By killing so many people in the prime of their
lives, AIDS poses a serious threat to development. By reducing growth,
weakening governance, destroying human capital, discouraging investment
and eroding productivity, AIDS undermines countries' efforts to reduce
poverty and improve living standards.
on economies and poverty
- AIDS has a profound
impact on growth, income and poverty. It is estimated that the annual
per capita growth in half the countries of sub-Saharan Africa is falling
by 0.5-1.2% as a direct result of AIDS. By 2010, per capita GDP in some
of the hardest hit countries may drop by 8% and per capita consumption
may fall even farther.
- People at all income
levels are vulnerable to the economic impact of HIV, but the poor suffer
most acutely. AIDS pushes people deeper into poverty as households lose
their breadwinners to AIDS, livelihoods are compromised, and savings
are consumed by the cost of health care and funerals. In some countries,
conservative estimates indicate that the number of people living in
poverty has already increased by 5% as a result of the epidemic. This
is jeopardizing efforts to reach the Millennium Summit goal of halving
the proportion of people living in extreme poverty by 2015.
- With less access
to jobs, health care and other services, impoverished people are more
likely to resort to commercial sex and other survival strategies that
put them at risk of contracting HIV, thus creating a vicious cycle.
- Governments are
losing valuable skilled employees and are confronted with mounting expenses
for health and orphan care, reduced revenues and lower return on social
- Governments in
a number of low-income countries depend heavily on a small number of
policy-makers and managers whose skills are often scarce in important
areas of public management and core social services. In heavily affected
countries, the ranks of such personnel are being thinned further as
more civil servants fall prey to the epidemic. The loss of such officials
is reducing capacity, while raising the costs of recruitment, training,
benefits and replacements.
the production sectors
- Companies of all
types face higher costs in training, insurance, benefits, absenteeism
and illness. There are many forecasts of health care costs increasing
as much as tenfold within a few years. This slows private sector development—-a
core element in the development strategies of many nations.
- AIDS is reducing
the ratio of healthy workers to dependants. Productivity growth may
be cut by as much as 50% in hard-hit countries. Combined with the erosion
of human capital and loss of skilled and experienced workers, this will
result in a mismatch between human resources and labour requirements.
- In agriculture,
HIV/AIDS is reducing investments in irrigation, soil enhancement and
other capital improvements, thereby inhibiting production. Households
are shifting to crops that are less labour-intensive but also less nourishing.
AIDS is forcing families to sell assets in order to cover the costs
of care and funerals. As a result, lower food production is already
being reported in some areas, further threatening the Millennium Summit
goal of halving the proportion of people suffering from hunger by 2015.
the social sectors
- AIDS overburdens
social systems and hinders health and educational development. Life
expectancy has fallen by up to 20 years in some countries. The current
number of children who have lost their mothers or both parents to the
epidemic—13.2 million-is forecast to more than double by 2010. This
poses unprecedented social welfare demands for countries already burdened
by huge development challenges.
- Teachers and students
are dying or leaving school, reducing both the quality and efficiency
of educational systems. Faltering education services will also diminish
human capital in every other sector. The Millennium Summit goal of ensuring
universal primary education by 2015 is at risk in the worst affected
- Health care systems
in many countries are overstretched as they deal with a growing number
of AIDS patients and the loss of health care personnel.
- AIDS is also undermining
social cohesion in many countries and is increasingly recognized as
a threat to social and political stability.
- Women and girls
are more vulnerable to HIV/AIDS and are disproportionately affected
by the epidemic. The greatest burden of care also rests on their shoulders.
Families often remove girls from school to care for sick relatives or
assume other family responsibilities, jeopardizing the girls' education
and future prospects.
- The effect on girls'
development is especially detrimental, leaving girls even more vulnerable
to HIV infection. Girls who are forced to abandon their schooling are
less likely to achieve the earning power required to increase their
economic independence. Reduced education for women also impedes national
- Countries that
have registered successes in their struggles against the epidemic have
shown that development achievements can be safeguarded if HIV/AIDS activities
are integrated into overall development strategies and programmes.
- Improved and intensified
poverty reduction strategies are also essential. Efforts to promote
equitable growth, generate employment, raise incomes, improve agricultural
production and promote informal sector livelihoods need to be expanded.
- Countries that
explore innovative ways of maintaining and rebuilding capacity in government
are better equipped to contain the epidemic. Equally valuable are labour
and social legislation changes that boost people's rights, more effective
and equitable ways of delivering social services, and more extensive
programmes aimed at those worst hit by the epidemic (especially women
- It has been shown
that a successful response to AIDS requires that essential public services
such as education, health, security, justice and institutions of democratic
governance be maintained. Each sector has to take account of HIV/AIDS
in its own development plans and introduce measures to sustain public
sector functions. Such actions might include fast-track training, as
well as the recruitment of key civil servants and the reallocation of
budgets towards the most essential services.
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