As the AIDS epidemic rages on at rates even higher than the dire predictions of a decade ago, the effects of the disease are increasingly visible beyond infected individuals. The disease has stymied economic development and ravaged societies around the world.

The trend is most visible in developing nations, especially in sub-Saharan Africa, where the disease is most widespread and devastating.

As Moise Desvarieux, a University public health researcher, described, the social and economic implications of the disease are often intertwined.

“You have an impact because of the sheer number, you have an impact because of the age group, you have an impact because of the transmission to kids, you have an impact because those kids grow up orphans,” Desvarieux said.

Diseased economies

Pierre-Marie Girard was among a team of French public health researchers who recently visited the University. He was part of the International Training Research and Exchange Program in Infectious Disease Epidemiology, a partnership between the University and the Universite de Paris VII which Desvarieux heads.

At a meeting during his visit, Girard produced a graph that charted the gross domestic product of nations against the prevalence of AIDS.

While not fully explaining the problem, the graph does illustrate an important point about AIDS in the developing world: AIDS decreases productivity – and therefore GDP – while falling GDP simultaneously limits a nation’s ability to fight the disease.

A main factor in lower productivity is that AIDS mainly targets the young and able-bodied – the labor force that fuels production, Girard said.

Also, he added, AIDS is a debilitating disease, often leaving those infected bedridden and needing care for months or years. Not only is the infected person taken out of the labor force, so are the friends of family members who care for the infected person.

Still, for several reasons it is difficult to quantify the larger impact of the AIDS epidemic on economics.

For instance, basic economic information on developing countries – those most affected by the epidemic – is often weak to begin with, even without trying to measure AIDS’ impact, said G. Edward Schuh, a University professor at the Humphrey Institute of Public Affairs.

Also, it is hard to segregate the economic symptoms of AIDS in those countries from the complex factors of development, such as urbanization and changing incomes.

Moreover, access to drugs is, in some countries, forming a rift between the rich and the poor.

As Roland Landman, another INTREPIDE researcher, bluntly put it, in most developing nations the poor have “zero” access to drugs.

Those within the developing world with higher incomes are not only more able to afford treatment; they also have greater access to treatment programs because they are often living in population centers.

“It’s important that we don’t strengthen the divide through the drug program between those who can afford the antiretroviral drugs and those who can’t,” Desvarieux said.

A generation of orphans

One of the most dramatic effects of the disease on some African societies is the incredible number of children orphaned by AIDS.

In some places, the epidemic leaves one in 20 parentless. In Uganda, orphans number 1 million, Girard said.

Also, in cultures where the extended family is highly valued – as is often the case in Africa – family members often play a role in caring for the sick, which can be physically and mentally exhausting.

On a more basic level, it is yet to be seen precisely how such large numbers succumbing to AIDS could change a society.

AIDS is now the biggest killer in Africa, responsible for one out of every five deaths, twice as many as the next biggest cause of death, Girard said. He said the life expectancy in Africa is 49, far lower than it would be without the impact of AIDS.

Some solutions

Ali Galaydh, former prime minister of Somalia and a current Humphrey Institute professor, said it is difficult to measure the impact of AIDS on Somalia. He can only say from experience that the country has been spared the ravaging its neighbors, such as Sudan, Ethiopia and especially Uganda, experienced.

He said long-lasting turmoil in the country has made tracking AIDS cases all but impossible. And the country hardly has an economy at all, let alone the ability to track AIDS effects on it, he said.

Concerning AIDS in Africa, Galaydh advocates several things to address the problem.

Galaydh suggested African nations that share geographic, cultural, ethnic and linguistic ties could join together politically to strengthen their disease-fighting efforts.

Economic development centered on bringing local products – such as coffee, tea or cocoa – to the international market would strengthen the economy, freeing up more money for AIDS treatment.

Most importantly, Galaydh said, Africa would benefit from enlightened political leadership and progressive action to combat the disease.

The stakes are high as the disease and its impact continue to grow. Africa faces a daunting task – one which Desvarieux said is “equivalent to a war.”

Dylan Thomas welcomes comments at [email protected]