Who's Counting: Costs For AIDS in Africa

“The death of one man is a tragedy. The death of a million men — that is statistics.” — Joseph Stalin.

The AIDS crisis in southern Africa is killing millions of people and, we are told, will lower the average life span in some countries there to the mid-30s, a level not seen since the days before Louis Pasteur determined the cause behind most infectious diseases in the mid-1800s.

Twenty percent of South Africa’s population is said to be HIV-positive, while one-third of Botswana’s citizens are believed infected.

This latter fraction, were it to hold in this country, would translate into 90 million infected Americans. That would include the residents of New York, Philadelphia, Atlanta, Miami, Chicago, Minneapolis, Houston, Denver, San Francisco, and Los Angeles with many millions more to spare — all living with a death sentence. Similar infection percentages hold for Swaziland, Namibia, and Zimbabwe.

One should, of course, question the numbers and percentages involved.

Uncertain Numbers, Certain Need

Figures on HIV-infection are notoriously inaccurate even in this country, no doubt more so in underdeveloped countries. Estimates of the number of people infected with the AIDS virus worldwide usually range between 30 million and 50 million, with some estimates outside this wide range.

Biased sampling, political motives, self-reporting of disease states, and other statistical problems undoubtedly exist. Still, whatever they are, the HIV figures for sub-Saharan Africa are certainly horrendous enough to more than justify the chintzy one billion dollar loan from the U.S. export-import bank announced on July 19.

Anyone who has written about risk assessment and cost-benefit analyses, as I have, has frequently heard from people who utter such twaddle as, “No matter what it costs, if it saves one life it’s worth it.” Where are these people now when a relatively small investment by the West could literally be a life-saver, millions of times over? And what do the presidential candidates who profess to be so ardently religious say about the millions who are dying?

A little more than 50 years ago the United States spent what would be the equivalent today of almost $100 billion on the Marshall Plan to help Europe recover after World War II. It was a magnanimous, humanitarian gesture that, by insuring a prosperous and vibrant Europe, also helped us economically.

There doesn’t seem to be the economic incentive or political will to do anything comparable for southern Africa today. Nevertheless, can we not spend roughly 5 percent of that total, say $5 billion (as a grant and not a loan), to help sub-Saharan Africa deal with the AIDS calamity?

Cost-Effective Approaches

The primary goal, of course, would be to drastically lower the HIV-infection rate. Public relations campaigns promoting the use of condoms, advertising the horrors of AIDS, and debunking belief in curses, witchcraft, and voodoo would be effective and relatively inexpensive. Such measures have worked in Uganda and other countries which have seen their new infection rates drop precipitously.

Also helpful would be promotion of male circumcision, which hinders transmission of the virus, and, perhaps, encouragement of abstinence, which hinders it even more. Better control over other sexually transmitted diseases is also essential.

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