(photo from http://www.debswana.com/)

On my drive home the other night, I listed to a radio program that was interviewing an executive at Debswana, the partially government owned diamond company in Botswana. Diamond sales globally have been hit hard due to the global economic crisis and the company had thus decide to halt production at many of its mines. Thousands of workers have been laid off. I briefly wondered to myself, what impact would this have on HIV? Would the government need to scale back ARV treatment programs? Would there be fewer migrants from other countries? Would there be more or less new cases of the disease?

Today, a news article from Zambia made me think about this topic again. Copper has also seen significant declines in its prices and production has also been shuttered in many copper mines in Zambia. The news report suggested that it has led to an increase in sex work and thus in all likelihood an increase in incidence of HIV/AIDS in the region.

There is no doubt that economic activity and economic well-being are inextricably linked to the spread of HIV/AIDS but it is not at all clear to me what direction the effect of the current economic crisis will go. The diamond and copper mines have always been seen as part of the reason why southern African nations have had higher levels of HIV/AIDS prevalence. Will the laid off employees return to their homes and spouses (will this increase or decrease the spread)? Will they buy more or less sex from sex workers (presumably a normal good)? Will international trade of goods be reduced and lead to less spread of the disease?

Emily Oster believes that there is a direct causal relationship between economic activity and HIV incidence. She argues that the decline in incidence of HIV seen in Uganda, and which has been heralded as the text book example of how to make prevention work, may have been due to a decline in coffee exports rather than any major change in behavior. She focuses on coffee exports, which may involve different human patterns than mining so it is not clear how generalizable these results are to other countries. If only I had better data…

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2 Responses to “Will the global economic crisis increase or decrease HIV incidence in Africa?”

  1. Alanna says:

    That’s a fascinating question. It bet there’s huge variation from community to community, depending on drivers of the epidemic and community structures.

    Here in Tajikistan, many migrant men are coming home for good because of the economic crisis in Russia. People are seeing this as a bad thing, and I keep wondering – something good must come from having the men back, right?

  2. James H. says:

    In terms of sub-Saharan Africa, you’d think that Zimbabwe would make a good case study of this, perhaps compared to Botswana. If one could do a good epidemiological comparison of incidence in the current mileu, that is.

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