LETTER: Aids: just one African killer

THERE is something deeply disturbing about the hysterical debate of Aids in Africa when it is in reality only a relatively minor contributor to the enormous human suffering there ("Aids epidemic chokes the life out of Southern Africa", 23 July).

The World Health Organisation's estimates of the number of deaths from Aids per year stands at 300,000 and is set to rise to 900,000 within five years. This is indeed appalling and I do not wish to underestimate the threat Aids may represent for Africans (though it is worth noting that the WHO has consistently overestimated this threat). However, Aids as a killer doesn't even come close to the scale of malaria (between 1.2 and 2.4 million African deaths each year) and has only recently become as important as tuberculosis.

In fact Aids is not even as big a killer as measles, tetanus, whooping cough and diptheria which combined claim around 500,000 lives every year. I suggest that Aids is special, not because of the threat it poses to human life, but because of the delicious combination of sex, disease and death which can be squared with a racially prejudiced view of the "dark continent".

I am deeply concerned that the hyperbole around Aids is having far more perverse effects on the understanding and treatment of health problems in Africa. Disease is being separated from the issue of progress and recast as an issue of moral behaviour. The clinical definition of Aids in Africa, put forth by the WHO in 1986, is an encouragement for established illness like TB and malaria to be interpreted as Aids. The frightening possibility is that as more and more curable diseases come under the heading of "Aids related complex" the doomsday image of Africa may become a self-fulfilling prophecy with millions condemned to die from diseases that should have been wiped out decades ago.

Stuart W G Derbyshire

University of Manchester Rheumatic Diseases Centre Salford, Greater Manchester