The study calculates the total cost of inaction on youth sexual and reproductive health and rights (SRHR), including HIV, to be US$3.6 billion over the lifetime of the current adolescent cohort.
That figure represents 12.9% of the country’s gross domestic product, a higher percentage than the combined national budgets for education, health, and social development in 2021.
The report, The Cost of Inaction, warns that poor access to youth-friendly SRHR services, high teenage pregnancy rates, HIV infections, and gender-based violence are placing a growing economic burden on the country.
“These costs need to be compared with the cost of different policy options for supporting youth SRHR,” it notes. While Zimbabwe’s economy is smaller than South Africa’s, the cost of doing nothing is heavier relative to the size of the economy. “The cost of inaction totals 92.5% of the total Zimbabwean Government budget for 2021,” the report states.
Teenage pregnancy is one of the main cost drivers. For Zimbabwe, early pregnancies among girls aged 15 to 19 account for US$2.95 billion of the total. The figure includes financial costs to the health system, individual out-of-pocket expenses, and the long-term loss of income for both adolescent mothers and fathers who leave school.
The report shows that 55% of girls in Zimbabwe drop out of school after giving birth, and only one in ten teenage fathers remains in school. Girls who do not finish secondary school earn significantly less over their lifetime, and are more likely to live in poverty. This, in turn, lowers productivity, tax revenues, and overall economic output.
The report explains, “Lower lifetime earnings and higher levels of unemployment reduce potential tax revenue received by the government and lead to lower productivity.”
The economic loss is compounded by the second-generation effects. Children born to adolescent mothers are more likely to suffer from poor health, drop out of school, and face a higher risk of early death. While these outcomes were not quantified in the cost analysis, the report acknowledges their long-term impact.
“There are consequences for the children of adolescent mothers, who are more likely to have low birth weight, poorer health, be physically abused, struggle academically and die prematurely,” it states.
HIV among young people also carries a heavy price. The report estimates that the lifetime cost of HIV for adolescents and young adults aged 15 to 24 in Zimbabwe is US$710 million. This includes the cost of antiretroviral treatment, the cost of accessing health facilities, and the prevention of mother-to-child transmission.
Young women are the most affected, accounting for most new infections in this age group. UNAIDS warns that delayed diagnosis and treatment reduces life expectancy and increases health care costs. “As a result, AIDS is the leading cause of adolescent mortality in 12 East and southern African countries,” the report notes.
Gender-based violence remains widespread, but Zimbabwe lacks reliable data to calculate its full economic impact. The report includes estimates from South Africa, where GBV costs the country over US$12.4 billion. This includes costs to survivors, the government, civil society, and businesses.
In Zimbabwe, GBV is also closely linked to teenage pregnancies and HIV. Girls who experience violence are less able to negotiate safe sex or refuse unwanted advances. The report calls for stronger gender equality policies and coordinated efforts to reduce violence. “A comprehensive approach tied closely to gender equality goals is needed,” it says.
The study proposes five areas where Zimbabwe can act to reduce these costs. These include integrating comprehensive sexuality education in schools, expanding access to youth-friendly SRHR services, keeping girls in school, reducing GBV, and preventing HIV. The report urges a shift from reactive to preventative approaches.
“Real change requires a proactive, prevention-based response rather than a reactive one,” it states. Investing early in adolescent health and education will not only reduce long-term costs but also strengthen the country’s workforce and future growth.
The report stress that the figures presented are conservative estimates. Some costs, such as lost productivity from opportunistic infections or second-generation effects of GBV, were excluded due to data limitations. This means the actual cost of inaction could be even higher. The report urges decision-makers to include the cost of inaction in budget planning and policy design.
“The cost of not acting is high,” it concludes. “This is an investment we have no choice but to make.”