Madeleine Wackernagel highlights some of the issues raised at the World Economic Forum
AT the February meeting of the World Economic Forum (WEF) in Davos, President Nelson Mandela made an impassioned plea for a renewed fight against Aids. His address made world headlines, but back home the “new struggle” has been sidelined by the Sarafina II and Virodene fiascos, despite growing evidence of a burgeoning problem, predicted to cost 1% of South Africa’s gross domestic product by 2005.
Last week’s Southern Africa Economic Summit of the WEF brought home the costs of inaction. Aids cannot be seen in isolation – the costs to productivity and, by implication, competitiveness are huge as whole swathes of economically productive people are wiped out.
Said Mandela: “Aids kills those on whom society relies to grow the crops, work in the mines and factories, run the schools and hospitals … thus increasing the number of dependent persons. It creates new pockets of poverty when parents and breadwinners die and children leave school earlier to support the remaining children.”
One Zimbabwean farmer related his experience – he has no employees in the 25 to 40 age group but plenty of younger and older workers. Another told the story of a bank that trains three people for one job in anticipation of Aids-related deaths.
But as Patrick Dixon, director of Global Change, emphasised, action must be taken before the situation is as dire as in Uganda, where children-headed households are common in rural areas.
Uganda finally moved to vanquish the “enemy” in 1990, taking a multi-sectoral approach, involving government, business and non-governmental organisations.
“Our policy in fighting Aids has been to give it a face and to expose it as a deadly enemy,” said Ugandan Prime Minister Abednego Kinto-Musoke at the WEF meeting. The picture is depressing: 500 000 people have died since the early 1980s, 1,5- million more are HIV-positive and the number of orphans is rising constantly. But infection rates have been cut from 30% to 15% in some urban areas.
“The situation is not hopeless. With appropriate prevention and care programmes, the enemy will eventually be conquered.”
Key to Uganda’s programme has been “a policy of openness and government commitment from the highest political level, spearheaded by President Museveni”, said the prime minister.
The lack of a political commitment is a problem in this country, says Dr Clive Evian, an expert on Aids. Ugandans only reacted once they had witnessed for themselves the “real” state of the epidemic, when the numerous empty villages could no longer be ignored. South Africa has virtually caught up in terms of the number of cases but not in terms of awareness and preventative measures.
“Other socio-economic issues, such as crime, tend to take precedence, thereby shifting Aids off the agenda. It is a highly politicised subject and needs political leadership all year round, not just on World Aids Day or in National Condom Week.
“Aids could have a more devastating effect on this country than apartheid. The question now is not whether there will be an epidemic, but how terrible it will be.”
Even with notoriously unreliable statistics, the consistent rise in infection rates is evident. Latest government data show 20% of pregnant women in KwaZulu-Natal testing positive and 25% in Durban.
Gencor’s Adriaan du Plessis told the conference the infection rates at South African mines were estimated at 20%, but without accurate data, it was difficult to devise a counter-plan.
Nonetheless, the costs to business overall could be broken down into 36% in lost production; 30% in training; 12% in healthcare and 13% in death. And by 2000, the epidemic was predicted to account for 60% of all healthcare costs.
Business, says Evian, is responding to the problem, although there is still room for improvement. Labour, on the other hand, is doing very little, even though Aids is a health and safety issue and thus falls under the unions’ brief.
“We should make Aids a national issue, covered in schools, businesses, union meetings and on television. Only once other countries’ experiences are brought home to us, once it is made real and given a face, will the devastating effects be driven home.”
Denial and obfuscation are still a problem – and not only among the population at large. Said Marvellous Mhloyi, professor of demographics at the University of Zimbabwe: “Governments have to take responsibility; denial is still too much in evidence. They can’t just abdicate because structural adjustment programmes mean spending cuts. Interventions by business will only work if they are given government support.”