The end of the Cold War ushered in a new era in American Foreign Policy. With the United States coming out as the dominant world power some predicted that the world was heading for a new age of peace, an “integrated international system based on the principles of liberal democracy and free markets” (Brower and Chalk 1). The United States’ victory proved that these were the best models for government and general social structure. Yet, the past decade has been filled with a growing sense of unease and the insurgence of non-traditional challenges. The threats may not be as imminent as possible mutual nuclear destruction, but they are vast and varied. In some ways, the world we live in now is more dangerous than that of the relatively monotonous Cold War years. There is no longer one major clear threat, no obvious division between good guy and bad guy. The majority of the current threats facing the United States are nebulous in nature with a common thread of transnationalism running through them. This includes the drug trade, environmental degradation, terrorism, and the spread of disease. None of these problems have a “return address,” and none of them can be traced back to a single people or nation. These are “threats without enemies” (Abshire 42). AIDS is such a threat. By the year 2011, the disease is expected to have killed over 80 million people worldwide (Brower and Chalk 7). Without doubt, Africa has been the hardest hit by the AIDS virus. The continental average is now 8.6 percent as opposed to 1.1 percent worldwide (Morrison 198). The impact of HIV/AIDS on Africa’s security and stability has been and continues to be substantial. Not only has the disease led to large-scale human death and suffering, but it has also undermined social and economic stability, weakened military preparedness and contributed to crime (Brower and Chalk 42). Without strong US leadership and multilateral international cooperation the AIDS epidemic in Africa will grow to monstrous proportions, severally turning back the tide of development in dozens of countries. The virus is so pervasive in South Africa that statisticians at the University of Cape Town project South African life expectancy at birth to fall to 40 years by 2010, down from 60 years in 1997 (Brower and Chalk 43). According to the Department of Health, by 2005 nearly one million South African children under the age of 15 will have lost their mother to the disease, a figure what will increase to over two million by 2010 (Kinghorn and Stienberg 14). In addition to the huge toll in human lives, HIV/AIDS will have significant effects on South Africa’s economic growth and development. Over a quarter of the country’s economically active population will have contracted HIV by 2005, affecting a multitude of economic sectors (Brower and Chalk 45). Employers will have to adjust their contribution to worker pensions as well as medical insurance, causing them to pass these higher input costs on to consumers in the form of higher prices. Government expenditures will also be affected as those with no private insurance come to the public sector for treatment. Assuming a cost of treatment at about $500 per person, this will lead to annual increases in healthcare expenditures in excess of $500 million over the next eight years (Brower and Chalk 46). The social costs of the disease are also staggering. In rural areas, AIDS is reducing the pool from which future community leaders can be drawn and is helping to undermine civil participation in political affairs. The deep stigma surrounding a positive diagnosis often leads to the ostracization of entire families within their communities. Not only have these factors resulted in entrenched feelings of hopelessness, depression, and anger, but they have also directly affected the trust, interaction, and cooperation that lie at the heart of a functioning civil society (Shell 19). Beyond human, economic, and social considerations, there is also the impact of HIV/AIDS on the South African National Defense Forces (SANDF). HIV/AIDS will undermine the combat readiness and effectiveness of SANDF in a number of ways. For example, soon more and more troops will have to be retired from active combat duty and transferred to less demanding support roles. Discipline and morale are also likely to suffer. Troops who find out that they are HIV-positive will have a tendency to be insubordinate, since they are now facing the possibility of imminent death. SANDF will also be less effective in dealing with regional conflict since it is current UN policy that no HIV-positive personnel participate in international peacekeeping missions in order to minimize the spread of the disease. This means that up to a quarter of SANDF cannot be deployed overseas, directly weakening South Africa’s credibility as a dominant force in the area (Heinecken 111). Because South Africa’s military is the best-equipped and trained in sub-Saharan Africa, “its absence from regional peacekeeping missions will significantly detract from the effectiveness of any future multinational deployments that are required” (Brower and Chalk 52). For example, the prevalence of AIDS among its troops is one the main reasons for the SANDF’s “failure to play a more active role in trying stymie the wave of civil violence that has engulfed the region surrounding the Democratic Republic of the Congo over the past three to four years” (Brower and Chalk 51). It is apparent that the AIDS crisis carries significant consequences for the security of South Africa and for the Africa content in general since “24 out of the world’s 25 most AIDS-affected countries are African” (Morrison 197). Africa remains a reservoir of HIV infection that puts other countries as risk. Thus, the AIDS epidemic will inescapably dominate US foreign policy toward the African continent. How we deal with the HIV/AIDS crisis in Africa will invariably shape our responses to the crisis in other parts of the world, increasingly making US response to this issue an interest to the whole global community. Traditionally, the United States has had a myriad of unilateral and multilateral programs and processes for combating HIV/AIDS in Africa, but often these programs have been neither coherent nor coordinated. Further complicating the situation is the fact that US aid for these programs had often been allocated based on “narrow political, rather than more comprehensive health security, concerns” (Brower and Chalk 102). Throughout the early Clinton administration, the Democrat-controlled Congress regularly increased funding for AIDS programs “above the amount requested by the former Republican administration,” but these funds were often nominal and relatively ineffective (Mann and Tarantola 204). By the end of 1990’s, the United States began to recognize that AIDS was not simply another crisis occurring on a crisis-prone continent. Ushered by a surge of activism in Congress, the year 1999 marked a turning point in US policy towards the AIDS epidemic, finally changing US trade policies and substantially raising US aid commitments to Africa (Morrison 199). At the core of this activism is heightened media interest and a new international and bipartisan consensus on the need for real results in the battle against this disease. With this new worldwide interest, Unites States’ leadership is essential. If it chooses to lead cogently, the US will be able to claim credit for defining and implementing the agenda for a crucial global issue. This vital leadership is expected by the American public, and will leverage other bilateral and multilateral contributions. In fact, the American public now exhibits “a surprisingly high knowledge of the HIV/AIDS pandemic [as well as] high levels of concern” (Lyman 5). A survey released by the Better World Campaign and the Center for Strategic and International Studies states that HIV/AIDS is “the top global health concern of the US electorate, and most Americans believe that increased US spending on HIV/AIDS will make meaningful progress in fighting the disease,” and that “Americans believe that the Unites States should channel its efforts to fight the global pandemic primarily through multilateral institutions.” Eagerly responding to this new interest, the Bush administration has requested a total of $1.3 billion in fiscal year 2003 for US international spending to combat HIV/AIDS. This is a 33% increase over FY02 ($1 billion) and an 81% increase over FY01 ($726 million) (United States 1). According to The Brookings Institution this amount, which is about 20-25 percent of the global need, is an appropriate portion of the cost for America to bear (Barks-Ruggles 7). The Unites States realizes that if it to leverage cooperation from other donor nations (such as Japan, Australia, and the European Union), it must provide substantial US aid over an extended period. Also, on February 21, 2001, “the Bush administration decided to let stand a May 2000 executive order that prohibits US retaliation against African nations promoting access to HIV/AIDS pharmaceuticals and medical equipment as long as their efforts are consistent with international treaties and agreements” (Barks-Ruggles 8). In the future, for the United States to lead the fight against AIDS coherently, a clear national policy about international AIDS must be laid down, coordination between different international organizations must increase, and mobilization of other donors must continue. These actions must be taken forcefully and with a clear commitment to the long-term, for only when “we have moved beyond ad hoc adjustments to strategic planning of our resource commitments will we increase certainty” about US success in the fight against AIDS (Morrison 207). Long-term efforts should also include programs to advance and disseminate scientific knowledge, as well as build the capacity of African nations to conduct research themselves. If Washington does not take the lead now, this promising public interest may wane and the chance to efficiently and effectively battle the AIDS epidemic will pass. HIV/AIDS, then, is a major destabilizing threat worldwide, but especially in sub-Saharan Africa. The disease is one of the new “non-state” dangers of the post-Cold War world. Though there has been apathy amount the American public and government, there is now hope that strong US leadership combined with concerted international efforts can bring down new infection rates and expand access to treatment for those already infected. To achieve success the United States must provide strong leadership, taking full advantage of the bipartisan congressional and international opinion on the necessity to act now and in the long term, or watch this opportunity slip through its fingers and engender the possible social and economic collapse of sub-Saharan Africa.

