Methoden und Konzepte der Internationalen Entwicklungszusammenarbeit

1. Methoden und Konzepte der Internationalen Entwicklungszusammenarbeit Vorlesung WS 2005/6 HIV/AIDS - IMPAKT

2. Literatur zur Vorlesung • UNDP; Bericht über die menschliche Entwicklung (HDR) 2003 (Handbibliothek) und 2005 www.undp.org • UNICEF, MI: Damage Assessment Report www.unicef.org • UNICEF: Facts for Life www.unicef.org • UNAIDS/WHO: Report on the Global AIDS Epidemic 2004 www.unaids.org • UNAIDS: Sexual behaviour change for HIV: Where have theories taken us? 1999 UNAIDS Best Practice Collection www.unaids.org • Barnett, T. & A. Whiteside: AIDS in the Twenty-First Century. Disease and Globalisation. 2002 (Handbibliothek) • Worldbank: Confronting AIDS. Public Priorities in a Global Epidemic. 1999 Revised Edition. www.worldbank.org (Handbibliothek) • Todaro, M: Economic Development (8. Ausgabe) 2003 (Handbibliothek)

3. Auswirkungen von HIV/AIDS Auf die Menschliche Entwicklung 1. Lebenserwartung

4. Eastern Europe & Central Asia 1.4 million [920 000 – 2.1 million] Western & Central Europe 610 000 [480 000 – 760 000] North America 1.0 million [540 000 – 1.6 million] East Asia 1.1 million [560 000 – 1.8 million] North Africa & Middle East 540 000 [230 000 – 1.5 million] Caribbean 440 000 [270 000 – 780 000] South & South-East Asia 7.1 million [4.4 – 10.6 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] Latin America 1.7 million [1.3 – 2.2 million] Oceania 35 000 [25 000 – 48 000] Total: 39.4 (35.9 – 44.3) million Adults and children estimated to be living with HIV as of end 2004

5. Changes in life expectancy in selected African countries with high and low HIV prevalence: 1950-2005 65 60 with high HIV prevalence: Zimbabwe 55 South Africa Botswana 50 Life expectancy (years) 45 with low HIV prevalence: 40 Madagascar Senegal 35 Mali 30 1950– 1955 1955- 1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980 1980- 1985 1985- 1990 1990- 1995 2000- 2005 1995- 2000 Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision

6. Predicted loss in life expectancy due to HIV/AIDS in children born in 2000 Predicted life expectancy Loss in life expectancy due to HIV/AIDS Botswana Zimbabwe South Africa Kenya Zambia Côte d'Ivoire Rwanda Mozambique Haiti Cambodia 0 10 20 30 40 50 60 70 Life expectancy at birth (years) Source: U.S. Census Bureau, 2000

7. Projected population structure with and without the AIDS epidemic, Botswana, 2020 80 Projected population structure in 2020 75 Males Females 70 65 Deficits due to AIDS 60 55 50 Age in years 45 40 35 30 25 20 15 10 5 0 140 120 100 80 60 40 20 0 0 20 40 60 80 100 120 140 Population (thousands) Source: US Census Bureau, World Population Profile 2000

8. Auswirkungen von HIV/AIDS Auf die Menschliche Entwicklung - verschiedene Ebenen

9. Savings/Disavings Impact of HIV/AIDS on urban households, Côte d’Ivoire General population Families living with AIDS 30 000 Francs CFA 25 000 Monthly income per capita 20 000 15 000 Monthly consumption per capita 10 000 5 000 0 – 5 000 Source: Simulation-based on data from Bechu, Delcroix and Guillaume, 1997

10. Impact of HIV/AIDS on agricultural production in Ethiopia Hours spent by women on agricultural tasks: HIV/AIDS affected households: 11.6 - 16.4 hours/week Non-HIV/AIDS affected households: 33.6 hours/week Source: A. Baryoh, 1994, unpublished.

