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HIV/AIDS: The Modern-Day Plague?

Is HIV/AIDS replacing the Black Death as the world’s worst plague?

July 27, 2005

Is HIV/AIDS replacing the Black Death as the world's worst plague?

When the Yersinia pestis bacterium hit Europe in the fall of 1347, no one at the time could imagine the consequences of that mysterious pestilence.

Before long, it would challenge the integrity of city-states, turn the continent’s economy on its head and set the surviving populace on a course that would lead to the collapse of feudalism and the rise of the Protestant Reformation.

The Black Death — or pneumonic plague — raged across the European continent between 1347 and 1352, peaking in most regions in 1348.

Though the plague returned several times during the 14th and 15th centuries, it did not claim a catastrophic toll again until the plague of London in the 1660s.

So astronomical was the impact of the 14th century Black Death that historians for six subsequent centuries were left to puzzle over what was termed the Great Mortality.

By 1420, Europe’s population was merely one-third of what it had been in 1320. It would not begin to grow appreciably until 1460 — and many parts of the continent still had not reached their previous demographic heights by the end of the 16th century.

No event in documented world history, before or since, has had as dramatic an impact on the human population — until the arrival of HIV.

Nobody knows exactly how many people perished in the Black Death, but experts believe that HIV has already surpassed the numbers of people sickened by the plague.

And when the currently HIV-infected cohort of 40 million people have succumbed to the disease, AIDS will rank as the worst plague of all human history.

By 1360, the Black Death had radically altered the demographic distribution of most of Europe.

The numbers of adults over 60 years old remained stable, but societies were nearly depleted of productive-aged adults between 14 and 60 years old. Nearly half of the survivors were under fourteen years of age.

The net outcome — called a chimney effect — was the creation of an enormous dependency problem, with societies overwhelmed by child orphans and senior citizens.

The imbalance of child survivors shifted with subsequent waves of the plague in the 15th century as Yersinia pestis adapted to human beings and became a pediatric disease, according to medieval historian Samuel Cohn.

Prior to 1347, much of Europe was divided into tiny fiefdoms and city-states. Agricultural labor was performed by serfs and subjects who lived in slave-like conditions, forced to yield crop profits to their overlords.

Labor had almost no real value. Workers were utterly interchangeable and dispensable. Wars raged across the continent continuously, as feudal lords and city-state rulers raised private armies to attack one another — most commonly in trade and property disputes.

Culturally and politically, Europe was dominated by the Catholic Church, with a succession of pontiffs mustering their own military forces, manipulating the affairs of fiefs and states and amassing considerable wealth.

Much of this was turned upside down by the plague’s carnage. Because the Church could neither explain the plague nor stop it, its power eroded in the eyes of average Europeans.

Many turned to mysticism, superstition or blends of ancient paganism and Catholicism to fill their spiritual needs. Worse, the Church lost nearly half of its priests and bishops, weakening its infrastructure.

In hopes of rapidly restoring the Church’s power base, Pope Clement VI sold priesthoods, offering the new clerics opportunity to recoup their investments through the sale of indulgences.

The exploitative behavior of many of these new priests sowed seeds of profound discontent, spawning several dissident Christian sects — and probably contributing to the Protestant Reformation.

The power base of many fiefdoms and city-states was also eroded, as the ranks of all forms of labor — particularly agricultural and military — were devastated.

Workers were able to dictate some of their terms of employment — rejecting servitude, letting fields go fallow and foregoing military service.

Massive crop and livestock deficiencies resulted and persisted for many decades thereafter. Skilled laborers — such as artisans and craftsmen — were in such demand that many became itinerant, growing rich by selling their services to the highest bidders in Europe.

The Grim Reaper’s harvest radically disrupted lines of aristocratic lineage and inheritance, throwing Europe into decades of property disputes.

Orphaned children, lacking protection from adults, often lost their inheritances and were left to forage across Europe in search of sustenance and employment.

These factors contributed to fundamental shifts in society.

They changed the relationship between the wealthy and poor, relations between parents and their children, the breakdown of boundaries and lineages of fiefdoms and feudal states, the nature of warfare (which now required less labor and more technology in the form of guns and cannons) and expectations of the state.

In the immediate wake of the Black Death, city-states like Florence and nations such as England recognized that social services are components of state survival. They created orphanages, sanatoriums, public hospitals and health systems, subsidized education and trained professional militaries.

According to noted historian David Herlihy, in the 14th and 15th century, “plagues undermined the stability of European culture.

“Continuing high mortalities thinned the ranks of the skilled and the learned and debased the quality of cultural expressions of every sort. Europe faced the formidable task of maintaining and repairing its cultural heritage.”

Adapted from the author’s report for the Council on Foreign Relations, HIV and National Security: Where Are the Links?