Guyana and the wider world
On rflection
Health scourge
Scope
HIV/AIDS and development
by Dr Clive Thomas
Stabroek News
July 8, 2001
Our examination of globalisation and the "fraying web of life" started with an examination of the accelerated erosion of our natural environment and the rapid extinction of species. This destruction of the world's ecosystems, represents, as it were, the natural world manifestation of the negative aspect of globalisation. This was followed by an examination of the erosion of culture, as vividly demonstrated in the accelerated loss of spoken languages. As it was put, with this loss came the loss of knowledge, ideas, concepts, and experience at the global level. Humanity, as a whole, we argued, is worse off when any spoken language disappears. This represents therefore, the cultural manifestation of the negative aspect of globalisation.
More importantly, we linked the two dimensions, to the deeper underlying situation of social inequality and injustice, which persists between countries and cultures, and also within them. This social inequality, it was argued, parallels the deepening inequalities also evident from the economic indicators in this period of globalisation.
Put bluntly, we are advancing the view that, the observed widening gaps in incomes, wealth, technology, trade, consumption, and living standards between rich and poor countries and between rich and poor persons within most countries are intrinsic features of the unparalleled growth and economic expansion, which have occurred with globalisation. Social inequality and injustice are linked phenomena in economy, nature, and culture.
Today we conclude this area of our discussion with a look at what has become one of the greatest health scourges that has threatened the existence of the earth's population, namely, HIV/AIDS. It is pure coincidence that we approach this topic at the point in time when there is a worldwide focus on HIV/AIDS awareness. As we shall see, here too it is noticeable that this dreaded disease thrives in the context of social inequality and injustice between and within countries.
The scope of the HIV/AIDS epidemic is tremendous. It poses a threat to human kind that is very often not fully recognized. Starkly put, the HIV/AIDS virus is presently the greatest single threat to the human species. Consider a few facts. In the 20th century we have experienced an awesome loss of population through wars, including the two World Wars, (1914-1918 and 1939-1945). Great as this loss has been from wars, it is not widely known that over the past two decades alone, HIV/AIDS has killed more people than "all" the wars in the 20th century. This is, by any measure, destruction on a truly monumental scale.
It is estimated that worldwide, 36 million people are currently affected with HIV/AIDS. The concentration of these numbers is greatest in the developing world. As many of 95 percent of all infected persons live there. Sub-Saharan Africa alone accounts for 70 percent of the infected population. Each day in Sub?Saharan Africa more than 10,000 persons are diagnosed with HIV/AIDS. Within a decade, these persons will in all probability be dead. The death toll there is already in excess of 14 million persons. It is projected that another 23 million will be dead by 2020.
Infection rates in Asia and Latin America are lower, but rising. In India, for example, the rate is about 1 percent. However, because of the size of its population, India has the highest absolute number of HIV/AIDS infected persons in the world . This fact is also not widely known.
Of note, it has been recently reported that the Caribbean has the second highest infection rate in the world. The dramatic consequences of this for us here in Guyana will be felt increasingly over time.
For a long time the approach to dealing with AIDS was basically a health approach. That is, the focus was on diagnosis, treatment, and care. As cases have multiplied, today's approach recognises that HIV/AIDS has become a development problem as well. Its developmental effects on the individual, family/household, community and nation are staggering.
To begin with, generally HIV/AIDS attacks persons at their most productive years. Long illness and eventual death take their toll on the individual's earnings, welfare, and standard-of-living. It has been estimated that, typically, the fall in household income when an adult parent acquires HIV/AIDS is on average 40-60 percent. A decline in income of this magnitude adversely impacts on the family. Because it is a parent who typically contracts the disease first, children suffer. Moreso in light of the probability that the other parent will subsequently show signs of the disease.
In such stressful situations the family is forced to adopt survival strategies, which could include the run down of its savings, disposal of assets, curtailment of the education of children, and eating less. The aggregate impact on the community and country when many families are so affected is great. At both the national and community level resources will have to be diverted to the provision of health care. For the country as a whole, the cumulative effect on natural life expectancy can be dramatic. Thus in Botswana, where many Guyanese teachers migrate to, the average life expectancy has fallen from 66 years to 33 years, due to the impact of HIV/AIDS.
A health scourge of this magnitude runs the risk of becoming an uncontrolled pandemic, worse than all the plagues we have ever known combined. As we shall see next week, this threat of HIV/AIDS to the survival of human kind cannot be isolated from the social inequality and injustice we referred to, and which globalisation is worsening.