There is no question about the seriousness of the AIDS epidemic in Africa. It has been clear for some years that problems associated with the epidemic are enormous. The depth of the problem has been documented repeatedly. Now that we have moved into what is described below as the ‘acceptance-response phase’, it is timely to look beyond present problems to the legacy that will remain once the epidemic has been confronted by medical science and endured by its millions of victims and their families, most especially in Africa. This article argues that as a result of many pre-existing conditions, having little to do with AIDS, aggressive responses to the epidemic, especially by the international community, are likely to undermine African autonomy and impede future development, particularly politically and psychologically. While AIDS is one of many deterrents to development, it has, in many affected countries contributed significantly to undermining their future prospects.

From several perspectives the AIDS epidemic can be seen to have levelled an enormous toll on Africa, especially in the eastern and southern regions. This article confines itself to the non-medical consequences of the epidemic where it has been most profound. Although the epidemic has possibly passed its peak, evidence of the toll of the disease, with its related health problems is now clear. In its wake are serious multidimensional problems: anthropological, sociological, economic and political. AIDS has greatly diminished prospects for increased autonomy in many countries, and dashed hopes for major improvements in their quality of life. These multisectoral dimensions of the AIDS impact are likely to affect African development negatively for many years to come. As an extreme example of the enormous difficulties, a recent report suggests an HIV rate of 50 per cent in seven armies in central Africa. Such reports highlight consequences that affect development prospects in general. These and related problems undermine the sense of nationalism and national identity so eagerly fought for in all parts of Africa during the independence era. This article focuses on these dimensions of the epidemic and suggests possible consequences in terms of national development in those countries most affected.