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The Eighth Plague is Crushing Africa

Ferial Haffajee

It's hard not to get biblical about AIDS, to see it as a plague visited on a planet that has angered the gods. It's hard not to get biblical, especially in Africa - the disease's epicentre, where 3,800 people are infected daily with the virus that causes death, especially in the poor world.

Yet, HIV and AIDS are still designated "emerging issues" for the least developed countries. Arguably, the issue has emerged and it threatens to submerge nascent development.

Where life expectancy in the world's poorest nations had edged up to 59 years at the end of the 1980s, AIDS threatens to slash it back down to 45 years in the next decades.

The disease (we call it a "disease" and not a plague to label it beatable; to not surrender to it) is in its killing phase in sub-Saharan Africa. It grips the southern reaches of the continent; it's extending its reach into West and Central Africa too, crushing the development dividend.

The UNAIDS representative, Noerine Kaleeba knows the disease intimately: her husband succumbed to it 14 years ago. "Although I tested HIV negative, I've lived with the stigma of AIDS. I came here to speak to you as an African woman and as someone affected by HIV," she told a conference session yesterday.

"I am affected because AIDS has been back to visit. It's taken many people I have known. It's turned from a health issue to a development crisis," believes Kaleeba. AIDS is sending growth rates plummeting - in a cruel twist, its reach is most severe on two of the continent's economic stars: Botswana, which with an infection rate of almost one in two people, is the world's leader in AIDS infection. Life expectancy has plummeted in the last decade from 67 to 29 years. "AIDS is laying waste to a generation of workers, sons and daughters, partners and parents.

AIDS is reversing the positive social indicators of which we have been so very proud," says President Festus Mogae. In one town, there is a funeral every two days - its graveyard a heap of freshly turned graves.

Botswana's neighbour, South Africa, has an infection rate of one in nine adults. Zambia, Zimbabwe and Swaziland follow closely behind. As the disease peaks, its impact on growth and development will become more acute.

In one key sphere, agricultural production, the figures are dismal. Kaleeba says maize, cotton, vegetable, peanuts and cane production have gone down by an average 50 per cent.

In Burkina Faso (which has a 6.4 per cent HIV/AIDS infection rate), agricultural revenues slid by between 25 per cent and 50 per cent in the past decade.

AIDS places intolerable burdens on health and educational systems in the least developed countries - those with the highest rates are buckling. A Rwandan study showed that people who are not HIV-positive visit their hospitals an average 0.3 times a year; HIV-positive people make 11 calls. Annual per capita expenditure is three dollars on average, but 63 dollars for those who are HIV-positive, the rate of school enrolment for AIDS orphans is half that for children who have a mother or father; while teachers are dying more quickly than new ones graduate, creating a net loss of educators. Kaleeba also speaks of a development loss that is far, far more difficult to quantify and that is of social capital. "Even though they lost their father, at least my five daughters had me to learn from.

Children affected by AIDS are losing people from whom they should learn how to deal with life."

How AIDS affects development

- Destroys human and social capital

- Hampers economic growth

- Reduces agricultural production - food security

- Reduces school enrolment; kills teachers

- Increases business costs; reduces profits

- Increases pressure on the public health system

Source: AIDS in Africa - country by country; AIDS in Africa; UNAIDS/ECA

How to turn around the scourge

- Raise the profile of HIV/AIDS in development policy

- Attack the AIDS stigma; mobilise political leaders

- Cheaper life-saving AIDS drugs; vaccine development

- Attacking the weak spots - conflict situations, where infection spreads rapidly