- The Washington Times - Sunday, July 16, 2000

Nothing exposes the shortfalls of a health care system as mercilessly as an AIDS epidemic. AIDS is expected to kill more people in Africa in the next 10 years than all the wars of the 20th century worldwide.

So there was little to celebrate at the 13th International AIDS Conference in South Africa going on last week. By 2005, the gross domestic product in most AIDS affected sub-Saharan countries will drop by 14 percent, which will further undercut the regions' already limited ability to contain the epidemic.

In Africa, there are too many examples of how the virus itself limits the region's ability to battle it. The epidemic is creating a large number of orphans in Africa, which is draining the region of much-needed funds to combat AIDS. The cost of taking care of a child in an orphanage is $2,000 a year, an astronomical sum in sub-Saharan Africa. And the immediate expense of maintaining orphans is the small end of the problem. According to a recent study by UNAIDS, the U.N. agency dealing with the disease, 48 percent of primary school-age orphans interviewed in rural Zimbabwe had dropped out of school, and not one child of secondary school age was still in school.

One of the reasons for widespread AIDS transmission is a lack of understanding of the disease and its causes, especially among girls. A recent UNICEF survey shows that in Haiti, Zambia and Zimbabwe, more than half of sexually active girls do not believe they are at risk, even though in Africa, unlike the developed world, AIDS is transmitted mainly through heterosexual sex. The survey also found that in 34 developing countries, a majority of girls between the ages of 15 to 19 didn't know that a person who looked healthy can still be carrying the virus. Unsurprisingly, in Africa AIDS is taking the lives of the very people who can educate others about the virus. In Zambia, for example, 1,300 teachers, two-thirds the number of new teachers trained a year, died of the disease in the first 10 months of 1998.

Africa must take urgent measures to rein in the spread of AIDS, or its outlook for the future is too bleak to contemplate both in human and economic terms. Already, many Africans living in AIDS-infested countries seem to be living in another era, with a vastly inferior quality of life. Life expectancy in some African countries hit by the AIDS epidemic is expected to fall to around age 30 by 2010.

Developed countries could help the region free up resources by forgiving bilateral and multilateral debt. Unfortunately, though, many African countries haven't been able to meet the economic policy requirements lending organizations have set for debt-forgiveness, which doesn't speak very well of their governments.

The private sector could also continue to help. Last week, German drug maker Boehringer Ingelheim made the generous offer of providing Africa drugs to prevent mother-to-child AIDS transmission during childbirth. Boehringer should be commended for its significant contribution, but drugs are just part of the solution.

Much will depend on Africa itself. The region's leaders have squandered countless millions in aid on dubious projects that make Western nations reluctant to lend still more. Institutions that the West takes for granted such as the rule of law and property rights often don't exist, contributing to a lack of political stability. The region could help itself by establishing such institutions and make it a better candidate for the aid it needs.

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