AIDS, unemployment and disability in South Africa: The case for welfare reform

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Southern African Journal of HIV Medicine

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University of Cape Town

South Africa is facing a dual crisis of AIDS and unemployment. According to the ASSA2002 demographic model, by 2005 19% of adults (and 11% of all South Africans) were HIV-positive. This amounts to a socioeconomic crisis of significant proportions. AIDS undermines the economic security of households by reducing the productivity of (and eventually killing) mainly prime-age adults while simultaneously diverting scarce household resources towards health care. Poor households are especially vulnerable to these shocks. In most of sub-Saharan Africa, where agriculture accounts for a significant portion of employment and output, AIDS has affected the poor mainly through its negative impact on productivity in peasant agriculture. By contrast, South Africa’s history of de-agrarianisation and the destruction of peasant farming under apartheid have left the vast majority of households dependent on wage labour. Under these conditions, the negative impact of AIDS is experienced directly through illness-induced retirement from wage-labour, and indirectly through the contraction of employment opportunities (especially unskilled jobs) by firms trying to avoid AIDS-related costs.