BLOEMFONTEIN, SOUTH AFRICA — Every two weeks, Evelyn Mapota haunts her local pharmacy, pleading for medicine to keep her daughter alive. And every two weeks, she is told to try again another day.
After five months of waiting, Mrs. Mapota feels a wave of fear whenever she hears little Thato cough or thinks she might be catching a cold. “I worry and I start panicking,” she says. “I have sleepless nights thinking about it.”
Five-year-old Thato is one of an estimated 15,000 people in Free State, a province in the centre of South Africa, who are waiting for anti-retroviral (ARV) drugs. About 30 are dying every day.
Two years ago, the picture was much different. Estimates of the number of people newly infected with HIV declined from 3 million in 2001 to 2.7 million in 2007, while access to treatment rose by 42%. This was an unprecedented gain. Now, drug shortages brought on by donor cutbacks resulting from the economic crisis are reversing much of the progress that was made in the last four years.
These drug shortages will have a devastating effect on the already weak economies of African nations. Without access to medicines, anti-retrovirals, many more of those who are HIV positive will contract full blown AIDS. Not only will they be unable to work, they will also require significant care from others. HIV/AIDS is the fastest way for a family to move from relative wealth to poverty. Families often take on extra work, sell assets, borrow money and take children, usually girls, out of school and use the school fees to pay for medical interventions and the girls for care giving and other household tasks. Each of these strategies provides a short-term solution, but makes the family worse off in the long term.
The drug shortages also mean that more people will die, and more children will be left orphaned. If children who are orphaned by AIDS are lucky, they are cared for by grandparents or other members of their extended family. Many though, are left to fend for themselves and face a future blighted by stigmatization, lack of education and poverty.