EVIDENCE is growing of the high impact of AIDS on developing nations' economies.
Industries face the loss of trained employees while many farms are losing laborers, according to two recent studies by the World Bank on AIDS in Africa. The continent has more than half the world's AIDS (acquired immune deficiency syndrome) cases. Interviews with AIDS patients here underscore assessments by Kenyan officials that the AIDS crisis in Africa has both a personal dimension for individuals and an economic one for the whole population.
The problems now confronting Africa may soon become the problems of Asia, according to Michael Merson, director of the AIDS program for the World Health Organization. By the end of the decade, Asia may have a higher annual rate of AIDS infection than Africa, he says.
Dr. Merson is calling for a $3 billion AIDS prevention program in developing countries, which he says could cut in half the expected deaths from AIDS by the year 2000. "So many lives could be saved," he says. "The world can find this money when it wants to." World Bank economist Dean Jamison says the $3 billion represents only a fraction of the $170 billion spent on health care each year in the developing world. Mr. Jamison says important strides have been made in extending life expectancy in the develop ing countries. But without a crash AIDS prevention program, these gains could be undone, he adds.
"The AIDS epidemic is a serious health problem with broad implications for every sector of the economy," says Edward Jaycox, the World Bank's regional vice president for Africa. "It is dealing a major blow to countries struggling for economic recovery." The toll extends throughout the economy, including:
* Stopping people at the peak of their working careers, draining industries of manpower, and raising employers' costs covering absence, sick pay, and health insurance. AIDS is taking people, many "with scarce skills that are difficult to replace," Mr. Jaycox says.
* Slowing the production of cash crops in developing countries. Deaths of breadwinners are forcing remaining family members to cut back their agricultural activity. And many families "are taking children out of school to replace labor lost on farms," Jaycox says.
* Diverting money from investment and saving. Instead of building their capital, many families are forced to spend everything and go into debt to pay health-care and funeral costs.
Such broad assessments are based on the experiences of millions of individuals in Africa.
Edwin Odera, a college graduate in mechanical engineering here in Kenya, for example, was tested in 1989 and diagnosed as having the AIDS virus. He would be holding down a full-time job, he says, but "no employer can accept my inconsistency in work."
Mr. Odera says he is concerned that his family, which sacrificed to pay his educational costs, will not get the economic support they need from him. "I was the hope," he says. "Now I've failed them." But Odera is using his energy to counsel others about the disease and how to help prevent it. (AIDS in Africa is most commonly transmitted heterosexually.)
Gilbert Jimbo, manager of Kenya's National Aids Control Program, says that AIDS patients occupy up to 60 percent of the nation's hospital beds in some areas.
"The impact of AIDS on the economy in Kenya will be the loss of 22 years of the patients' lives, which will cause a shortfall of between 6 percent and 15 percent in gross domestic product [GDP] by the year 2000," Dr. Jimbo says.
A World Bank study on neighboring Tanzania estimates labor- force losses there due to AIDS could cause a 14 percent to 24 percent drop in GDP levels by 2010. But 4.5 million lives could be saved in Tanzania over the next 20 years if a successful prevention program is put in place, according to Jeannette Murphy, who directed the study.