As world leaders meet this week in Johannesburg to try to chart a course for worldwide sustainable development, they face many daunting challenges -- but none so immediate and horrific as AIDS. One in four South Africans is HIV-positive, and one in nine has developed AIDS. Places like Ingwavuma, an isolated hamlet near the Mozambique and Swaziland borders, are fighting not for sustainable development but to prevent wholesale social and economic collapse. If the disease cannot be stemmed, "there's no talking about sustainable development of any kind," said John Stremlau, head of international relations at Witwatersrand University in Johannesburg. "You're talking instead about failed states."

Ingwavuma, like many towns in KwaZulu-Natal, has fallen victim to AIDS for reasons both beyond and within its control. For generations the men, lacking local jobs, traveled to Johannesburg to work in the capital's rich gold mines while their wives stayed in their villages, waiting for occasional visits from their husbands and lining up to receive the few dollars sent home. Under South Africa's apartheid system, wives were not allowed to join the men in the city, so many workers turned to prostitutes or started second families there. When AIDS appeared, many men carried it home to their wives. A tradition of multiple partners, male dominance in sexual relationships, and a long-standing fear of condoms as a white effort to curb the black population has set the stage for the epidemic. In addition, the government has waffled on how to fight the disease.

Many schools around Ingwavuma are struggling as teachers die and students miss classes to attend funerals. The explosion in the number of orphans is closing avenues to a better life even for those who do finish school. Several non-profits are working in the town to slow its social slide. Orphan Care, a South African agency created to assist AIDS orphans, is now providing thousands of parentless kids in far northern KwaZulu-Natal with school uniforms, fees, food and assistance in navigating the tortuous bureaucratic tangle that separates them from a $45 monthly benefit check. Other non-profits have set up programs to train women.

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