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Downward spiral: HIV/AIDS, state capacity, and political conflict in Zimbabwe
Andrew T. Price-Smith and John L. Daly, United States Institute of Peace
April 12, 2005

http://www.reliefweb.int/rw/RWB.NSF/db900SID/HMYT-6BDNDQ?OpenDocument&rc=1&cc=zwe

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Introduction
Once regarded as the emerging star of postcolonial Africa, Zimbabwe is now a nation teetering on the brink of economic and political collapse. In recent years, the country has been wracked by rising levels of politically motivated violence, elections marred by widespread fraud, an ill-advised military involvement in the Democratic Republic of Congo (DRC), the seizure of farms from white populations without due regard for the law, and violence against supporters of the political opposition.¹ Aside from its rampant governance problems, Zimbabwe is also beset with a declining GDP, a high rate of inflation, persistently high unemployment, and increasing poverty. To make matters worse, the southern portion of the country has experienced significant drought over the past few years. Finally, Zimbabwe exhibits one of the highest levels of HIV/AIDS sero-prevalence in the world, with approximately 34 percent of the adult population now infected with the human immunodeficiency virus.²

This study traces the effects of the HIV/AIDS epidemic on both the withering economy and the tottering apparatus of governance in Zimbabwe. This task is complicated by the presence of other factors contributing to Zimbabwe’s malaise, namely, extensive political corruption within the Mugabe regime, a land distribution crisis, and an enduring drought in the south of the country. Given the complex mix of factors working to destabilize Zimbabwe, it is perhaps best to think of the HIV/AIDS epidemic as a powerful "stressor" that is exerting a significant negative influence on the nation’s economic health and political stability. In the context of poor governance (i.e., low levels of political will and state capac-ity), HIV/AIDS reinforces a vicious spiral within affected societies, threatening the stability of the state. In the case of Zimbabwe, HIV/AIDS induced mortality and morbidity have already begun to destabilize the country, and this effect will intensify in the near future.

Infectious disease has recently come to be seen as a threat to both international development and national security. The nascent field of "health security" is fast developing; as yet, however, few studies have assessed the threat posed by infectious disease to states and societies at both the microlevel and the macrolevel.³ This study illustrates how HIV/AIDS is acting across various domains demographic, economic, and institutional to compromise Zimbabwe’s economy and structures of governance and, ultimately, to undermine its national security.

Although Zimbabwe is beset with many other infectious diseases (notably, tuberculosis) that promise to impede its economic development, the HIV/AIDS epidemic threatens to have by far the most severe impact in the decades to come.⁴ HIV/AIDS constitutes both a direct and an indirect threat to Zimbabwean governance and national security. It also prom-ises significant economic and social dislocation for many other states in Sub-Saharan Africa whose populations exhibit high HIV seroprevalence levels, including Swaziland, Zambia, South Africa, Botswana, and Nigeria.

We begin this report by briefly chronicling the influence that epidemic disease has had on the stability of human societies throughout history, noting the social and political destabilization that occurs as a result of extensive contagion. Next, we review the utility of the concept of state capacity and apply it to the case of HIV/AIDS and Zimbabwe. The report then moves on to dissect the corrosive effect of HIV/AIDS on Zimbabwe’s national institutions. First, we examine the demographic effects of the disease, in the process exam-ining the economic and political consequences of the large cohort of orphans generated by HIV/AIDS induced mortality. Second, we detail how HIV/AIDS undercuts economic productivity at the microlevel (the level of family and firm) and the macrolevel. Third, we analyze the deleterious effects of the epidemic on the institutional structure of the state, including national military forces, to assess the ultimate effect of the disease on governance. Finally, after briefly reviewing the Zimbabwean government’s response to HIV/AIDS, we offer a set of policy recommendations for the international community in general, and for the U.S. government in particular, designed to ameliorate the spread of HIV in Zimbabwe.  

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1. For an intriguing analysis of the increasingly despotic behavior of the Mugabe administra-tion, see Sandra J. Maclean, "Mugabe at War: The Political Economy of Conflict in Zimbabwe," Third World Quarterly 23, no. 3 (2002): 513–528.
2. This figure comes from the UNAIDS epidemiological fact sheet for Zimbabwe. Similar data are available for other countries; see www.unaids.org
3. For a detailed discussion of health and security concerns and their relationship to the concept of state capacity, see Andrew T. Price-Smith, The Health of Nations: Infectious Disease, Environmen-tal Change and Their Effects on National Security and Development (Cambridge, Mass.: MIT Press, 2002); and Andrew T. Price-Smith, ed., Plagues and Politics: Infectious Disease and International Policy (Houndmills, UK: Palgrave/Macmillan Press, 2001).
4. Almost 75 percent of HIV-positive individuals in Zimbabwe are coinfected with tuberculosis.

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