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Economic and Development Problems in South Africa and Africa Session 12 AIDS

Economic and Development Problems in South Africa and Africa Session 12 AIDS. Aims for today. Background information on HIV/AIDS Where are we in 2011? ( Epidemic update ) Can concurrency explain the AIDS’ severity in SSA? (Uganda?) AIDS and the economy Costs of AIDS?

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Economic and Development Problems in South Africa and Africa Session 12 AIDS

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  1. Economic and Development Problems in South Africa and AfricaSession 12AIDS

  2. Aims for today • Background information on HIV/AIDS • Where are we in 2011? (Epidemic update) • Can concurrency explain the AIDS’ severity in SSA? (Uganda?) • AIDS and the economy • Costs of AIDS? • How best to combat AIDS?

  3. Readings • What we know about AIDS (Nattrass) – good introduction to the biology of AIDS and background of AIDS denialism • The Jagged Tear (Simkins) – more about education (brief section on AIDS) • Still Crazy After All These Years: The Challenge of AIDS Denialism for Science (Nattrass) – self-explanatory • UN AIDS 2010 Global report – excellent, comprehensive report on the state of AIDS around the world (highly recommnded) • Mitigating the impact of HIV-AIDS on Education (Coombe) – Also education focused • Children and AIDS – Stocktaking Report (2008)

  4. Background information on HIV/AIDS What is AIDS? • HIV = Human Immunodeficiency Virus  • AIDS = Acquired Immune Deficiency Syndrome • HIV attacks CD4 cells which are immunologically important • “The CD4+ T-lymphocyte is the primary target for HIV infection because of the affinity of the virus for the CD4 surface marker (3). The CD4+ T-lymphocyte coordinates a number of important immunologic functions, and a loss of these functions results in progressive impairment of the immune response.” • If you are HIV+ and your CD4 count < 200  you have AIDS

  5. Spot test • How much do you know about AIDS?

  6. So where are we in 2011? UNAIDS 2010 Global Report

  7. So where are we in 2011?

  8. So where are we in 2011?

  9. So where are we in 2011?

  10. Hans Rosling...

  11. Countries in Africa most affected by AIDS Why is SSA so heavily affected by AIDS?

  12. Q - What is concurrency?A - Overlapping sexual partnerships in which sexual intercourse with one partner occurs between two acts of intercourse with another partnerUsing an illustration… Can concurrency explain the spread of AIDS in SSA? (ala Epstein, Rosling, Pisani)

  13. HIV Negative Male Effects of Concurrency HIV Positive Viremic Male HIV Positive Non-Viremic Male HIV Negative Female HIV Positive Viremic Female HIV Positive Non-Viremic Female Source: Stewart Parkinson

  14. Concurrency December

  15. Concurrency January

  16. Concurrency February

  17. Concurrency March

  18. Concurrency April

  19. Concurrency May

  20. Concurrency June

  21. Concurrency July

  22. Concurrency August

  23. Serial Monogamy December

  24. Serial Monogamy January

  25. Serial Monogamy February

  26. Serial Monogamy March

  27. Serial Monogamy April

  28. Serial Monogamy May

  29. Serial Monogamy June

  30. Serial Monogamy July

  31. Serial Monogamy August

  32. Early successes: Uganda and “zero grazing”

  33. Gender differences UNAIDS 2010 Global Report

  34. Population-based HIV prevalence, 2002

  35. Questions we need to answer: • Where is the AIDS epidemic at? • 2009 1.2 million people received ARV’s (30% inc in 1 year) • Expanding access to treatment  19% decline in deaths amongst those with HIV (2004-2009) • BUT - 10 million people living with HIV eligible for treatment but don’t have access • What are the costs of AIDS? (economic/social?) • What is the future of AIDS? (AIDS in 2020?) • What is the best way to combat AIDS? • Behaviour change? (difficult) • Make existing behaviour more responsible? (condoms) • Managing the problem better? (ARV’s)

  36. Sinosizo case study

  37. Socio-economic impact of AIDS (Coombe) • Financial burden of HIV/AIDS 30% > than other deaths • Often more than one family member infected • If income-earner(s) infected then: • Children are removed from school to earn income* or care for the sick • Fewer resources for education, due to lower income and increased medical costs “A common reason that HIV/AIDS-affected children drop out of school, or perform poorly, is lack of material resources to meet basic needs” (p34) • The poor are particularly vulnerable to AIDS • Less education about prevention • More sexual abuse • More fragile social environments  conducive to early sexual activity

  38. AIDS and the economy 3 channels for impacting the economy • Direct costs - AIDS treatment (including opportunistic diseases like TB)  reduction in savings lower accumulation of capital (entrenched poverty). - For government: higher spending on health, insurance, orphans • Indirect costs (short term) - AIDS  invalidity  reduction in labour participation. - Depression • Deferred indirect costs (long term) -AIDS  Alteration of the long-term choices of the agents (households and firms)  lower investment in physical & ‘human capital (education, knowledge, know-how) -Opportunity costs of AIDS programmes for otherpovertyreductionstrategies & treatment of other patients Source: Gavin George HEARD

  39. AIDS & demand for educational services • Size of learner population • Increasing deaths among adults of reproductive age • Declining fertility rates • Increased child mortality • “It is anticipated that Zimbabwe will experience a 24.1% reduction in primary school age population by 2010; Zambia 20.4%, Kenya 13.8%, and Uganda 12.2% (Abt Associates, 2001, p4; World Bank, 2000a, p3)” (see population pyramid) • Demand for education • Fewer resources & poor performance by affected children • “In Malawi, during 1999, the % of children in school who had lost one or both parents increased from 12% to 17%. One third of children in one study reported they had missed school in order to care for the sick.” • More complex learner cohorts • Orphans will make up a significant proponent of children Source: Coombe

  40. Caveat…

  41. Variations in antenatal HIV - prevalence in Africa

  42. Provincially?

  43. Trends in HIV-AIDS? • http://www.gapminder.org/world/#$majorMode=chart$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=19;stl=t;st=t;nsl=t;se=t$wst;tts=C$ts;sp=3.12322580645162;ti=2009$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj1jiMAkmq1iMg;by=ind$inc_y;mmid=YCOORDS;iid=pyj6tScZqmEfbZyl0qjbiRQ;by=ind$inc_s;uniValue=8.21;iid=pyj6tScZqmEe1GaiYJX2qGA;by=ind$inc_c;uniValue=255;gid=CATID0;iid=phAwcNAVuyj02SA7cGjnRbA;by=ind$map_x;scale=log;dataMin=394;dataMax=18073$map_y;scale=log;dataMin=0.0107;dataMax=34$map_s;sma=49;smi=2.65$map_c;scale=lin$cd;bd=0$inds=i153_h001979adam;i209_d001981acav;i28_d001979aEaG;i235_d001979aiav

  44. South Africa’s AIDS awareness program

  45. European AIDS awareness program

  46. Extremely poor HIV/AIDS leadership in SA

  47. Let’s get rational… AIDS\Elizabeth Pisani_ Sex, drugs and HIV let's get rational.flv

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