AIDS: In the Grip Of the Scourge

"Oh, what will happen in this world if we have to die when we make love? AIDS is the century's evil." That lament, from a pop ballad that is sweeping west Africa, probably seems overdrawn to most Americans. Not so for Josephine Najingo, a 28-year-old mother of five who lives in the dusty Ugandan trading center of Kyotera, near the Tanzanian border. For her, the lyrics describe a bitter reality. Josephine is dying because she had sexual intercourse with her late husband. A prosperous trader, he had contracted "slim disease," a painful wasting away of body tissues by uncontrolled weight loss, chronic diarrhea and prolonged fever. The affliction is the most common way that AIDS manifests itself in Africa.

By now, Josephine's own symptoms are well along. She knows she will die, just as thousands of people in her town and the surrounding countryside have already died after being infected with the AIDS virus. Townspeople first attributed the mysterious disease to witchcraft. Now they know that their lovemaking is to blame. They have seen the pattern of infection as it travels from husband to wife to lover. Fifty of Kyotera's leading businessmen are dead. The streets are filling with homeless orphans, the offspring of AIDS victims in outlying areas. Josephine, racked by fevers, chronic diarrhea, throat lesions and a painful itching rash that covers her chest and arms, now passes her days sitting listlessly on a straw mat outside her house, waiting to die.

Josephine's tragedy is the tragedy of central Africa. AIDS has swept across the midsection of the continent like an ancient curse, and will soon have extended its reach through most of western and southern Africa. In Uganda the number of AIDS victims is doubling every four to six months. Says Dr. Samuel Okware, the Ministry of Health official in charge of Uganda's AIDS prevention program: "In the year 2000, one in every two sexually active adults will be infected." The Geneva-based World Health Organization estimates that 2 million to 5 million Africans are now carriers of the AIDS virus. Leading researchers believe at least 50,000 people have already died of AIDS in Africa, and unless a treatment and vaccine are found, a million and a half more may succumb over the next decade.

What is most frightening about the AIDS epidemic in Africa is that it primarily affects heterosexuals, striking down men and women in equal numbers. "Many of us are very alarmed by what we are seeing in Africa," says Dr. Thomas Quinn, an infectious-disease expert at the National Institutes of Health in Bethesda, Md. In the West, modern medical facilities, blood- screening equipment and speedy communications may keep AIDS under control. But Africa is on the front line of what some researchers are already calling an AIDS pandemic. The African experience suggests the dangers and tenacity of AIDS: how thoroughly it can infect a heterosexual population, how difficult it can be to convince people to change their sexual behavior, even in the face of death.