Works Cited Abshire, David, “US Foreign Policy in the Post Cold War Era: The Need for an Agile Strategy,” Washington Quarterly Vol. 19, No 2, 1996, pp.42-44

Barks-Ruggles, Erica. “Meeting the Global Challenge of HIV/AIDS: Why the United States Should Act Quickly.” The Brookings Institution April. 2001 http://www.brook.edu/comm/policybriefs/pb75.htm

Brower, Jennifer, and Peter Chalk. The Global Threat of New an Reemerging Infection Diseases: Reconciling US National Security and Public Health Policy. Rand, 2003.

Heinecken, Lindy, “HIV/AIDS, the Military and the Impact on National and International Security,” paper presented at the millennium colloquium of the South African Political Studies Association, Bloemfontein, South Africa, September 20-22, 2000.

Kinghorn and Stienberg, “HIV/AIDS in South Africa: The Impact and the Priorities,” Department of Health (South Africa) document (undated), p.14, cited in Martin Schonteich, “Aids and Age: SA’s Crime Time Bomb?” AIDS Analysis Africa, Vol. 10, No. 2, 1999 p.1.

Lyman, Princeton. “Halting the Global Spread of HIV/AIDS: The Future of US Bilateral and Multilateral Response.” Congressional Testimony. Foreign Relations Committee, US Senate. 13 Feb. 2002.

Mann, Jonathan M., and Daniel Tarantola, eds. AIDS in the World II. New York: Oxford University Press, 1996.

Morrison, J. Stephen. “The African Pandemic Hits Washington.” The Washington Quarterly 24:1 (Winter 2001): 197-209.

Shell, Robert, “Halfway to the Holocaust: The Economic, Demographic and Social Implication of the AIDS Pandemic to the Year 2010 in the Southern African Region,” in HIV/AIDS: A Threat to the African Renaissance? Konrad-Adenauer-Stiftung Occasional Paper, June 2000.

United States. Department of State. Fact Sheet: US is Leading International Donor on HIV/AIDS. Office of the Spokesman Washington, DC: NOV 29, 2002.