ABSTRACT
Much has changed since the first HIV infection was documented in Africa some 25 years ago. The epidemic has evolved differently in different regions and our ability to understand that evolution has grown markedly. From an initial prevailing view that HIV/AIDS was not an important development issue, the world has now come to a consensus that the epidemic is a major development disaster of perhaps biblical proportions. In the most heavily affected regions the epidemic has reversed many development achievements of past generations and now jeopardises the prospects of the next. The most dramatic effects are reflected in changes in life expectancy. Where the epidemic has hit hardest, it has slashed life expectancy in half, amidst doubling or even trebling of adult mortality.
