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HIV  AIDS IMPACT Powered By Docstoc
					       HIV / AIDS
    Dr. Abdalla A.wahid Saeed
Tuesday 17.5.1430H 9:00 - 9:50 AM
• A-To know the IMPACT of HIV/AIDS on
Individual, Family and Community:
1-Socially 2-Culturally 3-Demographically
• B- To know the impact on social services:
• Health , Education

•   The Human Immunodeficiency Virus (HIV) and the
    Acquired Immunodeficiency Syndrome (AIDS) have for
    the past two decades continued to spread across all
    continents killing millions of adults in their prime,
    disrupting and impoverishing families, turning millions
    of children into orphans, weakening the workforce and
    threatening the social and economic fabric of the
•   Furthermore households affected by HIV/AIDS are
    often driven into deeper poverty
    Aggravating Factors
• Social Mobility
   – Global economy
   – HIV/AIDS follows routes of commerce
• Stigma and Denial
   – Denial and silence is the norm
   – Stigma prevents acknowledgment of
     problem and care-seeking
• People in Conflict
   – Context of war and struggle of power
     spreads AIDS
                 Factors cont/d
• Cultural Factors
   •   Traditions, beliefs and practices affect understanding
       of health and disease and acceptance of conventional
       medical treatment
   •   Culture can create barriers which prevent people, and
       especially women, from taking precautions
• Gender
   •   In many cultures men are expected to have many
       sexual relationships
   •   Women suffer gender inequalities, often economic in
              Factors cont/d
• Poverty

  •   Lack of information needed to understand and
      prevent HIV

• Drug Use and Alcohol Consumption

  •   Impaired judgment
  •   Sharing of needles and equipment
•   • The inter-relationship between HIV/AIDS and
•   poverty is complex.
•   • HIV/AIDS precipitates families into poverty and
•   even into destitution.
•   • HIV/AIDS lead to poverty by eliminating the
•   productive sector of society, 15-49 year age
•   group.
•   • Poverty have negative impacts at all levels of
•   society namely Individual, household (homeless
•   children, children at risk, single parent/child
•   headed ), community and National
• Poverty can contribute to HIV/AIDS by:

  (a) reducing accessibility to preventive
  (b) increasing nutritional deficiency and
      shorting the incubation period between HIV
      infection and the onset of full-blown AIDS
  (c) reducing accessibility to affordable care
  (d) reducing access to information on AIDS by
      limiting access to education.

•   – affecting the active age group required for
•   economic growth in the country and this leads to loss
•   of productivity in all sectors.
•   – Reduced life expectancy now at 2/3 of the expected
•   years at birth projected without HIV/AIDS.
•   – Increased number of orphans.
•   – High burden of disease which has overwhelmed the
•   Health Care delivery system .
•   – HIV/AIDS have negative impact on virtually all
•   aspect of development and society
             Impacts          cont/d

• • Health Workers:
• - Too few to cope with increased demand
• - Poor conditions of service BUT overworked
•  can lead to strike actions -
• Peer pressure from colleagues who have
• • Extended families failing to cope in caring for
  Children, hence pre-disposing them to being
  street children, and abused
• AIDS affects population growth through
  two mechanisms:

 (a) increase in the number of deaths and

 (b) reduction in fertility among infected
     women and reducing the number of
     potential mothers by dying during
     the reproductive periods.
           Demography cont /d

• Life expectancy fell to two thirds of
• Using mortality rates, probability that a 15
  year old reaches age 50 is:
  – 28% (males) & 22% (females) in HIV/AIDS
  – 94% (males) & 97% (females) in no-HIV/AIDS
   Projected : HIV/AIDS and Non-HIV/AIDS
Annual AIDS deaths are projected to increase to around 30,000 by 2015
                 Economic Growth
Economic Context:
    –   Slow economic growth
    –   Declining Foreign Direct Investment
    –   High unemployment
Between 1 to 3% annual loss in GDP growth
• The manufacturing industry loses about 5
  days per year due to HIV/AIDS related
 absenteeism: 0.9 days leave for HIV
  negative workers and 18 days leave for
  HIV positive workers
• The direct costs of HIV-related illness and death
  includes costs of treatment and care, care for
  AIDS orphans, funerals, prevention and testing,
  and health system upgrading.

