JWANENG, Botswana -- The digging does not stop. Not when night falls or when a three-year drought sears the countryside or when the nation edges toward famine. Workers for Debswana Diamond Co. have not stopped digging for 20 years, scooping out enough wealth to make Jwaneng the world's richest diamond mine and Botswana's economy one of the fastest-growing in southern Africa.
Gems, and the miners who dig them up, are building the nation. So when the death rate among Debswana's 6,000 employees doubled in five years and nearly a third of the workforce -- including 18% of its executives -- became infected with human immunodeficiency virus, the company took an unprecedented step. In 1999, it began offering voluntary testing for HIV, which can lead to AIDS, at mining operations around Botswana.
"We decided that AIDS was the biggest threat to our business," said Assistant General Manager Sebetlela Sebetlela. So last year, Debswana became the first company in Africa to give HIV-fighting anti-retroviral therapy to its employees, he said.
"It wasn't just that we wanted to be good," he added. "We realized that unless we did something, we could have had a situation where production came to a halt."
Acquired immune deficiency syndrome is beginning to take an economic toll on sub-Saharan Africa, hindering the region's efforts to lift itself out of poverty.
Companies in the region are reporting increased absenteeism and rising recruitment and training costs as AIDS-stricken workers sicken and die. Studies have shown that businesses are spending six to 10 times as much money on HIV-infected employees as on healthy workers. Production losses so far have been modest, but they are noticeable and deepening.
Sub-Saharan Africa is the focal point of the pandemic, according to a United Nations report released last month. In the hardest-hit countries -- Lesotho, Swaziland and Zimbabwe -- one of every three residents has HIV. Of the 3.1 million deaths due to AIDS this year, 77% have occurred in sub-Saharan Africa.
In a recent speech in Johannesburg, South Africa, Stephen Lewis, the U.N. special envoy for HIV/AIDS for this continent, said the pandemic has devastated the region's agricultural sector and is driving a food shortage that is putting 15 million Africans at risk of starvation.
Botswana's Affluence
Botswana has the region's highest per capita income and one of the most stable governments, having avoided the civil wars and the harsh colonial rule that its neighbors Zimbabwe and South Africa endured. But Botswana's relative affluence and progressive health policies haven't protected it from the pandemic; nearly four of 10 people in this nation of 1.6 million are infected by HIV.
With the beef industry suffering because of parched grasslands, diamonds -- especially the ones from the Jwaneng mine -- are all that stand between the country and ruin. Profit from Debswana's mines is fueling Botswana's economy, which is expected to grow 9% this year, up from 8% in 2001.
The company, which is jointly owned by the government and DeBeers, has set a powerful example in the region by offering to cover most of the cost for employees' anti-retroviral drugs, which attack HIV. This year, the government also started giving out anti-retroviral therapies at four hospitals. About 3,000 people are receiving the life-saving drugs, and the government plans to open four more dispensaries next year.
"Debswana is the model for our country," said Dr. Banu Khan, head of Botswana's AIDS programs. "Anti-retroviral therapies will lead to AIDS prevention, they will prevent children from becoming orphans, they will prolong life."
Botswana's programs became feasible only after pharmaceutical companies reduced prices for AIDS medicines -- sometimes by as much as 90% -- after a clash last year with several African countries. New drugs with fewer side effects and simplified regimens also helped.
A Lesson for S. Africa
South African companies have watched Debswana and Botswana's government for two years, and now dozens of businesses -- including multinationals such as DaimlerChrysler, Coca-Cola and Barclay's Bank -- are offering anti-retroviral treatment along with AIDS awareness programs.
"We're stepping in because the government isn't," said Errol Sackstein, general director of pen manufacturer Bic South Africa.
It took an international outcry before the South African government acknowledged the link between HIV and AIDS and realized that anti-retroviral therapies are the country's best hope of mitigating the pandemic. But there still is no plan to provide the drugs on a wide scale.
The examples set by Botswana and the private industry are inspiring, said Dr. Ayanda Ntsaluba, head of South Africa's public health department. But they are of little use to his country, which has the world's greatest concentration of HIV cases: about 4.7 million people, nearly three times Botswana's entire population.
