Since the beginning of the epidemic more than 15 million Africans have died from AIDS. Nearly two-thirds of all people living with HIV are found in sub-Saharan Africa, although this region contains only about 10% of the world’s population.

The Impact on the Health Sector

  • As the epidemic matures, the demand for care for those living with HIV rises, as does the toll of AIDS on health workers.
  • In sub-Saharan Africa, the direct medical cost of AIDS has been estimated at about US$30 per year for each person infected.
  • In sub-Saharan, Africa, people with HIV-related disease occupy more than half of the hospital beds.
  • HIV positive patients stay in the hospital four times longer than other patients
  • To save space, people aren’t being admitted until they are in the later stages of illness, reducing their chances of recovery.
  • There has been an increased shortage of healthcare professionals due to infection and death, as well as excessive workloads, poor pay, and the temptation to migrate to richer countries once trained.
  • Although the recent increase in the provision of antiretroviral drugs (ARVs, which significantly delay the progression from HIV to AIDS) has brought hope to many in Africa, it has also put increased strain on healthcare workers because providing ARVs requires more time and training than is currently available in most countries.

The Impact on Households

  • Often the poorest sectors of society are most vulnerable and for whom the consequences are most severe.
  • In many cases, households dissolve because of AIDS, because parents die and children are sent to relatives for care and upbringing.
  • Data suggests that households in which an adult had died from AIDS were four times more likely to disband than those in which no deaths had occurred.
  • In Botswana, it is estimated that, on average, every income earner is likely to acquire one additional dependent over the next ten years due to the AIDS epidemic.
  • Children may be forced to abandon their education
  • Already poor households coping with members who are sick from HIV or AIDS are forced to reduce spending on necessities like clothing, electricity and even food.
  • The death of males appears to reduce the production of ‘cash crops’ (e.g. coffee, tea, and sugar), while the death of females reduces the production of grain and other crops necessary for household survival.
  • Loss of income, additional care-related expenses, the reduced ability of caregivers to work, and mounting medical fees push affected households deeper into poverty.
  • HIV-related care can absorb one-third of a household’s monthly income.
  • Tapping into available savings and taking on more debt are usually the first options chosen by households struggling to pay for medical treatment or funerals. As debts mount, precious assets such as livestock and even land are sold, and as debt increases, the chance to recover and rebuild diminishes.

The Impact on Children

  • As parents and family members fall ill, children take on more responsibility to earn an income, produce food, and provide care for family members.
  • It is harder for these children to access adequate nutrition, basic health care, housing, and clothing.
  • Often both parents are HIV positive in Africa, consequently more children have been orphaned by AIDS in Africa than anywhere else.
  • One of the more unfortunate responses to a death in poorer households is removing the children (especially girls) from school, as uniforms and fees become unaffordable. A good basic education ranks among the most effective and cost-effective means of preventing HIV.

The Impact on Enterprises and Workplaces

  • The vast majority of people living with HIV in Africa are between the ages of 15 and 49 – in the prime of their working lives. As a result, labor is dramatically affected, creating a set-back in economic and social progress.
  • Company costs for health-care, funeral benefits, and pension fund commitments are likely to rise as the number of people taking early retirement, or dying, increases.
  • As the impact of the epidemic on individual households grows severe, market demand for products and services consequently fall.
  • The epidemic hits productivity through increased absenteeism, which can account for as much as 25-54% of company costs according to comparative studies of East African businesses.
  • In southern African countries, these AIDS-related effects could cut profits by at least 6-8%. 40% of companies reported a negative effect caused by HIV and AIDS.
  • Only 13% of the companies (with fewer than 100 workers) surveyed had a company policy in place to deal with HIV and AIDS.

The Economic Impact

  • HIV and AIDS cause a reduced labor supply through increased mortality and illness. Amongst those who are able to work, productivity is likely to decline as a result of HIV-related illness.
  • Government income also declines, as tax revenues fall and governments are pressured to increase their spending to deal with the expanding epidemic.
  • AIDS limits the ability of African countries to attract industries that depend on low-cost labor, and because of the level of risk, investments in African businesses are less desirable.
  • The impact that AIDS has had on the economies of African countries is difficult to measure but scholars estimate that there is a loss of 1% in sub-Saharan Africa’s gross domestic product (GDP). This may seem small, but it has the potential to grow over time.

HIV/AIDS in Botswana

1) What is the HIV prevalence rate in the general population of Botswana?
2) In what ways does HIV affect people in Botswana?
3) Who forms the African Comprehensive HIV/AIDS Partnership (ACHAP)?
4) In what ways does the partnership help?
5) What evidence is there that the programme has been successful?
6) What has it demonstrated to the rest of Africa?
7) What is the second phase of the programme and what does it require?