Government and Governance

Abstract

A review of HIV prevalence shows that the worst sexually transmitted epidemics are in the ‘new’ nations of Africa and the Caribbean. In former Soviet countries and satellites, drug-driven epidemics are spiralling out of control. Those countries in Europe, Asia and Latin America with a history of nationhood have the lowest prevalence. The second half of the twentieth century saw two periods of state formation. Independence came to most African, Asian and Caribbean countries in the 1950s and 1960s. The last decade saw the breakup of the Soviet Union with the creation of 15 new countries including the Russian Federation. The former Yugoslavia spawned five countries, Czechoslovakia split into the Czech and Slovak Republics and in Africa Eritrea gained independence from Ethiopia. This process of ‘Balkanisation’ may continue in the Democratic Republic of Congo and Indonesia. This is not to suggest that there is any simple correlation between ideologies and histories of nationhood and low seroprevalence. It is worth noting, however, certain predictable relationships:

• ‘old’ European nations were also imperial powers and benefited from that in terms of wealth

• ‘old’ nations have strong and legitimate state ideologies which enable concerted social action — plus, in many cases, the resources and infrastructure with which to act

• in Latin America and the Philippines, churches are very powerful and there is a history of strong oligarchic control combined with unequal income distribution and overall low wealth.