Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
&
Demographic Impact of
HIV/AIDS
in South Africa
HEARD
The Health Economics & HIV/AIDS
Research Division
University of Natal, Durban
www.und.ac.za/und/heard
Presentation Structure
• HIV/AIDS in South Africa
• The Demographic Impact
• Economic Impact
• Social Impact
• The Impact on Democratic Governance
• Summary and Conclusions
• An action agenda
HIV/AIDS
in
South Africa
Provincial HIV prevalence:
Antenatal clinic attendees
KwaZulu-Natal
40
point prevalence rate (%)
Mpumalanga
35
Free State
30
North-West Province
25
Gauteng
20
South Africa
15
Eastern Cape
10
Northern Cape
5
0 Northern Province
year
40
HIV prevalence rate (%)
30 1996
20 1997
10 1998
0 1999
<20 20-24 25-29 30-34 35-39 40-44 45-49 2000
6000000
5000000
population
4000000
3000000
2000000
1000000
0
1995 2000 2005 2010
years
800000
600000
400000
200000
0
1995 2000 2005 2010 2015
year
Forecast Mortality
0.06
No AIDS AIDS 1995
proportion of age cohort
0.04
0.03
0.02
0.01
0.00
20
25
30
35
40
45
50
55
60
65
-2
-2
-3
-4
-4
-5
-6
-3
-5
-6
4
9
9
9
age group (years)
MACRO-ECONOMY
Smaller
population
HOUSEHOLD
MORTALITY LABOUR
MARKET
Change in
AIDS age structure
FIRM/SECTOR
MORBIDITY
GOVERNMENT
Productivity
Individual level
• Incubation period
– 5-8 years from infection until the onset of
AIDS
– very little economic impact during this time
• AIDS
– Period of escalating illness
– Ability to work is reduced
– The cost of care increases
Household level
• Due to the sexual nature of transmission
often more than one household member is
infected.
• Infections are concentrated among the
primary carers and earners
• Double impact of reduced income and
increased costs of care
Household level cont.….
• Less money available for other consumption
• Increased need for care diverts time and effort
from other tasks
– children, often girls, may be removed from school
to provide care or generate income
• Death(s), often multiple, lead to funeral costs
which are usually large
• Disaving may result
Impact of HIV/AIDS in urban households,
Côte d’Ivoire
General population
Families living with AIDS
30 000 Francs CFA
25 000
Monthly
income
20 000
per capita
15 000
Monthly
10 000 consumption
per capita
5 000
Savings/Disavi
0 ngs
– 5 000
Company A Company B
Absenteeism
14% Turnover*
Turnover* 22%
17% Absenteeism
Productivity
34%
loss
7%
Medical care
4%
Productivity
Retirement/ *Recruitment, training, vacancy loss
disability 40%
62%
• Government legitimacy/effectiveness
• Public compliance
• Public awareness
• Social-cultural factors arising from a
democratic environment
Summary and Conclusions
Conclusions
• HIV has already reached very high levels in South
Africa and is set to rise for a few more years
• The resultant increase in death will change the
structure of the population
• Households and individuals will feel the greatest
economic impact
• The impact on companies and sectors will vary
• The macroeconomic impact will be felt in the long
term
Conclusions…..
• Health care, welfare and education systems will be
adversely affected
• HIV/AIDS is the single greatest threat to
development in South Africa
• Our greatest concern is the impact that HIV will
have on our children
• Innovation in, and commitment to fighting this
problem are required to reduce the impact on this
and future generations
An Action Agenda
There are no:
– Simple solutions
– Short term solutions
– Technical/medical solutions
– Imposed solutions
– Money is not the answer
– Drugs are only part of the answer
– A multisectoral response is needed