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.
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.
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.
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
$ $ Macroeconomic Impact • Negative and potentially substantial impact on GDP. • AIDS discourages foreign and domestic investors.
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.
Projected Loss of Agricultural Labor Force Because of HIV/AIDS, 1985-2020
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.
Impact on Households • Impoverishment • Income loss • Additional care-related expenses • Funeral costs • Family dissolution • Children removed from school • Reduced food consumption
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.
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.
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.
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.