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11-01 - HIV/AIDS and Africa HIV/AIDS Understanding Social...

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Unformatted text preview: HIV/AIDS and Africa: HIV/AIDS Understanding Social and Understanding Economic Impact Economic Shelley White, MPH, OTR African World Perspectives November 1, 2007 Over 12,000 “Every day lost is a day when ten thousand Every more people became infected with HIV. We can beat this disease, and we must” We - Kofi Annan, 2001 Kofi Global HIV/AIDS Global There are ~40 million people currently infected with HIV/AIDS worldwide Every Year: Newly Infected: Die from AIDS: ~4.5 million ~3 million Every Day: Every Hour: ~12,300 ~8,200 ~500 ~340 Do we have the will? Do “We value others’ health differently; or We perhaps more rationally. We accept that some interventions are costly and cannot be available for all.” be “A key question is whether we believe key ‘health’ is a public good rather than a purely individual responsibility.” purely -Barnett & Whiteside, p.197 Is healthcare a right or a privilege? Is A Preventable Disease Preventable Three Modes of Transmission: Sexual Transmission Shared Injection Drug Paraphernalia Mother to Child Transmission Blood to Blood Contact Many Prevention Techniques: Sexual risk reduction: ABC: Abstinence, Be Faithful, Condoms Needle Exchange, Addictions Counseling, Social Services Medication during pregnancy, Birth by c-section, bottle feeding Drug use risk reduction: Mother to child risk reduction: Universal Precautions/Screened blood supply Social Causation of Disease Social AIDS doesn’t discriminate? Global Health Inequality Of ~40 million people living with HIV/AIDS: 95% are in low- and middle-income countries 63% are in Sub-Saharan Africa 32% are in Southern Africa 72% were in Sub-Saharan Africa http://www.globalhealthfacts.org/bytopic.jsp Of ~3 million people who died of AIDS in 2006 Global distribution of persons living with HIV/AIDS 2005 (millions) with Total: 38.6 million Source: Report on the global AIDS epidemic (2006) UNAIDS Who is contracting HIV? Who Adults (age 15-49) Mothers, Fathers, Workers… 48% of all PLWHA (ppl living with HIV/AIDS) globally 59% of all PLWHA in Sub-Saharan Africa (SSA) About 40% of new infections globally In SSA, young women are becoming infected at a rate In three times faster than young men three Over 2 million infected globally; 91% are in SSA Women Young Adults (age 15-24) Children Individual Adult Impact Individual No treatment, average adult lifespan w/ HIV: 7-10 yrs SSA: about ¼ of ppl needing medication have access Social location: Who is the individual? What does Social s/he contribute to social reproduction? s/he Workers: Workers: AIDS shaves 15 years off the average worker’s life Decreasing productivity and absenteeism due to: ill Decreasing health, care of sick relatives, funeral attendance health, A bus company in Zimbabwe found that 54% of its AIDS costs bus were due to AIDS-related absenteeism were A llarge cement company in Zambia experienced a 15-fold arge increase in absenteeism for funeral attendance over 3 yrs increase Household Impact Women likely become infected by their partners Women 60-80% of African women with HIV had one partner Greater expenses; fewer resources Fewer workers, more household members (increasing Fewer dependency ratio) dependency Disappearing households Grandparent, relative, or neighbor-headed; cluster foster Grandparent, care (households are interdependent) care Community saturation, leading to child-headed households HIV/AIDS-affected households have: Changing household compositions Household Impact, Cont. Household Poverty: “One of the striking features of economic impact of AIDS in One affected families in Zambia is the rapid transition from relative wealth to relative poverty” (Barnett/Whiteside, p.204) relative Disposable mo. income fell >80% in >2/3 of AIDS-affected Disposable families families Sale of household assets (necessary for recovery and Sale rebuilding): rebuilding): Bicycle Radio Clothing Land and farming equipment Impact on Children Impact Chance of being HIV infected at birth ~30% if no preventive treatment ~2% with preventive treatment Still, 40% of childhood HIV/AIDS cases in SSA are Still, the result of transmission from mother the Orphaning (UNAIDS: child under 15 who has Orphaning lost mother or both parents - double orphan) lost Globally, there are 15 million orphans 12 million are in SSA UNICEF estimates that 12% of all children in SSA will UNICEF be orphaned by 2010 be Impact on Children, Cont. Impact Hardship at home: worse health, poor food Hardship security/malnutrition security/malnutrition Taking on adult roles Early and repeated experiences with death and dying: Early “successive orphaning” “successive Less access/poorer quality education Loss of inheritance/family assets Vulnerability to sexual abuse/exploitation, crime, child Vulnerability soldiering soldiering Stigmatization Socialization: Who passes on skills, heritage, life lessons? Country Level Economic Effects Country A Generalized epidemic = 1% adult prevalence Adult prevalence for all of SSA: 5.9% Reduction in life expectancy Sheer size of labor force will be 10-34% smaller in 10-15 Sheer years in high-prevalence countries (ILO, 2003) years As labor force shrinks, and households favor medical As expenditures, consumer base shrinks expenditures, Per-capita income will fall 0.5-1.2% annually in half the Per-capita sub-Saharan African countries (UNAIDS in ILO, 2003) By 2010, GDP may fall by 8% for worst-affected countries. (UNAIDS in ILO, 2003) Macroeconomic study of Botswana: ‘most likely’ scenario, GDP will fall 30% in 25 years (2001) http://www.census.gov/ipc/www/idb/pyramids.html Successes Successes Uganda: Early 1990s: Early Nationwide prevalence = 15% Nationwide Prevalence in Kampala = 30% 2000/2001: Nationwide prevalence = 5% Prevalence in Kampala = 12% Nationwide approach: Expressed political will Education: ABC model, behavior change Prevention measures: condom distribution “Every day lost is a day when ten thousand Every more people became infected with HIV. We can beat this disease, and we must” We - Kofi Annan, 2001 Kofi ...
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