Disease, Conflict and Security: The Case of HIV/AIDS

While the ways conflict undermines health are well-studied, less understood are the potential impacts of disease on conflict and security. HIV/AIDS may contribute to instability and conflict through its impact on soldiers, peacekeepers, and socio-economic stability. HIV prevalence among African armed forces is at least equal to civilian rates from the same country. These high rates will complicate the future staffing of African officer corps, while the loss of soldiers to AIDS will decrease military effectiveness. High prevalence of HIV/AIDS in countries that contribute to UN and regional peacekeeping operations, such as South Africa and Nigeria, will make it increasingly difficult to staff these missions. The impact of the epidemic is not limited to Africa. Russia's HIV/AIDS epidemic is exacerbating existing shortages of healthy conscripts for military service, and China and India are increasingly monitoring HIV among their armed forces.

Despite drastic reductions in life expectancy to fewer than 40 years in nine African nations, and 2.3 million deaths from AIDS in 2004, there is no direct evidence that HIV/AIDS has directly undermined state stability. Nonetheless, global health leaders and US intelligence officials warn that HIV/AIDS may contribute to state instability and failure in high prevalence states by undermining the operation of governments, industry, civil society and by creating millions of AIDS orphans. HIV/AIDS is also raising internal security challenges in Russia, India and China because the epidemic is driven in significant part by injection drug users along heroin trafficking routes that often overlap with areas of ethnic minorities, separatist sentiment and insurgency. HIV/AIDS prevention and treatment activities in these areas may fail due to a lack of trust in the government, while a lack of action may increase political tensions.

The links between HIV/AIDS, conflict and security are of substantial political importance. Consideration of HIV/AIDS and other public health problems as threats to state security may elevate political attention and funding for these diseases, while creating new risks through the politization of public health. The interaction between HIV/AIDS and conflict and security should be understood as a bi-directional relationship with major political ramifications.