Diamonds and viruses: Reconstructing the epidemiological origins of HIV-1 in Angola's mining frontier

In 1988, the remote mining town of Dundo, in Lunda-Norte, Angola, displayed an anomalously high HIV-1 prevalence of 14.2%, despite the absence of recognised epidemic drivers. Archival and epidemiological evidence suggests that colonial medical interventions, rather than sexual transmission alone, were central to the early amplification of the virus. Under the Companhia de Diamantes de Angola (Diamang), a vast corporate health system promoted extensive use of injections and blood transfusions, relying on reusable equipment and limited sterilization. Quantitative data on transfusion ratios and injection frequencies, combined with evidence of rising tuberculosis, anaemia, and vitamin deficiencies, indicate conditions conducive to iatrogenic spread. By integrating epidemiological, virological, and socio-historical perspectives, the study develops a biosocial framework to reinterpret early HIV transmission dynamics. The findings challenge prevailing “urban-centric” explanations of epidemic emergence and highlight how colonial infrastructures, labour regimes, and biomedical technologies inadvertently created new pathways for viral circulation. Understanding these histories broadens current debates on the socio-political roots of epidemics and the long-term legacies of colonial medicine in shaping global health vulnerabilities.