1. ‘AIDS: A Darwinian Event?’ by Alan Whiteside 1 & Alex de Waal 2 The Centre for AIDS Research University of Southampton 1. Director HEARD University of KwaZulu-Natal 2. Research Fellow, Global Equity Initiative, Harvard University

2. Outline of Presentation What do I mean - Darwinian - Event Evidence Looking back

3. What do I mean? Darwinian – that which results in change in our genetic, social, economic or psychological makeup

4. What do I mean? Event – something we can measure as we look back or, in the case of AIDS, look forward

5. Examples The Black Death (see Barbara Tuchman ‘A Distant Mirror’) The extermination of colonial times – Tasmania Slavery? SMS texting with mobile phones?

6. What is AIDS? HIV / AIDS an historical event – so what is our historical perspective A candidate as a Darwinian Event?

7. Outline of Presentation What do I mean - Darwinian - Event Evidence Looking back

8. The Scale of the Epidemic HIV prevalence of 40% Mortality

10. A model of future AIDS and non-AIDS deaths

11. Numbers infected, sick & dead ASSA2000

13. Changing life expectancy in African countries with high and low HIV prevalence: 1950-2005 Source: UNAIDS, 2002. Report on the global HIV/AIDS epidemic

14. South AfricaBotswana Changes in Population Structure due to AIDS – 2000-2025 32

15. AIDS orphans in South Africa 33

16. Forecast GDP Growth 2002- 15

17. 30

18. What goes around comes around

19. Outline of Presentation What do I mean - Darwinian - Event Evidence Looking back

20. Demography Size (decrease, stabilise, grow more slowly) Structure male:female, dependency ratios orphans

21. Social/psychological Selection by Wealth Skills Ability or characteristics eg artists or entrepreneurs

22. Wealth and HIV 1000 $ 2000 $ 3000 $ Per capita 1999 Adult HIV prevalence end 1999 Botswana South Africa Namibia Swaziland Zimbabwe Uganda Cote d’Ivoire Zambia 10 2030

24. Some Populations Harder Hit than Others *Above average deaths from AIDS (++ high impact, maybe higher numbers) AIDS epidemic Young women Unemployed Migrants, temp, contract workers Drivers & mobile workers Miners/hazardous occupations Political leaders? Newly prosperous Soldiers Sex workers Teachers++ Some regions: KZN, Gauteng, Mpu’ga Caprivi – E&W Botswana Swaziland, Lesotho Dying* orphans Corridors & Crossroads Maputo Beira Durban Trans-Kalahari? Gov’t workers++ Short-term thinkers Uncircumcised AIDS epidemic High income Non- migrant families Settled, long-term employed Tertiary education Some regions: W. Cape N. Cape Sn. Namibia Northern Prov. E. Cape Grandparents Surviving** **Below average deaths from AIDS (the foundation of the future) Long-term thinkers Isolated areas Chaste & faithful Circumcised Cohesive, candid societies Intro.

25. Memetic evolution Memes are replicable information in the brain. Circumcision Risk taking Funeral ceremonies Nepotism and altruism

26. Is AIDS a Darwinian event? Yes Populations decline Some groups v.adversely affected Memetic impact Economic & social effects No Pop. Decline limited Epidemic isolated in certain areas & groups The ‘dyers’ don’t matter The scale too short

27. Ozymandias I met a traveler from an antique land Who said: Two vast and trunkless legs of stone Stand in the desert. Near them, on the sand, Half sunk, a shattered visage lies, whose frown, And wrinkled lip, and sneer of cold command, Tell that its sculptor well those passions read, Which yet survive, stamped on these lifeless things, The hand that mocked them, and the heart that fed, And on the pedestal these words appear: "My name is Ozymandias, King of Kings: Look upon my works, ye Mighty, and despair!" Nothing beside remains. Round the decay Of that colossal wreck, boundless and bare The lone and level sands stretch far away. Percy Bysshe Shelley 1792-1822

28. No Man is an Island No man is an island, entire of itself every man is a piece of the continent, a part of the main if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friends or of thine own were any man's death diminishes me, because I am involved in mankind and therefore never send to know for whom the bell tolls it tolls for thee. -- John Donne

29. HIV/AIDS is an historical event! A ‘history’ is being written. The responsibilityof historians provide: ideas, paradigms & methodologies for understanding and responding

30. And finally There is an awful predictability about HIV/AIDS and what it has the potential to do. Historians have the unique experience of seeing an event of unparalleled significance unfold before their eyes. This history can be written in advance.