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Nowhere in the world is the HIV/AIDS epidemic more prevalent than the continent of Africa. For South Africa, political turmoil, apartheid, and government denial has fed an epidemic that has reached disastrous proportions. As the number of infected and dead continue to rise, the impact on the people of South Africa and the entire world is growing. This edition of HIV Around the World takes us to Africa, a country with an unparalleled HIV crisis.

South Africa – Demographics

First some facts about South Africa:

• located at the southern-most tip of the African continent

• a country of 46.6 million people (about one sixth as many as the US) spread over 1.2 million square miles (about one fourth the size of Texas)

• eleven official languages including English

• religiously diverse but predominantly Christian

• a 1991 law created four officially recognized races: "Africans," "Whites," "Coloreds" and "Asians." While the law has been abolished, people still view themselves and others in these four categories.

• racial make-up is 79 percent African (black) and 10 percent white; there are several ethnicities within the African segment of the population.

• ruled by a parliamentary democracy that has seen a history of significant political unrest, violence and racial discrimination (apartheid).

• while apartheid related violence has decreased significantly, violent crime and organized crime is occurring at increasing frequency.

The Status of HIV in South Africa

Here are some facts about HIV and AIDS in South Africa:

• the most current estimate is that 5.5 million people are living with HIV, which represents about 12 percent of the population

• one in four people age 15 to 49 years is infected with HIV

• over 1,700 AIDS related deaths each day

• currently it is estimated that there are 600,000 orphaned children as a result of AIDS

• a survey done in 2004 reported that South African citizens spend more time at funerals than weddings, haircuts, or grocery shopping

The History of HIV in South Africa

The HIV/AIDS epidemic emerged in South African around 1982. However, the country was in the midst of the racial horrors of apartheid, so the HIV problem was for the most part ignored. Silently, while political unrest dominated the media, HIV began to take hold, primarily in the gay community.

Quickly, the disease spread outside of the gay population and by 1991 the heterosexual transmission rate equaled the rate of new infections among men who have sex with men (MSM). By the mid-1990s, HIV rates had increased by 60 percent, yet the government was still slow in its response to what was becoming a public health disaster.

Finally, in 2000 the South African Department of Health outlined a five-year HIV/AIDS plan, but got little support from South African President Thabo Mbeki. After consulting a group of HIV denialists headed by Dr. Peter Duesberg, Mbeki rejected conventional HIV science and instead blamed the growing AIDS epidemic on poverty.

Without government support, the five-year plan did not get off the ground. In the meantime, HIV among pregnant South African women soared from eight-tenths of one percent in 1990 to 30 percent 10 years later.

It was obvious that without political support, prevention efforts had a difficult time gaining a foothold. Even when the South African government gave in to worldwide pressure and established a plan that would make HIV medications publicly available, the government response was slow and inadequate.

By 2005, the extent of publicly available HIV medications were drastically behind goals set forth in 2003. Today, HIV experts around the world believe that a combination of political unrest, poor government support and political denial has fueled the public health disaster in South Africa.

The New Apartheid

From 1948 to 1992, South Africa’s white minority government sanctioned discrimination based on race and economic status. This policy, known as apartheid, still exists today, but not as the world has come to know it.

For the vast majority of HIV-infected people, poverty is a cruel reality. Their only resort for health care is the government-sponsored public health sector. Unfortunately, public health care resources are scarce. There is little or no access to quality medical care, HIV testing, or, most importantly, HIV medications.

The rich and those who are better educated get the best medical care including HIV medications they need to stay healthy. So while political apartheid has officially ended, an AIDS apartheid remains and the poor are paying the price.

Let's go to page two and see who's infected.