The economic consequences of AIDS in Africa
Ilinigumugabo, A.
African Journal of Fertility Sexuality and Reproductive Health 1(2): 153-161
1996
PMID: 12321198 Document Number: 556729
The economic and social consequences of the AIDS epidemic in Africa are enormous because of the prevalence of the disease and the age structure of patients. AIDS has caused a rise in early childhood and adult mortality, leading to a younger age distribution and a less favorable dependency ratio. All epidemiological studies have shown a strong seroprevalence in urban areas, and some show higher infection rates among the educated. The consequences of AIDS at the household level begin with the appearance of symptoms and often continue past the death of the patient. Expenditures for medical care, treatment of opportunistic infections, loss of income of the patient (who frequently is the main breadwinner), depletion of savings, funeral expenses, and care for others who may have become infected create an enormous burden for most households. Widows with no inheritance rights are left destitute with their children, who may be taken out of school to reduce expenses. UNICEF estimates that some 5.5 million children in East and Central Africa will be orphaned by AIDS by the year 2000. Many such children end up in the streets, prime targets for prostitution and HIV infection. The coping mechanisms of poor communities with high prevalence rates are soon overwhelmed by demands for assistance. Businesses are affected by health care costs, lessened productivity, and absenteeism. Costs of training increase for jobs requiring skilled workers. AIDS tends to reduce agricultural productivity, especially in areas with little rainfall and high seasonal manpower needs. Cash crops, which frequently depend on advanced technology, are more vulnerable than is subsistence agriculture. Agronomists may be hard to replace, and large unskilled migratory labor forces living apart from families may develop habits of promiscuity that allow HIV to spread rapidly. The few studies done on direct health costs of AIDS show that they vary tremendously depending on the country's level of development and national health budget. AIDS-related expenditures already consume a large share of the health budgets of the most affected countries, and they are projected to increase significantly. The macroeconomic impact of the AIDS epidemic includes effects due to deteriorating health, such as decreased productivity, increased health expenditures, reduced savings, and decreased investment in education and human resources.