Sick of hearing about AIDS in Africa? Relax, here comes the next wave.

Far away from our TV screens, yet again, famine is falling on Africa. But in a historic first, the cause is not drought but AIDS. A startling 14.4 million people are at risk for starvation. HIVers throughout southern Africa are increasingly too sick to farm. "So many people, particularly women, have died, or have immune systems that are like shrinking parchment," Stephen Lewis, the UN's special advisor on AIDS in Africa reeled in October at a World Medical Association meeting, "that there simply aren't enough farmers left to plant the seeds, till the soil, harvest the crops."

Calling sub-Saharan Africa the canary in the AIDS mine, Lewis implored the physicians gathered in DC to heed the lessons of a region where up to 39 percent of the people have perished at peak production age. Lewis urged immediate action to prevent the "next wave" countries -- Russia, China, India, Ethiopia and Nigeria -- from an even worse devastation.

But the sleeping giant may be stirring. For the first time in August, at the World Summit on Sustainable Development in Johannesburg, AIDS made the agenda. As Peter Piot, head of UNAIDS, said, "If AIDS is not brought under control, [development] will not happen." Meanwhile, at Africa's southern-most point, delegates from all over the continent converged in Cape Town to launch the Pan-African HIV/AIDS Treatment Access Movement (PHATAM).

Then, a September report on AIDS by the National Intelligence Council, a panel of security experts, warned that unless strong measures are taken at once, the "next wave" nations, home to 40 percent of the world's population, will have 50 to 75 million HIVers by 2010. This explosion, the report said, may exacerbate already weakened economic, health and military structures, toppling governments and posing a global security emergency.

"It's not enough to engage the world simply by having an incomparable human catastrophe," Lewis said drily of the news. "It has to have security implications to make it come alive." If the next wave doesn't break, he concluded: "We may be witness to one of those appalling, traumatic societal upheavals where the world shifts on its axis."