One in six adults in sub-Saharan Africa will die in their prime of AIDS. It is a stunning cataclysm, plunging life expectancy to pre-modern levels and orphaning millions of children. Yet political trauma does not grip Africa. People living with AIDS are not rioting in the streets or overthrowing governments. In fact, democratic governance is spreading. Contrary to fearful predictions, the social fabric is not being ripped apart by bands of unsocialized orphan children.

AIDS and Power explains why social and political life in Africa goes on in a remarkably normal way, and how political leaders have successfully managed the AIDS epidemic so as to overcome any threats to their power. Partly because of pervasive denial, AIDS is not a political priority for electorates, and therefore not for democratic leaders either. AIDS activists have not directly challenged the political order, instead using international networks to promote a rights-based approach to tackling the epidemic. African political systems have proven resilient in the face of AIDS’s stresses, and rulers have learned to co-opt international AIDS efforts to their own political ends.

In contrast with these successes, African governments and international agencies have a sorry record of tackling the epidemic itself. AIDS and Power concludes without political incentives for HIV prevention, this failure will persist.