to do research and the global community seeks to offer care and comfort to the suffering and grieving, human efforts can accomplish only so much. The efforts being made are noble, and all of us should pray for their success—but the situation is no more optimistic than it was more than 20 years ago when the crisis began.

If we are to find hope in the midst of what humanly appears to be hopeless, we must look beyond human ability.

If we are to find hope in the midst of what humanly appears to be hopeless, we must look beyond human ability. We must co nsider the heart of our compassionate God, who alone can bring hope to the hopeless.

To see God’s heart for the sick and hurting, we must turn to His Word—the Bible.