Written by Leon Spencer
Executive Director, Washington Office on Africa
When the Reverend Lucas Amosse, moderator of the United Congregational Churches of Southern Africa, called AIDS the “external face of injustice,” he was joining an increasing number of voices, in Africa and throughout the world, that link the AIDS pandemic with issues of economic justice.
What we are seeing today, the argument runs, is an AIDS crisis that expands far beyond the confines of a health issue. It is a crisis of development, a product of poverty, an expression of the marginalization of a continent. “While a virus causes AIDS,” Lawrence Altman observed in the New York Times, “social conditions feed the epidemic. Patterns of behavior – fed by poverty, ignorance and despair – have resulted in a disease so widespread that it has left millions of orphans and threatens to destroy much of Africa’s economy and to wipe out a generation of young people.” [‘Another Approach to AIDS in Africa’, New York Times, July 16, 2000]
AIDS attacks adults in their most “productive” years, leaving behind not only dependent children but dependent aging parents. It puts an incredible strain upon a glaringly inadequate health system. It prompts a decline in agricultural production and threatens food security.
Businesses face increased expenditures – the frequent need to train new employees is a prime example – and decreased revenues – from the decline in the economy generally and for such problems as illness-related absences from work. Education suffers, as the supply of teachers shrinks, healthy children withdraw from school to care for family, and the increasing number of HIV-infected children either do not survive to school age or struggle with health problems during their studies.
Tragically, economic data is already confirming this grim picture. UNAIDS reports that Botswana (with an HIV-positive rate of 36%) already shows declining economic growth. Projecting the data, economists predict that by 2025 its economy will be nearly a third smaller than it would have been if not for HIV/AIDS. Worsening that reality, health spending may well have to increase by a third if there is to be a meaningful response to the pandemic. Whether it can or not is another matter.
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