Botswana Watches Economic Success Destroyed by AIDS

Peaceful, bucolic Botswana, with its steady climb out of abject poverty, should have been the star of this week's World Summit on Sustainable Development in neighboring South Africa. Instead, it has become Exhibit A for how human development has, in many ways, gone in reverse since world leaders gathered in Rio de Janeiro 10 years ago.

In the three decades before AIDS exploded in Botswana in the mid-1990s, per capita income soared from $300 to $3,300, thanks largely to the discovery of diamonds. Primary school enrollment advanced to 97 percent of all children from 50 percent. Infant mortality fell from 108 deaths per 1,000 births to 38, and life expectancy was nearing 70 years. Now the country estimates that AIDS may rob it of 30 percent of economic growth over the next 20 years. More than 20 percent of all children may end up as orphans.

Botswana recorded its first AIDS case in 1985; by the 1990s, HIV was spreading furiously. The epidemic was kindled by the country's rapid development, ignorance about the disease, and a taboo about acknowledging its presence. An extensive new road network made the population, and the virus, more mobile. Jobs took workers far from their families, and many started new sexual relationships. Botswana's neighbors have seen similar patterns, but the extraordinary pace of its economic expansion accelerated the infection rate.

To preserve its disappearing labor force, Botswana is trying to keep its younger generation from getting infected while also treating the sick in a program called Vision 2016, with hope for tangible progress nearly a generation away. AIDS prevention efforts now begin in primary school. The Bill & Melinda Gates Foundation and the Merck Company Foundation have pledged $100 million to fight AIDS in Botswana, and Merck is donating antiretroviral medicines for government treatment programs. The US Peace Corps, which left Botswana in 1997 after 30 years of aiding development, is reopening its mission, and soon about two dozen volunteers will help with the national AIDS program. The government estimates it will cost $500 million over five years to provide antiretrovirals, which means that development projects will likely be scaled back.

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