1. Demographic, Health and Socio-economic Effects of HIV and AIDS

2. Presentation Objectives By the end of this session you should be able to: describe the demographic and health effects of the pandemic; describe the socio-economic impact of the pandemic.

3. Lower Life Expectancy In heavily affected countries death rates are substantially higher with AIDS. In eastern and southern Africa, crude death rates are 50% to 500% higher. Average life expectancy has dropped to below age 40 in eight African countries. –In 2002 life expectancy in Botswana is 33.9 years, by 2010, it is expected to fall to 26.7 years. Under 5 mortality rates are substantially higher –¾ of child deaths in Botswana are AIDS related.

4. Effect of HIV/AIDS on Life Expectancy in 2010

5. Slower Population Growth While populations continue to grow, the growth is much less than it would be without AIDS. Some countries will experience zero or negative growth rates by 2010. AIDS deaths are altering the age structures of many countries. In countries with 15% prevalence, AIDS will eventually kill 1/3 of current 15 year olds. High population losses among women in their 20s and 30s and men in their 40s and 50s.

6. Projected Population of South Africa With and Without AIDS, 1990-2050

7. Projected Population Structure of Botswana in 2020 With and Without AIDS

8. Socio-economic Impact

9. Impact on Health Sector Pressure on health budgets Other health problems relegated to lesser importance Toll on healthcare workers –Lusaka, 1991: 44% of nurses tested positive for HIV Increased hospitalizations resulting in bed shortage Declining quality of care

10. Macroeconomic Impact Negative and potentially substantial impact on GDP. AIDS discourages foreign and domestic investors. $ $

11. Business, Labor, and Income HIV affects people of prime working age. Businesses suffer increased operating costs, decreased productivity, and declining markets. AIDS disrupts rural agricultural production –FAO estimates that 23 million agricultural workers will die between 1985 and 2020 in 25 African countries.

12. Impact of HIV and AIDS on a Business

13. Projected Loss of Agricultural Labor Force Because of HIV/AIDS, 1985-2020

14. Impact on Education In Kenya, it is estimated that the number of teacher deaths tripled between 1995 and 1999, the largest contributor thought to be HIV/AIDS (Kelly, 2000). The estimated HIV prevalence is 7% with about 2.9million people affected. It is estimated that some 16, 450 teachers are infected with the virus. The provision of quality education is being affected by HIV/AIDS particularly through increased teacher absenteeism and loss of learning time. Replacing chronically-sick teachers with relief/substitute teachers is problematic given the freeze on the national teacher wage bill. Community support and resources for schooling are declining. According to projections, Kenya could lose 1.8% of its teachers annually unless deliberate interventions are put in place.

15. Impact on Households Impoverishment –Income loss –Additional care-related expenses –Funeral costs Family dissolution Children removed from school Reduced food consumption

16. Families and Communities AIDS erodes household socioeconomic well being –Income drops as health expenses increase AIDS threatens social cohesion of families and communities. Stigma and discrimination further marginalize affected families and orphans.

17. Orphans due to AIDS in South Africa and Zimbabwe, 1990–2010 Source: Metropolitan Life Scenario 80 00 0.50.5 1.01.0 1.51.5 2.02.0 2.52.5 1990199019951995200020002005200520102010 MillionMillion projectionsprojections Zimbabwe South Africa UNAIDS–Addis–May 1999

18. Children Affected by AIDS Lack food, medical care, and money for school fees. Lack protection from neglect and abuse. Bear the responsibility for caring for ill family members; often thrust upon girls. Are further marginalized by stigma and discrimination. These factors increase their own vulnerability to HIV.

19. Governance and Public Service Countries lose hard to replace civil servants. Government revenues decline and costs rise. –In half the countries in SSA, annual per capita growth is declining by 0.5 to 1.2 %. Demand for social services increase –AIDS contributes to rising poverty and greater social welfare needs.

20. Impact on Security Undermines stability and progress. Weakens pillars of social cohesion. Makes it difficult for the State to protect citizens from suffering. Rule of law. Social disruption and political unrest.