Earth Policy Institute: Health Challenges Growing

african child suffering from malaria
Lester R. Brown


Health challenges are becoming more numerous as new infectious diseases such as SARS, West Nile virus, and avian flu emerge. In addition, the accumulation of chemical pollutants in the environment is starting to take a toll. While infectious diseases are fairly well understood, the health effects of many environmental pollutants are not yet known.

Among the leading infectious diseases, malaria claims more than 1 million lives each year, 89 percent of them in Africa. The number of people who suffer from it most of their lives is many times greater. Economist Jeffrey Sachs estimates that reduced worker productivity and other costs associated with malaria are cutting economic growth by a full percentage point in heavily affected countries.

Although diseases such as malaria and cholera exact a heavy toll, there is no recent precedent of a disease affecting as many people as the HIV epidemic does. To find anything similar to such a potentially devastating loss of life, we have to go back to the smallpox decimation of Native American communities in the sixteenth century or to the bubonic plague that took roughly a fourth of Europe’s population during the fourteenth century. HIV is an epidemic of epic proportions that, if not checked soon, could take more lives during this century than were claimed by all the wars of the last century.

Since the human immunodeficiency virus was identified in 1981, it has spread worldwide, leading to the deaths of more than 25 million people. Today 22 million HIV-positive people live in sub-Saharan Africa, but only 2 million or so are being treated with anti-retroviral drugs. Infection rates are climbing. Without effective treatment, the areas of sub-Saharan Africa with the highest infection rates face a staggering loss of life. Countries like Botswana and Zimbabwe could lose more than a fifth of their adult populations within a decade.

The HIV epidemic affects every facet of life and every sector of the economy. The downward spiral in family welfare typically begins when the first adult falls victim to the illness–a development that is doubly disruptive because for each person who is sick and unable to work, another adult must care for that person. Food production per person, already lagging in most countries in sub-Saharan Africa, is now falling fast in some as the number of field workers shrinks.

Education is also affected as the ranks of teachers are decimated by the virus. With students, when one or both parents die, children are forced to stay home simply because there is not enough money to buy books and to pay school fees. The epidemic is leaving millions of orphans in its wake. The effects on health care are equally devastating. In many hospitals in eastern and southern Africa, a majority of the beds are now occupied by AIDS victims, leaving less space for those with other illnesses. With health care systems now unable to provide even basic care, the toll of traditional disease is also rising. Life expectancy is dropping not only because of AIDS, but also because of the deterioration in overall health care associated with it.

The HIV epidemic in Africa is now a development problem, threatening not only to undermine future progress but also to eliminate past gains. It threatens food security, undermines the educational system, and dries up foreign investment. Stephen Lewis, when he was the U.N. Special Envoy for HIV/AIDS in Africa, said that the epidemic can be curbed and the infection trends can be reversed, but it will take help from the international community. The failure to fully fund the Global Fund to Fight AIDS, Tuberculosis and Malaria, he said, is “mass murder by complacency.”

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