• The most important indirect costs stem from the
  private losses to households, extended families and
  communities due to pre-mature death of young
  adults of prime working age.
           Costs .. Cont/d
• One year cost of basic medical treatment
  can amount to two to three times the per
  capita GDP in many developing countries –.

• In Thailand, annual cost for basic medical
  care averages around US$ 1,000 per person,
  or about 25 times the government's current
  per capita health expenditure.
• Source : World Bank
Impact on Demand for Health Care Services

• Average of 46% of inpatients in hospitals were
  infected with HIV in some countries

• Patient loads and admissions for conditions strongly
  associated with HIV/AIDS have risen

   – Fourfold increase in number of TB patients
• Diversion of staff is “crowding out” care for other

• Number of individuals receiving Antiretroviral
  Therapy (ART) has risen dramatically
                 TB problem
• TB carriers who become infected with HIV face a
  30 to 50 fold increase in their risk of developing
  active TB.

• About 25 % of patients dying of TB in the coming
  years worldwide would not have been infected
  with the bacillus in the absence of HIV/AIDS
  epidemic –

• Source : World Bank.
           Long term effects
• A long-term macro-economic effect of the
  epidemic stems from:
• (a) labour force shortage,
• (b) human capital erosion,
• (c) increase in dependency ratio, and
• (d) loss of labour productivity.

• Increased morbidity and mortality levels affect
  national economies by reducing the volume of
  savings available and changing the ways savings
  are used, ultimately affecting GNP growth rate.
         Household Coping
*Using savings.
* Borrowing money.
* Taking on debt at high rates.
* Searching for additional income (child labour).
* Diverting expenditures from other essential areas.
* Disposing of non-productive assets and
* Finally disposing productive assets such as land,
animals and equipment, which can lead to ultimate
 Channels of Economic Impact

           Change in    LABOUR        MACRO
           age          MARKET        ECONOMY
HIV/AIDS   structure
           Impact on Education
• Loss of human resources – among teachers and other
  school staff: (supply of experienced teachers and other
  school staff will be reduced by AIDS-related illness
  and death).

• Declining demand-fewer and poor children (children may
  be kept out of the school to care for sick family members
  or to work in the fields. Children drop out of the school if
  their families cannot afford school fess due to reduced
  household income).

• Reduced financial resources and increased costs-
  competition for public and private funds.
Impact on Agriculture/Food security
• Food security and agricultural production will be
  threatened by loss of agricultural labourers,
  reduction in investments in productive
  agricultural inputs due to increased costs of care
  and number of person-years lost labour.

• According to FAO estimates, 7 million
  agricultural workers have died and some 16
  million more would die by 2020.
               Impacts on
•   Children
•   Women
•   Elderly
•   Young
             Individual level
• Incubation period (HIV)
   – 5-8 years from infection until the onset of AIDS
   – Very little economic impact during this time

• AIDS phase
   – Period of escalating illness
   – Ability to work is reduced
   – Cost of care increases
          Household level
• Often more than one household member is
  infected (sexually transmitted)

• Infections are concentrated among the
  primary carers and earners

• Double impact of reduced income and
  increased costs of care
    Household level cont….
• Less money available for other consumption

• Increased need for care diverts time and
  effort from other tasks
• children, often girls, may be removed
  from school to provide care or generate
• Death(s), often multiple, lead to funeral costs
   which are usually large in some countries
Impact of HIV/AIDS in urban households

             General population                            Families living with AIDS
30 000 Francs CFA