11. Maize 61% Cotton 47% Vegetables 49% Groundnuts 37% Cattle owned 29% Reduction in production in a household with an AIDS death, Zimbabwe Crops Reduction in output • • • • • Source: Stover & Bollinger, 1999

12. Impact at the Household Level Production & earnings Investment and consumption Household health and composition Psychic costs ¨ Disutility to ¨ ¨ ¨ Reduced Medical costs Health maintaining income activities reduced individual ¨ Funeral costs ¨ ¨ ¨ Reduced Loss of deceased Grief of ¨ productivity survivors Legal fees ¨ Poor health of ¨ ¨ Reallocation of survivors Dissavings labour & land ¨ ¨ Dissolution of Changes in household consumption & investment Source: Terminology - S. Kongsin, 2000

13. Household Impact: Caring for Orphans • A study from Uganda shows that 25% of households are providing for an orphan Source: Lyons, M. 1997 • A study from Tanzania shows that 21% of the families in Bukoba district were fostering an orphan Source: Rugalema, 1999

14. Percentage of workforce lost to AIDS by 2005 and 2020 in selected African countries 50 2005 2020 40 30 % 20 10 0 Botswana Côte d’Ivoire Togo Mozambique Ethiopia Cameroon Nigeria UR Tanzania CAR Zimbabwe Guinea-Bissau South Africa Sources: ILO (2000) POPILO population and labour force projection; UN Department of Economic and Social Affairs, Population Division (1998) World Population Prospects: the 1998 Revision

15. Newly diagnosed AIDS cases and medical expenditure on an agricultural estate in Kenya, 1989 to 1997 25 120 new AIDS cases medical spending 100 20 80 15 Number of newly diagnosed AIDS cases Medical expenditure (KSh millions) 60 10 40 5 20 0 0 1997 1989 90 91 92 93 94 95 96 Source: Rugalema et al. HIV/AIDS and the commercial agricultural sector of Ken UNDP/FAO, 1999

16. Hours lost to Sickness and Funerals,Chilanga-Works(Source Ministry of Health-Zambia)

17. HIV prevalence in military personnel in Africa • Nigeria:11% among peacekeepers returning from Sierra Leone and Liberia vs 5% in adult population • South Africa:60-70% in military vs 20% in adult population Source: Nigeria AIDS bulletin No 15, May 20, 2000; The Mail & Guardian, Pretoria, March 31, 2000; UNAIDS/WHO 1999 estimate

18. Economic Growth Impact of HIV (1990-97) Figure 2: Growth Impact of HIV (1990-97) (80 developing countries) 0 -0.2 -0.4 -0.6 Reduction in growth rate GDP per capita (%, per year) -0.8 -1 -1.2 -1.4 -1.6 0 5 10 15 20 25 30 35 HIV Prevalence Rate (%) Source: R. Bonnel (2000) Economic Analysis ofHIV/AIDS, ADF2000 Background paper, World Bank

19. Estimated impact of AIDS on under-5 child mortality rates, selected African countries, 2010 250 Deaths per 1,000 live births 200 WithoutAIDS WithAIDS 150 100 50 0 Botswana Malawi Kenya Tanzania Zambia Zimbabwe Source: US Census Bureau

20. Projected reduction in size of primary-school-age population by 2010, in selected African countries 30 25 20 % reduction 15 10 5 0 Zimbabwe Zambia Kenya Uganda Source: World Bank, 2000

21. Success stories

22. Trends in HIV prevalence among pregnant women in Kampala, Uganda: 1991-2000 40 30 Percentage 20 10 0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report

23. 35 30 25 20 15 10 5 0 Prevalence among pregnant women in major urban areas, Uganda Prevalence 1985 86 87 88 89 90 91 92 93 94 95 96 97 98 99 2000 Source: Uganda National AIDS Programme

24. HIV prevalence rate among 13 to 19-year-olds Masaka, Uganda, 1989 to 1997 5 Girls 4 Boys 3 HIV prevalence (%) 2 1 0 1989/90 1990/91 1991/92 1992/93 1993/94 1994/95 1995/96 1996/97 Source: Kamali et al. AIDS 2000, 14: 427-434

25. Increase in reported condom use with non-regular partners in selected districts in Uganda: 1996-2000 80 60 % condom use 40 20 0 1997 1999 1996 1999 1997 2000 1997 2000 Mbara Mpigi Masindi Pallisa Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report

26. Condom use among men with non-regular partners in selected sub-Saharan African countries: 1994-2000 70 Malawi United Rep. of Tanzania 60 Uganda Zambia 50 40 % 30 20 10 0 1994 1995 1996 1997 1998 1999 2000 Source: Macro International (1994-2000) Demographic and Health Surveys; Measure Evaluation

27. 2015 1985 1990 1995 2000 2005 2010 2020 Scenario of the epidemic in Thailand, had there been no intervention through 2020, and observed epidemic curve 10,000 No Intervention Observed 8,000 6,000 Number of HIV infections (thousands) 4,000 2,000 0 Source: Division of AIDS, Ministry of Public Health in Thailand; Thai Working Group on HIV/AIDS Projection (2001) HIV/AIDS Projections for Thailand: 2000-2020