Economic and Development Problems in South Africa and AfricaSession 10AIDS
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?
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) NB Essays – you must have readall the supplementary materials on DVD for your section
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
Spot test How much do you know about AIDS?
So where are we in 2011? UNAIDS 2010 Global Report
Countries in Africa most affected by AIDS Why is SSA so heavily affected by AIDS?
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)
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
Serial Monogamy December
Serial Monogamy January
Serial Monogamy February
Serial Monogamy March
Serial Monogamy April
Serial Monogamy May
Serial Monogamy June
Serial Monogamy July
Serial Monogamy August
Gender differences UNAIDS 2010 Global Report
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)
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
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
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
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