War-torn Afghanistan and bonny Scotland are a world apart. But they are united by HIV—and interlocking AIDS epidemics that illustrate how the disease has become a global community crisis. In Afghanistan, HIV infection rates have increased fourfold during the past year, with nearly 60 percent of reported cases stemming from IV-drug use and the country’s rich opium trade. As the country exports the drug, HIV infection travels with it. Scotland’s prevention officials fear that an influx of Afghani heroin will cause HIV rates among IV-drug users to escalate. New infections have recently doubled in Scotland’s capital, Edinburgh, and the surrounding area. While most new cases involved sexual transmission, HIV infection rates are steadily approaching the late-’80s peak depicted in the 1996 Ewan McGregor film Trainspotting.
Roy Kilpatrick of HIV Scotland says that health officials must be vigilant. “The external conditions that existed in the 1980s and contributed to the epidemic then are very similar now,” he says. “It’s our job to ensure that policy, strategy and resources are directed on the basis of need and evidence.” But who will help Afghanistan?