Thirty-two years ago, when the HIV virus was first diagnosed, the disease was a death sentence and there were no medicines able to prolong life for those infected with HIV. Seventeen years ago, when the first decent anti-viral drugs appeared, treatment cost $10,000 per year, an amount that was far beyond the means of most patients or their governments. Nowadays it is possible to get quality treatment for just $200 per year and there are numerous international support programs for those infected, which have created opportunities for HIV+ people to live full lives.
Today, more than 8 million people globally are undergoing treatment, though the total number of those in urgent need of treatment is about 15 million. But this is progress and it has resulted in the number of annual deaths falling from 2.3 million in 2005 to 1.7 million in 2011. In addition, the number of new cases of infection each year is falling thanks to the successful introduction of a number of measures that include promoting safe sex and preventative steps to prevent transmitting the infection from mother to newborns.
A recent report from UNAIDS, established in 1996 by the United Nations to combat the HIV infection, shows the rate of new HIV infections, which is down in many parts of the world, but especially in the sub-Saharan countries of Africa. Although 70% of all new HIV infections still happen in this region, the dynamic is positive. From 1998 to 2011, the number of people with the HIV infection in the region has fallen from 2.6 million to 1.8 million. Individual countries with the world’s highest HIV prevalence are also demonstrating positive changes. The number of new infections in Malawi has declined 73% since 2001, while Botswana has dropped by 71%, Namibia by 68%, Zambia by 58%, and Zimbabwe by 50%. This is largely due to the successful promotion of safe sex and the spread of anti-retroviral drugs, which, in addition to extending life for those already infected, prevent the transmission of the virus from mother to child.
“The UNAIDS report shows that in 25 countries with low and middle-incomes, a more than 50% reduction in the number of new HIV cases has been recorded,” Jean-Elie Malkin, Director of the UNAIDS Regional Support Team for Eastern Europe and Central Asia, said in an interview with WEJ. “And more than half of these cases are in Africa, a region where the HIV infection is most widespread. In addition, over the past six years, countries south of the Sahara have seen a decline in AIDS deaths by one-third and a 59% increase in the number of people receiving anti-retroviral therapy. Governments have increased their domestic investments in problems concerning AIDS. From 2001 to 2011, more than 81 countries increased their domestic investments in this area by 50%. If we can keep this trend going and continue scaling-up prevention and treatment, we can achieve sustainable success.”
The Economic Dimension of AIDS
Modern medicines only suppress the virus without removing it from the body, meaning that treatment has to be continued throughout the patient’s life. This means two things. First, until a complete cure is found, someone has to be paid for the infected person’s long-term, anti-retroviral treatment. The total cost of treatment in low and middle-income countries is $17 billion annually. And while countries in this group are already covering more than half of these costs, it will still be a long time before subsidies from wealthy countries are no longer needed.
Secondly, the lack of a medicine that is able to completely clear the blood of this virus means there is still need to invest a lot of money towards developing drugs to do just that. In this regard, there is true reason to hope. For example, some people who have certain genetic mutations are immune to the infection. Timothy Brown was the first to have the opportunity to take advantage of this, having undergone a transplant with genetically mutated stem cells. There are also people who are infected with the virus but don’t present with symptoms. There is reason to believe that if one starts taking medication soon after the infection occurs, it is likely that the person will only carry the virus and not develop symptoms of the disease. Of special significance was the fact that on March 3, 2013, it was announced that for the first time in history, scientists were able to completely cure a child of HIV with the use of medicine.
In addition, according to UN data, there is a correlation between a decline in life expectancy brought on by the HIV infection in developing countries and a reduction of GNP in these countries. According to the World Bank, AIDS slows annual GDP growth on average by 0.8-1.4%.
The impact of AIDS on economic performance is explained not just by a decline in the number of working-age people, but also by requiring large spending on the part of governments to provide treatment for those infected. At the same time, the economic situation affects the ability of individuals or countries to have access to anti-retroviral therapies. It’s a vicious cycle: Countries with high numbers of HIV-infected people begin experiencing economic difficulties because of a lack of manpower and economic performance declines as a result, which has a negative impact on the sick.
Jean-Elie Malkin commented on this situation to WEJ, explaining that “the decline in the rate of economic growth worldwide has resulted in fewer jobs, revenue decline, and an increase in poverty. All of this has a strong influence on people already infected with HIV – it becomes harder for them to continue treatment as health care becomes unaffordable to them. In addition, the crisis has affected the ability of governments to provide funding for programs aimed at combatting HIV. Because of the long-term nature of the disease, the immune system is weakened and leads to death, which apparently has a direct impact on the labor market, with a reduction in the number of working-age people and labor productivity. Assessing the impact of HIV on the economy is a very difficult task. There are a number of studies that point out that the AIDS epidemic has clearly defined economic impact, showing an annual reduction of 2-4% in the national growth rates across all of Africa.”
Big Business in Battling HIV
Many Western companies doing business on the African continent have their own anti-HIV programs. It’s a logical move – imagine that a Western company trains a highly specialized person, investing time and money into him and suddenly he falls ill. After some time, that person will have to be replaced by a new employee who is less qualified. The damage to the company is obvious.
Mining giant Anglo American, based out of South Africa, offers all of its employees regular HIV testing and lectures about means of transmission and methods of protection, while leaders in the mine, where there is the lowest number of cases, receive encouragement from company management. The company’s policy is bearing fruit – not a single Anglo employee who was HIV negative in 2012 had the disease in 2013. In addition, Anglo American is a good example of a responsible business, where all HIV positive employees receive anti-retroviral treatment at the cost of their employer. Employees in South Africa are also given such social guarantees by the largest beer-brewing company, SABMiller, which, among other things, distributes free condoms to visitors wherever its products are sold.
The results of the efforts by the international community and businesses in the fight against AIDS are already being felt. In the near future, even if a cure isn’t found, the number of new infections will be greatly reduced and in the foreseeable future, it could be reduced to zero.
Text: Olga Irisova