Abstract The consequences of the evolving HIV/AIDS epidemic have not been properly considered by any agency. Most existing development indicators do not pick up the impact of AIDS nor do they measure the complex adverse consequences the disease may have in the decades ahead. Incomplete and conflicting demographic and health indicators compound the problem. This epidemic is a ‘long wave’ event and its effects will be seen in Africa and elsewhere for many decades ahead. The result is that development targets may be unattainable and the way development is carried out may need to be rethought in many countries. Copyright © 2001 John Wiley & Sons, Ltd.