Sir: Bryan Appleyard appears (21 April) to dismiss efforts to control the Aids pandemic as a response to westerners' own unease over their sexual liberation. He regards the doom-laden statistics and apocalyptic vision of rampant and untreatable infection as an emotional response to Western feelings that we have 'gone too far'. But the devastating effect of Aids is all too real.

In many parts of Africa, and Central and Southern America, an appalling tragedy is already unfolding. The cartoon accompanying the article showed a totally misleading picture of the death rate dwindling to nothing; in reality the spread of the disease worldwide continues apace.

With infections rising to more than 30 per cent of the population of some East African towns, in the next decade 5.5 million children may lose their mothers, with up to 3 million women dying. The child death rate is rising rapidly, and may double.

In Rakai, Uganda, 12.5 per cent of under-18s are parentless. The full loss of healthy adults means that communities must not only care for orphaned children, but there are also fewer people to work in the fields; less food is grown and plots are reverting to bush. Teenagers are missing out on education because their labour in the fields is essential. Teenage girls are particularly vulnerable: they are targeted for sexual exploitation by men because they are regarded as uninfected. This may provide some girls with much-needed money to pay for school fees, but they will almost inevitably become infected.

Far from being history, Aids is an ever-present menace for millions: the devastating consequences are being suffered now, reversing decades of health gains made previously in Africa, and its burdens fall most heavily on the poorest.

The spread of Aids in Western Europe may have slowed, but we should not allow feelings of self-satisfaction at our own condition to blind us to the very serious consequences of Aids elsewhere in the world.

Yours faithfully,

LUCY CHANDLER

Deputy Chair

Save the Children Fund

London, SE5