The Moral Economy of Aids in South Africa
by Nicoli Nattrass
(Cambridge University Press)
Mix economics with Aids and generally my first response is a glazing of eyes, shifting of feet and quick dash to the nearest exit. But The Moral Economy of Aids in South Africa by Nicoli Nattrass, an economist at the University of Cape Town, makes even financially-challenged individuals like me grasp the concept of budget deficits, gross domestic product and how we can afford to pay for an anti-retroviral treatment plan.
In October last year the government announced the long-awaited anti-retroviral treatment plan, paving the way for the challenges facing the country to be widely discussed. Nattrass, in a no-nonsense approach, tackles these issues, looking at whether the introduction of drugs will lead to riskier sex as well as endorsing prevention and nutritional campaigns.
The book is devoid of economic jargon on budgets and deficits. Nattrass places these economic decisions against a social background of poverty-alleviation programmes and nutritional needs of people living with HIV/Aids. She captures a brief history of the pandemic, and does not shy from the fact that treatment is going to cost the country a lot of money.
Nattrass puts forward a strong argument for Aids prevention and treatment to be linked to a basic income grant, saying it would address poverty directly by “channelling an income into the hands of the poor”, helping to lower the spread of HIV. But financing a full-scale Aids intervention programme and a basic income grant would mean a significant increase in taxation.
“Either we are going to have to cut back on spending elsewhere,” she says, “or we are going to have to bite the bullet and increase taxation.”
For Nattrass the constant harping on about complexity and the need for endless planning effectively delays the moment when tough financial choices have to be made. “This may be a good short-term electioneering tactic for the ANC, but we will be paying for it in terms of human lives.”