Demographic, Health and Socioeconomic Effects of HIV and AIDS

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Demographic, Health and Socio-economic Effects of
HIV and AIDS
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Presentation Objectives

• By the end of this session you should be able to
• describe the demographic and health effects of
  the pandemic
• describe the socio-economic impact of the
  pandemic.

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Lower Life Expectancy

• In heavily affected countries death rates are
  substantially higher with AIDS.
• In eastern and southern Africa, crude death rates
  are 50 to 500 higher.
• Average life expectancy has dropped to below age
  40 in eight African countries.
• In 2002 life expectancy in Botswana is 33.9
  years, by 2010, it is expected to fall to 26.7
  years.
• Under 5 mortality rates are substantially higher
• ¾ of child deaths in Botswana are AIDS related.

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Effect of HIV/AIDS on Life Expectancy in 2010
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Slower Population Growth

• While populations continue to grow, the growth is
  much less than it would be without AIDS.
• Some countries will experience zero or negative
  growth rates by 2010.
• AIDS deaths are altering the age structures of
  many countries.
• In countries with 15 prevalence, AIDS will
  eventually kill 1/3 of current 15 year olds.
• High population losses among women in their 20s
  and 30s and men in their 40s and 50s.

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Projected Population of South Africa With and
Without AIDS, 1990-2050
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Projected Population Structure of Botswana in
2020 With and Without AIDS
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Socio-economic Impact
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Impact on Health Sector

• Pressure on health budgets
• Other health problems relegated to lesser
  importance
• Toll on healthcare workers
• Lusaka, 1991 44 of nurses tested positive for
  HIV
• Increased hospitalizations resulting in bed
  shortage
• Declining quality of care

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Macroeconomic Impact

• Negative and potentially substantial impact on
  GDP.
• AIDS discourages foreign and domestic investors.

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Business, Labor, and Income

• HIV affects people of prime working age.
• Businesses suffer increased operating costs,
  decreased productivity, and declining markets.
• AIDS disrupts rural agricultural production
• FAO estimates that 23 million agricultural
  workers will die between 1985 and 2020 in 25
  African countries.

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Impact of HIV and AIDS on a Business
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Projected Loss of Agricultural Labor Force
Because of HIV/AIDS, 1985-2020
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Impact on Education

• In Kenya, it is estimated that the number of
  teacher deaths tripled between 1995 and 1999, the
  largest contributor thought to be HIV/AIDS
  (Kelly, 2000).
• The estimated HIV prevalence is 7 with about
  2.9million people affected. It is estimated that
  some 16, 450 teachers are infected with the
  virus.
• The provision of quality education is being
  affected by HIV/AIDS particularly through
  increased teacher absenteeism and loss of
  learning time.
• Replacing chronically-sick teachers with
  relief/substitute teachers is problematic given
  the freeze on the national teacher wage bill.
• Community support and resources for schooling are
  declining.
• According to projections, Kenya could lose 1.8
  of its teachers annually unless deliberate
  interventions are put in place.

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Impact on Households

• Impoverishment
• Income loss
• Additional care-related expenses
• Funeral costs
• Family dissolution
• Children removed from school
• Reduced food consumption

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Families and Communities

• AIDS erodes household socioeconomic well being
• Income drops as health expenses increase
• AIDS threatens social cohesion of families and
  communities.
• Stigma and discrimination further marginalize
  affected families and orphans.

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Orphans due to AIDS in South Africa and Zimbabwe,
19902010
2.5
Million
South Africa
2.0
1.5
1.0
Zimbabwe
0.5
0
1990
1995
2000
2005
2010
projections
Source Metropolitan Life Scenario 80
UNAIDSAddisMay 1999
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Children Affected by AIDS

• Lack food, medical care, and money for school
  fees.
• Lack protection from neglect and abuse.
• Bear the responsibility for caring for ill family
  members often thrust upon girls.
• Are further marginalized by stigma and
  discrimination.
• These factors increase their own vulnerability to
  HIV.

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Governance and Public Service

• Countries lose hard to replace civil servants.
• Government revenues decline and costs rise.
• In half the countries in SSA, annual per capita
  growth is declining by 0.5 to 1.2 .
• Demand for social services increase
• AIDS contributes to rising poverty and greater
  social welfare needs.

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Impact on Security

• Undermines stability and progress.
• Weakens pillars of social cohesion.
• Makes it difficult for the State to protect
  citizens from suffering.
• Rule of law.
• Social disruption and political unrest.