The HIV/AIDS pandemic in Africa has far-reaching implications for governance and development. In addition to killing millions of individuals and causing serious economic contractions, the pandemic threatens structural transformations in African economies, institutions and governance. Decreased adult life expectancy has important adverse impacts upon savings, capital accumulation, skills acquisition, and institutional functioning. This article examines how the impacts of the pandemic can be envisaged as running processes of demographic transition, economic development and the growth of a bureaucratic state, in reverse. Meanwhile, expanded HIV/AIDS programming is likely to become a major feature of some African countries. The article examines different models for social and political mobilization against the pandemic and sketches a unified framework for understanding its impact.
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