The recent International AIDS conference in Durban, South Africa, reminds us that Africa is dying. The HIV epidemic that is raging across Africa is now taking some 6,030 lives each day, the equivalent of 15 fully loaded jumbo jets crashing—with no survivors.

This number, climbing higher each year, is expected to double during this decade. Public attention has initially focused on the dramatic rise in adult mortality and the precipitous drop in life expectancy. But we need now to look at the longer term economic consequences—falling food production, deteriorating health care, and disintegrating educational systems.

Effectively dealing with this epidemic and the heavy loss of adults will make the rebuilding of Europe after World War II seem like child’s play by comparison. While industrial countries have held the HIV infection rate among the adult population to less than 1 percent, in some 16 African countries it is over 10 percent. In South Africa, it is 20 percent. In Zimbabwe and Swaziland, it is 25 percent. And in Botswana, which has the highest infection rate, 36 percent of adults are HIV positive.

Barring a medical miracle, these latter countries will lose one fifth to one third of their adults by the end of this decade. Attention in Durban focused on the high cost of treating those already ill, but the virus is continuing to spread. Unless its spread is curbed soon, it will take more lives in Africa than World War II claimed worldwide.

As deaths multiply, life expectancy falls. Without AIDS, countries with high infection rates, like Botswana, Zimbabwe, and South Africa would have a life expectancy of some 70 years or more. With the virus continuing to spread, life expectancy could drop to 30—more like a medieval than a modern life span.

Whereas infectious diseases typically take their heaviest toll among the eldest and the very young who have weaker immune systems, HIV claims mostly adults, depriving countries of their most productive workers. In the epidemic’s early stages, the virus typically spreads most rapidly among the better educated, more socially mobile segment of society. It takes the agronomists, engineers, and teachers on whom economic development depends.

The HIV epidemic is affecting every segment of society, every sector of the economy, and every facet of life. For example, close to half of Zimbabwe’s health care budget is used to treat AIDS patients. In some hospitals in Burundi and South Africa, AIDS patients occupy 60 percent of the beds. Health care workers are worked to exhaustion.

This epidemic, now producing thousands of orphans each day, could easily produce 20 million orphans by 2010, a number that could overwhelm the resources of extended families.

Education is also suffering. In Zambia, the number of teachers dying with AIDS each year approaches the number of new teachers being trained. In the Central African Republic, a shortage of teachers closed 107 primary schools, leaving only 66 open. At the college level, the damage is equally devastating. At the University of Durban-Westville in South Africa, 25 percent of the student body is HIV positive.

In addition to the continuing handicaps of a lack of infrastructure and trained personnel, Africa must now contend with the adverse economic effects of the epidemic. AIDS dramatically increases the dependency ratio, the number of young and elderly who depend on productive adults. This in turn makes it much more difficult for a society to save. Reduced savings means reduced investment and slower economic growth or even decline.

At the corporate level, firms in countries with high infection rates are seeing their employee health care insurance costs double, triple, or quadruple. Companies that were until recently comfortably in the black now find themselves in the red. Under these circumstances, investment inflows from abroad are declining and could dry up entirely. In a largely rural society, food security declines as the epidemic progresses.

Go To Africa Is Dying Part Two

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