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Half the AIDS victims in the world are in East and Southern Africa, where adult HIV sero-prevalence was 11.4 percent by the end of 1997 and over 25 percent in two countries of Southern Africa. HIV/AIDS infection is not the result of ignorance, as nearly everyone has sufficient knowledge about AIDS and how it is transmitted. The high levels of AIDS arise from the failure of African political and religious leaders to recognize social and sexual reality. The means for containing and conquering the epidemic are already known, and could prove effective if the leadership could be induced to adopt them. The lack of individual behavioral change and of the implementation of effective government policy has roots in attitudes to death and a silence about the epidemic arising from beliefs about its nature and the timing of death. International responsibility may have to be taken before the needed effective policies are put in place.