Introduction

The war against AIDS in Africa is not going well ("Africa" denotes sub-Saharan Africa throughout this book). In his opening address to the 8th International Conference on AIDS (1992), Jonathan Mann admitted, "The old public health vision has become a straightjacket" confining planners to approaches to the prevention of AIDS that are not succeeding. In an interview with Africa Report (1992), Dr. Peter Lamptey, director of USAID's $168 million global project to control AIDS, observes that with only a very few exceptions, even the most successful condom promotion programs in Africa have "failed to make a dent in the epidemic." I agree with these assessments. I believe that the two-pronged approach that has dominated AIDS control programs thus far—namely, the promotion of condom use and restricting one's number of sexual partners (and there may be a mixed message right there)—has merit but is too little, too late for Africa.