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

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

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

Adults and children estimated to be living with HIV as of end 2004 Total: 39.4 (35.9 – 44.3) million Western & Central Europe [ – ] North Africa & Middle East [ – 1.5 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] Eastern Europe & Central Asia 1.4 million [ – 2.1 million] South & South-East Asia 7.1 million [4.4 – 10.6 million] Oceania [ – ] North America 1.0 million [ – 1.6 million] Caribbean [ – ] Latin America 1.7 million [1.3 – 2.2 million] East Asia 1.1 million [ – 1.8 million]

00002-E-5 – 1 December 2003 Changes in life expectancy in selected African countries with high and low HIV prevalence: with high HIV prevalence: Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision Life expectancy (years) 1950–

Cambodia Haiti Mozambique Rwanda Côte d'Ivoire Zambia Kenya South Africa Zimbabwe Botswana Life expectancy at birth (years) Predicted life expectancyLoss in life expectancy due to HIV/AIDS Predicted loss in life expectancy due to HIV/AIDS in children born in 2000 Source: U.S. Census Bureau, 2000

Projected population structure with and without the AIDS epidemic, Botswana, MalesFemales Deficits due to AIDS Projected population structure in 2020 Population (thousands) Age in years Source: US Census Bureau, World Population Profile 2000

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

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

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

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

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

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

Percentage of workforce lost to AIDS by 2005 and 2020 in selected African countries % Botswana Cameroon CAR Côte d’Ivoire Ethiopia Guinea-Bissau Mozambique Nigeria South Africa Togo UR Tanzania Zimbabwe 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

Newly diagnosed AIDS cases and medical expenditure on an agricultural estate in Kenya, 1989 to Number of newly diagnosed AIDS cases Medical expenditure (KSh millions) new AIDS cases medical spending Source: Rugalema et al. HIV/AIDS and the commercial agricultural sector of Ken UNDP/FAO, 1999

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

HIV prevalence in military personnel in Africa l Nigeria: 11% among peacekeepers returning from Sierra Leone and Liberia vs 5% in adult population l 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

Economic Growth Impact of HIV ( ) Figure 2: Growth Impact of HIV ( ) (80 developing countries) HIV Prevalence Rate (%) Reduction in growth rate GDP per capita (%, per year) Source: R. Bonnel (2000) Economic Analysis ofHIV/AIDS, ADF2000 Background paper, World Bank

Estimated impact of AIDS on under-5 child mortality rates, selected African countries, 2010 Botswana Kenya Malawi Tanzania Zambia Zimbabwe Deaths per 1,000 live births Without AIDS With AIDS Source: US Census Bureau

Projected reduction in size of primary-school-age population by 2010, in selected African countries ZimbabweZambiaKenyaUganda % reduction Source: World Bank, 2000

Success stories

00002-E-22 – 1 December 2003 Trends in HIV prevalence among pregnant women in Kampala, Uganda: Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report Percentage

Prevalence among pregnant women in major urban areas, Uganda Source: Uganda National AIDS Programme Prevalence

HIV prevalence rate among 13 to 19-year-olds Masaka, Uganda, 1989 to 1997 Source: Kamali et al. AIDS 2000, 14: /901990/911991/921992/931993/941994/951995/961996/97 Girls Boys HIV prevalence (%)

Increase in reported condom use with non-regular partners in selected districts in Uganda: Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report % condom use MbaraMpigiMasindiPallisa

00002-E-26 – 1 December 2003 Condom use among men with non-regular partners in selected sub-Saharan African countries: Source: Macro International ( ) Demographic and Health Surveys; Measure Evaluation Malawi United Rep. of Tanzania Uganda Zambia %

00002-E-27 – 1 December 2003 Scenario of the epidemic in Thailand, had there been no intervention through 2020, and observed epidemic curve 0 2,000 4,000 6,000 8,000 10,000 Number of HIV infections (thousands) Observed No Intervention Source: Division of AIDS, Ministry of Public Health in Thailand; Thai Working Group on HIV/AIDS Projection (2001) HIV/AIDS Projections for Thailand: