The Rise (and Fall?) of HIV

An estimated thirty-eight million adults and children are infected with HIV/AIDS today; twenty million have died from the disease so far. By 2050, some 297 million people the equivalent of the entire United States population will have perished. Any plan to reach the unreached must grapple with AIDS.

Although the World Health Organization presently lists avian flu as the greatest threat to humanity, AIDS remains the disease with potentially the longest impact period. This analysis attempts to estimate the progress of HIV to 2025–something many think is impossible. It is difficult to track this and we need to keep two things in mind when looking at the table below. First, estimates of those living with HIV infections lack precision. In some countries the spread between the minimum and maximum estimates can literally be the tens of thousands of people. Second, projecting the future of HIV means not only estimating the number of people who will become infected through various means, but analyzing the impact of the national response (or lack thereof).

To try and simplify this, both 2001 and 2004 infection statistics were gathered from the most recent UNAIDS report (Bangkok 2004). For countries where data was missing, an estimate was interpolated from reviewing epidemological histories. The  percentage estimates were then broken down into seven categories: 0=0 to 0.1%; 1=0.1 to 0.5%; 2=0.5 to 1.0%; 3=1.0 to 5.0%; 4=5.0 to 15.0%; 5=15.0 to 30.0%; and 6=above 30%. Within the categories there is room for a great deal of movement. Thus, a country might move from 1% to 2% to 4%, then decline back to 2% all while staying in category 3.

After looking at the history, countries were slotted into categories they would most likely fit into for the years 2010 and 2025. In most cases this was a simple progression but in a few instances there were jumps.

The data table includes a review of each country, the categories for the years and a (very!) brief comment on the situation. Because of this simplified analysis, many countries are only briefly discussed. Countries with codes 0, 1 and 2 are all have less than 1% infection rates, which seems to be fairly manageable. Governments that respond quickly and comprehensively can contain the epidemic.

However, some countries are not monitoring the situation well. This is particularly dangerous, as no one knows the true HIV/AIDS picture in these countries. I have tried to estimate based on regional trends and other countries in similar situations, but these are places where HIV could rapidly increase.

The worst country is Botswana, which has the highest infection rate of any nation. Countries with the highest percentage of people infected in 2010 are all in Africa: Lesotho, Namibia, South Africa, Swaziland, Zambia, Zimbabwe and Botswana. However, countries with the most infections are not necessarily the ones with the highest percentage infected. For example, many observers believe that Russia, China and India will have the largest number of infections in the next decade or so, while still having small percentages.

Out of 164 countries touched by HIV, nearly one hundred have infection rates of less than 1%. However, a little over a third are teetering in category 3 (1-5%). Another twenty-five or so have terrible epidemics that have swept through the populace. Once a nation reaches categories 4 or 5, the economic and social consequences are horrendous and nearly impossible to deal with. Very few of these countries are close to eliminating the virus from their borders.

Interestingly, Christianized countries are seeing more of the serious effects of AIDS. Some seventy-five World C (majority-evangelized, majority-Christian) countries have serious, rampant epidemics, while only twelve World B (majority-evangelized, minority-Christian) countries and no World A (unevangelized) countries do. However, thirty-six World A and fifty World B countries are lightly infected.

There is no easy solution to HIV/AIDS. Simply stopping risky behavior is not always easy to do. Economic, social and educational realities in the field are complexities we must struggle with. However, it is chilling to note United Nations reports indicating aid to the twenty-eight countries with the greatest HIV prevalence declined one-third between 1995 and 2000.

We need to look at the command of Jesus: “As you do it to the least of these, you do it to me.” We need believers who are willing to spend time among those who are struggling with the disease. We need to help and be a blessing, rather than being people who cut off assistance to those who need it most. Thankfully there are partnerships of churches and agencies working on AIDS. As senior editor of Momentum magazine,, I am looking to put together a directory of agencies and partnerships that specialize in HIV/AIDS care. If you would like to be included, please email us at [email protected].

Justin Long manages and is senior editor for Momentum, a magazine devoted to unreached peoples. He can be reached at [email protected].