steady increase in the incidence of breakdowns, accidents, delays and misjudgements,
and output will suffer. The danger is that skilled workers, supervisors and managers
will die of AIDS faster than replacements can be trained (Southern African Economist
1992:19). One Bank has already lost 55 skilled personnel since 1989 and has been
forced to close some branches as a result. Some employers are now screening workers
and reconsidering their education and training programmes. In Zimbabwe, where the
average length of service of skilled workers with a particular company is thought to be
about three years, attempts are being made to resist employment discrimination against
workers carrying the virus. Many of those infected will have a productive working life
that extends beyond the length of time in any particular job.
The full implications of the spread of HIV have yet to be established and there
continues to be much uncertainty as to how the disease will develop and what effects it
will have on population growth and health status. If mortality rates do reach the levels
of the most pessimistic predictions the working age population may be decimated and
the social fabric of societies severely damaged. A recent prognosis suggests that
population growth rates could decline by between 1 % and 2 % as a result of increased
adult and child mortality and a consequent decline in life expectancy (Anderson et al
1991). Seroprevalence rates vary widely from country to country and reliable data
which might provide a comprehensive picture is largely absent. Reported rates of
seroprevalence amongst pregnant urban women who have been tested range from 5% to
20% or more in Sub-Saharan Africa, amongst sex workers figures as high as 70% to
80% have been found in some populations (de Bruyn 1992:249). In some central
African capitals 50% of the admissions to hospitals are now aids related (World Bank
1991).
African HIV infection occurs heterosexually. Patterns of infection vary but it appears to
be most common for seroprevalence rates to be greater amongst 15-29 year old females
than males, with the opposite trend amongst 30-50 year olds. In Tanzania the majority
of known cases of HIV are amongst women and about a quarter of those who were
pregnant and infected gave birth to infected children. About 30% of women attending
ante-natal clinics in Lusaka carry the virus. In Angola child mortality is estimated to
increase by 17% by the year 2000 as a result of AIDS. Women are responsible for
about 70% of the agricultural production in rural areas and the burden of caring for sick
children may result in declining food production. Estimates from Zambia suggest that
there may be as many as 600,000 orphans by the year 2000. In Sub Saharan Africa as a
whole the figure may be as high as 5 to 10 million orphans, with a further 10 million
children infected with AIDS by their parents (Southern African Economist 1992). The
direct costs of treatment have been estimated to range from 36% to 200% of GNP per
capita (Southern African Economist 1992:4). These are substantial, especially in
countries which have seen spending on health decline, and place an unsustainable
burden on public health systems as the numbers infected grow.