Last week’s pardon of six foreign medical workers accused of intentionally infecting over 400 children in Libya with HIV came as a big sigh of relief to many international observers and medical experts. The trial of the accused was highly publicized and caused international outrage at the Libyan government. The Libyan authorities had continually denied the appeals of the scientific community and various international HIV experts, who claimed that the HIV outbreak was not caused by the medical workers, but was a direct result of unsanitary conditions and poor hygienic practices in hospitals. Though the pardon is a step forward in bringing justice to those wrongly accused, the highly publicized nature of this case has enabled it to bring the focus to a greater problem facing people in Africa; namely, the high prevalence of HIV.  

To give some preliminary statistics, according to UNAIDS, 2.1 million people in Sub-Saharan Africa died of AIDS in 2005, while a further 12 million children are classified as HIV orphans.  Given that Sub-Saharan Africa is home to only 10% of the world’s population, it is a striking fact that the region is home to over two-thirds of the globe’s total HIV infections. Some countries in the region have prevalence rates as high as 33% of the population (Swaziland).  South Africa has shown no signs of slowing down, as incidence rates have continued to rise, peaking at close to 6 million cases in 2005. Reasons for the HIV epidemic’s failure to slow down in South Africa include rampant poverty and social instability, migratory labor systems, low status of women, and failing leadership from the lack of political initiative to address the problem; it was only a year ago that a top political leader in South Africa made the comment that the HIV problem was not that pressing. If political will and leadership is stalling, it is hard to think of other solutions that might lead to a more centralized and coordinated effort to address the issue.

In terms of economic development and indicators of social well being, though the consequences have been great in the region as a whole, the impact of HIV has been most profoundly felt in those nations with high prevalence rates. It is argued that close to 1-2% annual GDP is lost as a result of the epidemic. Labor loss in the agricultural sector has also led to food shortages and chronic hunger for many. Studies have shown that AIDS tends to affect the poor more than other segments of the population; this has led to responses by various governments to design programs aiming to tackle not only the epidemic itself, but also more fundamental problems such as inequality and poverty. Yet, these efforts are becoming seriously strained: governmental finances have continued to fall as a result of fewer wage earners in the economy and, thus, decreased revenue from taxes. Another consequence of the epidemic has been a fall in the number of trained medical specialists who have also contracted the disease and passed away. In Botswana it is recorded that close to 17% of health care specialists have died as a result of AIDS. What this implies is that, in the near future, not only will governments have reduced funds to battle HIV, but also the decreasing number of trained specialists could lead to wider prevalence and higher incidence of AIDS in affected areas. It is crucial that international donors and other international watchdogs recognize this shortcoming and step in by providing the necessary funds so that many Sub-Saharan governments are able to finance their crumbling health sector.

Another obstacle many of these nations are facing is the high price of antiretroviral medication and the unwillingness of many pharmaceutical companies to provide drugs at a subsidized value. To entice pharmaceutical companies, it seems as if organizations such as the UN and World Bank have to provide monetary incentives to companies by adopting push and pull programs. Finally it is important to realize that educational attainment has been severely affected by HIV/AIDS, as fewer teachers are able to be in the classroom and fewer students are able to attend primary schools. Studies have correlated that, on average, for every 5% of class time teachers miss, students are aversely affected by a reduction between 4-8% in average gains from learning. Taking all of this into account, it is important to realize that HIV/AIDS and poverty have a complex relationship that has led to greater financial strains and economic stagnation in the Sub-Saharan region of Africa. 

Describing the impact AIDS has had on the daily life of those in affected regions brings to light many of the complex economic and social issues facing Africa today; a failing health care system, financial strains on the central government, and declining standards of living for most of the population, are only a few of the numerous problems that can be related to the epidemic. If solutions are to be found, it will take the effort to scientists, international agencies, health care specialists and donor nations to combat the grip poverty still has on many of these nations. What will be important is not only if AIDS can be controlled in the Sub-Saharan region, but that some of the underlying determinants that have led to such high incidences can be combated and brought to bay. It was noted that the poorest segment of the population is more susceptible to AIDS due to a lack of proper hygiene, a direct consequence of the dire condition in which many of them live, and improving living conditions and battling food shortages should be high on the agenda of policy makers. Instead of creating a political climate that aims to accuse medical workers of deliberately infecting children with AIDS, it might be more conducive if governments with high HIV incidence spent more time and effort listening to their people and improving their conditions via policy and programs.

Sources:

UNAIDS 2006 Report on the Global AIDS Epidemic. http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH04_en.pdf

HIV in Site: Sub-Saharan Africa. http://hivinsite.ucsf.edu/global?page=cr09-00-00

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