Africa is sitting on a potentially devastating time-bomb. AIDS is a silent and stealthy destroyer. It lies dormant for years and then suddenly springs up with murderous effect. Over the next few years, Africa will be rocked by an avalanche of AIDS related deaths. What impact will this have on the continent's economy? Will AIDS also kill Africa's productive capacity? Tom Nevin has been finding out.
"It frightens me and makes me feel anguished inside that we're losing a population and nobody seems to be disturbed. We're going to depopulate an entire continent," says Professor Alan Smith, head of virology at Natal University medical school.
"New statistics released recently by Durex, the world's leading condom brand, show a frightening trend towards global apathy when it comes to converting HIV/AIDS awareness into action.
"Nearly the entire Durex Global AIDS survey population (97%) is now aware of AIDS and the chilling statistics associated with the epidemic," says Mr Peter Smith, managing director of Durex South Africa. "This awareness, however, is not translating into personal concern. Only a little over one-third (36%) of the global population worry a great deal about contracting the AIDS virus and an additional 29% of the population are only somewhat anxious."
Rather than taking preventative measures by using condoms, 45% have either reduced their number of sexual partners or are more particular about selecting them, relying on their own personal judgement to assess the safety of a current or potential partner. "It is frightening that in spite of the very high aware-ness of HIV/AIDS only 9% of South Africans are insisting that they or their partner wear a condom every time they have sex," says Mr Smith. "With more than 2.5m South Africans already infected, these results confirm that we are sitting on a time bomb."
The economic impact
The major problem with understanding the implications of AIDS is that it is a new and unique disease," says Mr Alan Whiteside, associate professor at the economic research unit of the University of Natal and a world authority on the economic implications of the disease. "This means that there are no parallels to which we can refer. Because AIDS is so new, there is no country in the world where the epidemic has run its course -- and it will be many decades before it does."
Since AIDS is primarily spread through sexual transmission, the peak ages of people becoming infected with HIV are 15-40 years and AIDS deaths occur 6-12 years after infection. As a consequence, AIDS increases mortality in age groups that typically have the lowest mortality rates.
'Disasters do not happen, they unfold,' note Blaikie, Cannon, Davis and Wisner, authors of a recent paper entitled Natural Hazards, People's Vul-nerability, and Disasters. This may be glaringly obvious in the case of slow-maturing disasters such as famine, the even slower AIDS pandemic, or ozone depletion, processes which unfold over a period of perhaps 30-80 years or more.
The most direct demographic consequence of AIDS is an increase in mortality. Without effective treatment of HIV infection, half of all infected adults in Africa will die in about 6-8 years and most of the rest will eventually develop AIDS and die if they do not die from other causes first. The average time from infection to death may be as short as six years in some developing countries and as long as 12 years in the industrialised ones.
"The economic effect of AIDS will not be uniform across countries or even within societies," says Professor Whiteside. "The impact will be felt at various levels and to various degrees.
"These effects derive from the fact that the individuals who fall ill and die are all economic actors, that is producers or consumers. The effect of an infection is felt first and most immediately by the person who falls ill and by their family. It then spreads like a ripple through the household, community, and then through the country as a whole."
In 1997, for the first time, both the United States and France have reported a decline in the number of AIDS deaths. This is probably due to new drug therapies. But such drugs are expensive and difficult to administer and for most of the developing world not available, and so HIV infection leads inevitably to AIDS and death.
Will this lead to a negative population growth? Conclusion from studies, says Prof. Whiteside, is that AIDS will cause negative population growth in Africa only if adult HIV prevalence-levels increase to 30-50% or fertility declines sharply. "It is possible," he notes, "that the...