Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

/ / personnel, but few countries have as yet fully understood the epidemic's impact on
human resources in their health sector. A study in Zambia showed that in one hospital, deaths in health care workers increased 13-fold over the 10-year period from
1980 to 1990, largely because of HIV. As in other sectors of the economy, rising
rates of HIV infection in health care workers will increase rates of absenteeism,
reduce productivity, and lead to higher levels of spending for treatment, death benefits, additional staff recruitment and training of new health personnel.
Impact on agriculture
Agriculture is one of the most important sectors in many developing countries, particularly when measured by the percentage of people dependent on it for their living. Although the sector may produce only 20% of a country's wealth (measured as
a percentage of the gross national product), it might provide a living or survival for
as much as 80% of the country's population. Indirectly, it provides a livelihood for
still other parts of the population, such as processing workers on sugar estates (see
"The bottom line", below).
i The effect of AIDS is devastating at family level. As an infected farmer becomes
increasingly ill, he and the family members looking after him spend less and less
time working on his family's crops. The family begins to lose income from unmarketed or incompletely tended cash crops, has to buy food it normally grows for..... itself, and may even have to sell off farm equipment or household goods to survive.
The vicious circle is compounded by the high costs of health care, whether the sick
S person turns to a traditional healer or to the health services. A 1997 study by the
Food and Agriculture Organization of the United Nations (FAO) showed that in the
7 mid-west of Cote d'lvoire, care for male AIDS patients cost on average about
US$ 300 a year, representing a quarter to a half of the net annual income of most
small-scale farms.
The time lost by family members must also be taken into account. For instance, the
repeated absence of another member of the farm to accompany the patient to a
healer also reduces the farm's production. And when the most debilitating phases
Sof AIDS coincide with key farming periods such as sowing or clearing, the time
spent nursing a sick person and lost to farm labour is sorely missed. A recent survey in the rural Bukoba district of the United Republic of Tanzania found a radical
shift in the allocation of labour time: a woman with a sick husband spent 60% less
time on agricultural activities than she would normally do.
Altogether, the effects on production can be serious. In West Africa, many cases
7: have been reported of reduced cultivation of cash crops or food products. These
include market gardening in the provinces of Sanguie and Boulkiemde in Burkina
4< i Faso and cotton, coffee and cocoa plantations in parts of C~te d'lvoire. A recent
study in Namibia by the FAO concluded that the impact on livestock is considerable, with a heavy gender bias: households headed by women and children gener
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