Failure to invest in youth sexual health could cost Zimbabwe $3.6bn

A new report by UNAIDS reveals that Zimbabwe stands to save billions of dollars by investing in sexual and reproductive health and rights (SRHR) services targeted at young people. The study, titled The Cost of Inaction, estimates that the lifetime economic cost of neglecting youth SRHR-including HIV infections, teenage pregnancies, and gender-based violence-amounts to a staggering US$3.6 billion for the current adolescent cohort.

This sum represents 12.9% of Zimbabwe's gross domestic product (GDP) and exceeds the combined national budgets allocated to education, health, and social development in 2021. The report highlights the urgent need to weigh these costs against the investments required to support comprehensive youth SRHR policies.

Teenage pregnancy emerges as the largest contributor to the financial burden, with early pregnancies among girls aged 15 to 19 costing the country approximately US$2.95 billion. These costs include healthcare expenses, out-of-pocket payments by families, and lost income resulting from adolescents-both mothers and fathers-dropping out of school. Data shows that 55% of adolescent mothers leave school after childbirth, while only one in ten teenage fathers remain enrolled. The consequences extend beyond individual families, as lower educational attainment correlates with reduced lifetime earnings, increased poverty, diminished productivity, and lower tax revenues, all of which hamper national economic growth.

Moreover, the report warns of serious "second-generation" effects: children born to adolescent mothers face higher risks of poor health, school dropout, and early mortality. Though these impacts were not quantified financially, their long-term implications for Zimbabwe's development are acknowledged as substantial.

HIV among young people is another costly challenge. The report estimates the lifetime cost of HIV for Zimbabwean adolescents and young adults aged 15 to 24 at US$710 million. This includes treatment costs, healthcare access, and prevention of mother-to-child transmission. Young women bear the brunt of new infections, and delayed diagnosis and treatment contribute to higher healthcare expenses and mortality, making AIDS the leading cause of death among adolescents in many southern African countries.

Gender-based violence (GBV) remains pervasive in Zimbabwe, though limited data hinders precise economic calculations. The report draws parallels with South Africa, where GBV costs over US$12.4 billion annually, affecting survivors, governments, civil society, and businesses. GBV is closely linked to teenage pregnancies and HIV infections, as victims often struggle to negotiate safe sex or resist coercion. The report stresses the need for stronger gender equality policies and coordinated interventions to reduce violence.

To address these interrelated issues, the study outlines five key areas for action: integrating comprehensive sexuality education in schools, expanding youth-friendly SRHR services, keeping girls in school, reducing gender-based violence, and preventing HIV transmission. It advocates for a proactive, prevention-focused approach rather than a reactive one, emphasizing that early investments in adolescent health and education will reduce long-term costs and contribute to Zimbabwe's economic and social development.

UNAIDS cautions that the presented figures are conservative estimates, as some costs-such as productivity losses due to opportunistic infections and long-term effects of GBV-were excluded due to insufficient data. This suggests the true economic burden of inaction may be even greater.

The report concludes with a clear message for policymakers: "The cost of not acting is high. This is an investment we have no choice but to make."