A review of THE COMING PLAGUE: NEWLY EMERGING DISEASES IN A WORLD OUT OF BALANCE by Laurie Garrett, published in 1994. CHAPTER 14: THIRDWORLDIZATION
The global AIDS pandemic might well make the world’s poorest nations much, much poorer
By 1988 Western economists and African leaders were asking “Will this epidemic slow, or even destroy, African development? Is it possible that AIDS will destroy all the development programs we have spent the last three decades building?” It seemed too horrible to contemplate, yet inescapably apparent, that the global AIDS pandemic might well make the world’s poorest nations much, much poorer. The African nations entered the AIDS era already severely impoverished. The 1987 GNP per capita in the United States was $16,690. In Tanzania it was $290, in Zaire a mere $170.
Familial destruction led to the economic collapse of whole villages
Research identified several key factors. Since the 1970s a host of new microbes had successfully emerged and swept across the continent: drug-resistant malaria, drug-resistant tuberculosis, urbanized yellow fever, Rift Valley fever, and waves of measles epidemics, to name a few. That meant that the health care systems of African nations were already stretched to their limits. Given scarce resources for health care – averaging $1 to $10 per capita annually – any additional burden seriously endangered the viability of entire national medical systems. Compounding the problem was the seeming synergy between microbial epidemics. Wherever AIDS became endemic, tuberculosis followed closely. One epidemic sparked another. Studies all over the continent showed that among the hardest-hit social groups was the well-educated urban elite who could navigate their countries out of postcolonial stagnation into prosperity. Whole families seemed to die off. In some devastated areas familial destruction led to the economic collapse of whole villages that could have a ripple effect through all tiers of the regional economy.
AIDS was creating “a global underclass,”
HIV infection rates in some groups were already staggering by 1988 and would reach positively horrendous proportions by 1993, when some studies would find that upward of 40% of women of reproductive age in key African cities carried the virus. As early as January 1988 economists were predicting financial hard times for the continent. They warned that AIDS was creating “a global underclass,” over and above the previously existent world community of impoverished individuals. The World Bank predicted two immediate consequences of AIDS in hard-hit African areas: a radical slowdown of national GDPs and tremendous competition for scarce health care resources.