25 000
                                                                                               Monthly income
                                                                                               per capita
20 000

15 000
                                                                                               Monthly consumption
10 000                                                                                         per capita

 5 000

– 5 000

    Source: Simulation based on data from Cote d’Ivoire (Bechu, Delcroix and Guillaume) 1997
            Labour Market
• AIDS impacts on the sexually / economically
  active population
• AIDS related illness leads to:
   – reduced productivity due to absenteeism,
     high turnover etc
• AIDS related death leads to:
   – change in labour force and labour
   – change in age structure of labour force
   – change in available skills and experience
               Company costs
Timeline      Progression of HIV/AIDS        Economic Impact on the Company
                 in the Workforce

Year 0     Employee becomes infected    No costs to company at this stage

           Morbidity begins             Morbidity-related costs are incurred
Year 1-5                                (e.g. absenteeism, individual & workforce
                                        productivity, management resources,
                                        medical care & insurance)

           Employee leaves workforce    Termination-related costs are incurred
 Year 6    (resigns or dies)            (e.g. payouts from pension or provident
  or 7                                  fund, funeral expenses, loss of morale,
                                        experience, & work-unit cohesion)

           Company hires replacement    Turnover costs are incurred
 Year 7    employee                     (e.g. recruiting, training, reduced
  or 8                                  productivity)
        Consumer Markets
• The absolute number of consumers will be
  reduced from what it would have been

• The age structure of the market will change

• The structure of demand will also change
   – eg increase in demand for medical goods and

• Consumption is constrained more by spending
  power than by consumer numbers.
       Government Finance
• Increased demand on government services
   – Health
   – Welfare
   – Poverty reduction
Social Impacts
• Health care
   – Increased demand
   – Decreased ability to offer services as a result of
     staff loss
   – Crowding out
   – Similar impact on Welfare services
• Education
   – Reduction in demand
   – Greater reduction in ability to offer services
• Psychological impact on children
   – Parental illness and death
   – Educator illness and death
   – Increased death in the community
• Care of orphans
   – The need to care for orphans will increase
   – Ability of traditional arrangements to cope will be
• Long term impact?
• HIV has already reached very high levels and is
  set to rise for a few more years

• The resultant increase in death will change the
  structure of the population

• Households and individuals will feel the greatest
  economic impact

• The impact on companies and sectors will vary

• The macroeconomic impact will be felt in the long
      Policy Recommendations
Averting future impact through prevention

• Formulation of policies and programmes based
  on careful analysis of reliable data from
  comprehensive national epidemiological and
  behavioural surveillance system.

• Prevention intervention should be carefully
  targeted, prioritized and tailored to the stages
  in the epidemic.
     Policy Recommendations
Alleviating the economic impact through
 economic support

• Two complementary interrelated
  strategies of building the economic
  resources of households and supporting
  the creation of social safety net, like
    Policy Recommendations
• Appropriate measures should be taken to
  counter stigmatization and
  discrimination towards affected persons
  and protect their rights.

• Affordable treatment targeted to low
  income and below poverty line
• Social forces are at the root of HIV/AIDS epidemic.

• The economic upheaval has resulted in increased population

•   Sexual transmission of HIV is exacerbated by this mobility.

• Migrant workers spending long periods of time away from home.
• Frequently visiting commercial sex workers-then returning home
• To infect their spouses,

• Who in turn pass the virus to their newborns.
• Throughout many regions, HIV is
  spreading along trucking routes:
• among traveling salesmen, seamen,
  soldiers, fishermen, and migrant workers,
  and within the sex industry, which is itself
  fueled by economic disparity.
• Health care, welfare and education systems will
  be adversely affected

• HIV/AIDS is the single greatest threat to
• Greatest concern is the impact that HIV will have
  on children

• HIV/AIDS not simply a public health problem – it
  demands a committed & innovative multisectoral
Best Wishes to ALL

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