AIDS Can Threaten National Stability


Sep 24, 2002

This commentary originally appeared in United Press International on September 24, 2002.

The recent announcement by South Africa's Anglo American Company that it would pay the cost of providing free anti-AIDS drugs to its 134,000 employees gives a clear insight into just how pervasive and debilitating the disease has become for that nation.

Anglo—South Africa's largest company—is concerned primarily about lost productivity and the costs associated with replacing a rapidly diminishing skilled workforce (nearly a quarter of its staff are already infected). But the spread of HIV poses a multi-dimensional threat to South Africa that has both regional and international relevance.

Estimates project that by 2010 more than six million South Africans will have died from AIDS or AIDS-related infections. AIDS orphans in the country are expected to surpass two million over the next eight years, while the number of people confirmed as HIV positive will probably plateau at around 16 percent of the population.

This horrendous toll will have profound consequences for every aspect of South African life during the next 10 to 15 years.

Economically, AIDS will force employers to adjust their net contributions to worker pension, life and medical insurance schemes—adding as much as 30 percent to overall wage bills for an average company. For the South African public, the net result will be lower take-home pay, reduced household incomes and falling domestic savings as a proportion of gross domestic product.

The social and civil implications of AIDS will be equally as profound. In many provinces, schooling is being severely disrupted as a result of AIDS-related teacher deaths, which have risen by more than 40 percent since 2000. Who knows how many future leaders have already been lost to the disease?

And HIV is having a profound negative influence on the fabric of civil society, with ignorance and prejudice often leading to the ostracism of entire families by their communities.

Beyond economic and social considerations, the AIDS crisis has a very real potential to significantly undercut the military effectiveness and profile of the South African National Defense Forces, where HIV prevalence rates may be as high as 60 percent (the government, itself, acknowledges that nearly a quarter of its soldiers are infected).

As the disease spreads, more and more troops will have to be retired from active combat duty, leading to a "hollowing out" and concurrent loss of expertise from the army's vital operational middle management. Apart from these organizational problems, AIDS is liable to directly impact the South African National Defense Forces' ability to participate in regional peace-keeping missions, where current United Nations standards stipulate that only HIV-negative personnel can be deployed.

Finally, HIV/AIDS could conceivably emerge as one of the most important drivers of South African crime and civil instability over the next decade. A burgeoning orphan population—most of whom will be impoverished and left to fend for themselves—will help to produce a juvenile sector that is at greater risk of engaging in delinquent behavior.

The disease is also forecast to have a devastating effect on the national police (which, given the age and marital structure of the force, is acutely prone to sexually-transmitted infections) and could further degrade what is an already inefficient court system by debilitating key players such as defense witnesses and trial prosecutors.

The implications of the South African AIDS crisis extend beyond the nation's boundaries. The Republic remains crucial to the overall stability of sub-Saharan Africa by virtue of its relative wealth, power, size and status. Any decisive reduction in Pretoria's own security, therefore, is sure to have a domino effect on wider regional stability, exacerbating the poverty, internal chaos and general disruption that have plagued countries like Zimbabwe, Zambia, Mozambique, Democratic Republic of the Congo, Malawi and Angola.

If South Africa is unable or unfit to discharge its regional duties, the onus for maintaining order in Africa will, by default, increasingly fall to the wider international community, including resource-rich and historically linked states such as the United States and Great Britain.

Most importantly, however, the AIDS epidemic serves as a stark reminder of the all-pervasive and insidious impact that infectious diseases can have on a nation's wider stability and viability. Many of the conditions underlying the seemingly unstoppable spread of the immunodeficiency virus—poverty, apathy, urban sprawl, misinformation, lack of public infrastructure and societal dislocation and imbalance—also affect disease incidence in general, and exist in many other countries in varying degrees.

A disease-based crisis of similar proportions could, therefore, break out in any country at any time, especially given the global and interdependent nature of our international environment.

Peter Chalk is a policy analyst at RAND Corp. in Santa Monica, Calif.

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