Report on the Global HIV/AIDS epidemic

Waking up to devastation

ally lose their cattle, thus jeopardizing the food security of the surviving members.
But even the poorer male-headed households experience a decrease in livestock
when a wife dies. In Zimbabwe, the output of communal agriculture (much of it subsistence farming) has fallen by 50% over the past five years owing largely, though
not solely, to the AIDS epidemic, according to a report published in 1998. Maize
production has seen a decline of 54% of harvested quantity and a further drop of
61% in marketed output. The number of hectares under cotton has decreased by
about 34% and marketed output by a further 47%, and the production of groundnuts and sunflowers has fallen by 40%. The Southern Africa AIDS Information
Dissemination Service (SAfAIDS), an AIDS-related nongovernmental organization in,
Zimbabwe, warned that a food crisis could erupt in Zimbabwe within the next 20
years as the group of people of productive age shrinks and the areas under cultivation diminish as a result.
The bottom line: HIV is hurting business
Given the proportion of adults infected with HIV and dying from associated diseases in Africa, it is inevitable that the business sector, as well as families, schools
and other sectors, will feel the cost. Yet many companies (in common with many f
governments) have ignored the early warning signs and have not acted against HIV
until sickness and deaths become too common to ignore. While experience sug- 7
gests that HIV prevention is most effective when it is introduced very early on,
before the virus gets a grip and the population of infected people becomes uncontrollably large, business people have taken some persuading. Interviews conducted
in engineering and construction companies in Gaborone, Botswana, found resistance to the idea of implementing HIV prevention and planning measures even
though 39% of people of working age in the city were estimated to be infected in
1998.
Some companies in Africa have already felt the impact of HIV on their bottom line.
Managers at one sugar estate in Kenya said they could count the cost of HIV infection in a number of ways: absenteeism (8000 days of labour lost due to sickness
between 1995 and 1997 alone), lower productivity (a 50% drop in the ratio of /
processed sugar recovered from raw cane between 1993 and 1997) and higher
overtime costs for workers obliged to work longer hours to fill in for sick colleagues.
Direct cash costs related to HIV infection have risen dramatically in this same company: spending on funerals rose fivefold between 1989 and 1997, while health
costs rocketed up by more than 10-fold over the same period, reaching KSh 19.4
million (US$ 325 000) in 1997. The company estimated that at least three-quarters i
of all illness is related to HIV infection. Indeed, illness and death have jumped from
last to first place in the list of reasons for people leaving a company, while old-age
retirement slipped from the leading cause of employee drop-out in the 1980s to just..
2% by 1997. Figure 12 shows the massive rise in both health spending and new /1
AIDS cases recorded by another agricultural estate in Kenya.

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