The socio-economic impact
In the mushrooming cities of the south, large new generations have grown up, formally forbidden from sexual relations before marriage, and without the resources to pay a dowry. These people are marrying later than their parents. And this has encouraged the massive development of prostitution in all the cities of the third world.
Things have not been helped by the increasing number of wars, and the collapse of neo-colonial states like Rwanda, Zaire and Liberia. Millions of Africans have been forced to migrate.
All these social factors have obvious consequences for sexual behaviour. An economic and social structure based on the family is exploding, to be replaced by an atomised, disjointed social framework, where traditional relationships are altered and overlaid by market relations. Sexual conduct has changed accordingly.
In many Moslem and animist villages, men used to pass one night with each of their wives in turn. Today, most of their multiple partners will be drawn from a relatively small pool of prostitutes. This acceleration of sexual exchanges has little to do with sexual liberation. Pleasure and promiscuity don't go hand in hand when they are reserved for men only. The right for both men and women to choose their sexual relationships implies liberty, discussion, exchange and respect. It is much easier to integrate the use of condoms into this kind of relationship.
There is no point in advocating fidelity instead of male promiscuity, which is a generalised phenomenon. The solution is sexual equality. Only sexual equality can enable men and women to achieve sexual pleasure and, in this age of AIDS, to discuss, and protect themselves. Human laws will never control our sexual behaviour. Today more than ever, we have need of new social laws
AIDS The social and economic impact of the epidemic on several Sub-Saharan African and South Asian countries is already profound. The direct costs of the epidemic include costs of education, testing, the increased use of healers, medicines, clinics and hospitals by people with HIV-related illnesses. funeral and mourning expenses, and care of the surviving and now-destitute elderly and orphans. UNICEF estimates there are already 1.5 million orphans with parents lost to AIDS in the most affected African countries.
HIV related illness is an extra burden that threatens to overwhelm the health systems of almost every nation in Africa and Asia. A local hospital or clinic will use scarce resources on treatable conditions, rather than deploy medicines and beds for care of patients that cannot be cured. If a person sick with something they believe to be HIV related knows that the local clinic or hospital can offer no treatment or cure, they will not travel or spend money uselessly, and will not even become an HIV statistic. For most of the affected communities, the direct cost of caring for a family member with AIDS is greater than the annual income, and just one AIDS death can plunge the family into irredeemable poverty. In countries where people rely on medical aid or insurance schemes for their health care families already affected by HIV cannot afford to pay the premiums. People testing positive for HIV are excluded
Because of its predominantly sexual transmission, HIV strikes disproportionately at those of working age. In some countries it has threatened the urban, trained and skilled labour force. In other areas, AIDS has removed tens of thousands of people from agricultural labour. Few countries can afford a drop in productive labour or the reversion of farming methods to below-subsistence levels, as children and the elderly take up the burdens previously born by the parents and young adults
HIV provokes disastrous indirect costs to the economy through absence from work, loss of productivity and the difficulty in replacing skilled labour. There is a significant loss in school attendance in families with an adult illness or death. Discriminatory responses to people with HIV in the education and health systems and in the workplace also carry an economic burden, through unnecessary screening, premature dismissals and industrial disruption.
In Thailand HIV may cost 20% of the GNP by the year 2000. Kenya's adult HIV rate of 14%, has caused an estimated 15-25% cuts in profits to noncapital intensive businesses over the last 10 years. In Tanzania, the cost of replacing teachers lost to AIDS over the next decade is estimated at US$40 m. Zambia relies for 90% of its export earnings on its copper mines (which are now being privatised at the insistence of the IMF), yet almost 60% of the mines skilled employees have HIV. In 1991 the Zimbabwe Trade Union Congress estimated that over one fifth of its membership had HIV or AIDS.
At a family level, the death of young adults from AIDS disrupts the generational flow and socialisation patterns. At a national level, AIDS deaths undermine the central infrastructure, with the most expensively (often foreign) educated being disproportionately affected and increasingly difficult to replace with experienced cadre. All eleven of Zambia's air traffic controllers have died of the disease. Such 'turnover" of higher echeIons can lead to national de-stabilisation. Some UN bodies have made HIV rates a key factor in their assessment that some nation states in Africa are becoming "unviable"
Many nations fear that international awareness of their high rates of HIV will affect investment and tourism. The first example was Haiti, where the discovery of high rates of AIDS in 1983 resulted in the decimation of tourist income, then that country's major earner.
Wars and UN interventions have quickened the spread of HIV, through troop movements, sex for money and rape. The UN interventions in Cambodia and Mozambique meant more commercial sex transactions and HIV incidence with infection of local women and foreign soldiers and officials.
The escalation of South Africa's HIV epidemic has occurred only in the 90s much later than the countries to its north. The country now has an estimated 2.4 million people with HIV, which represents an unparalleled socio-economic challenge. The costs of an epidemic of this scope, though well-predicted, were not factored against the promises of housing, jobs, health care and education in the ANC's (virtuallyabandoned) Reconstruction and
Development Program. Nor have they been accommodated within the current neo-liberal framework of policy making in the new South Africa. [KD] *
April 1997#287 25
AIDS Censorship