AIDS in Africa: Reassessing a Crisis

The Washington Post last week enters the extremely controversial debate about how trustworthy are the standard figures regarding an AIDS crisis in Africa with a front-page story. The Post story's conclusion is that the epidemic was overhyped in west and east Africa, though not in southern Africa.

An earlier, and far more detailed, discussion of the hows and whys of the apparent overstatement of an AIDS crisis in Africa in American mainstream media appeared in Rolling Stone back in November 2001 by Rian Malan. The Malan story emphasizes a wider variety of possible reasons for misleading AIDS stats; the Post's story mostly discusses how surveys based almost entirely on pregnant women at prenatal clinics overstated overall prevalence; though it does touch on how UNAIDS

produced reports that increasingly were subject to political calculations, with the emphasis on raising awareness and money.

"It's pure advocacy, really," said Jim Chin, a former U.N. official who made some of the first global HIV prevalence estimates while working for WHO in the late 1980s and early 1990s. "Once you get a high number, it's really hard once the data comes in to say, 'Whoops! It's not 100,000. It's 60,000.' "

Chin, speaking from Stockton, Calif., added, "They keep cranking out numbers that, when I look at them, you can't defend them."

Malan's old story from Rolling Stone casts a wider net--for example, questioning the reliability of the ELISA test on which so many AIDS diagnoses in Africa depend. For those interested in the complicated dimensions of assessing AIDS in Africa, both stories are worth reading in full.