HIV and AIDS in South Asia: An Economic Development Risk
'HIV and AIDS in South Asia: An Economic Development Risk' offers an original perspective on HIV and AIDS as major development issues for the region. Although the impact of HIV and AIDS on economic growth appears to be very small, three risks to development are associated with HIV and AIDS in South Asia: the risk of escalating concentrated epidemics, the economic welfare costs, and the fiscal costs of scaling up treatment. As the authors show, South Asian countries have relatively low estimated national HIV prevalence rates, but prevalence is growing rapidly among vulnerable groups at high risk, such as sex workers and their clients, men having sex with men, and injecting drug users and their partners. The cost benefits of targeted prevention programs are high, and the financing of prevention measures such as comprehensive harm reduction and condom use is a sound economic investment in low-prevalence countries with concentrated epidemics. Interventions that reduce the risks and stigma associated with HIV and AIDS have benefits beyond the cost of lives saved; they improve the welfare of those who are at risk and those who fear contracting HIV. Treatment for AIDS in South Asia is limited at present, with weak health systems contributing to low access to and use of services. The challenges of a comprehensive scaling up of antiretroviral treatment are substantial, underscoring the crucial role of effective prevention today. The authors conclude that the limited ability of many households to pay 'catastrophic' health expenses associated with treatment, as well as the negative consequences associated with poor adherence to treatment, suggest a large and central role for the public sector in the provision of antiretroviral therapy. 'HIV and AIDS in South Asia: An Economic Development Risk' will be of particular value to readers with interests in the areas of economic policy, microfinance, public health, and epidemiology.
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HIV and AIDS in South Asia: An Economic Development Risk
'HIV and AIDS in South Asia: An Economic Development Risk' offers an original perspective on HIV and AIDS as major development issues for the region. Although the impact of HIV and AIDS on economic growth appears to be very small, three risks to development are associated with HIV and AIDS in South Asia: the risk of escalating concentrated epidemics, the economic welfare costs, and the fiscal costs of scaling up treatment. As the authors show, South Asian countries have relatively low estimated national HIV prevalence rates, but prevalence is growing rapidly among vulnerable groups at high risk, such as sex workers and their clients, men having sex with men, and injecting drug users and their partners. The cost benefits of targeted prevention programs are high, and the financing of prevention measures such as comprehensive harm reduction and condom use is a sound economic investment in low-prevalence countries with concentrated epidemics. Interventions that reduce the risks and stigma associated with HIV and AIDS have benefits beyond the cost of lives saved; they improve the welfare of those who are at risk and those who fear contracting HIV. Treatment for AIDS in South Asia is limited at present, with weak health systems contributing to low access to and use of services. The challenges of a comprehensive scaling up of antiretroviral treatment are substantial, underscoring the crucial role of effective prevention today. The authors conclude that the limited ability of many households to pay 'catastrophic' health expenses associated with treatment, as well as the negative consequences associated with poor adherence to treatment, suggest a large and central role for the public sector in the provision of antiretroviral therapy. 'HIV and AIDS in South Asia: An Economic Development Risk' will be of particular value to readers with interests in the areas of economic policy, microfinance, public health, and epidemiology.
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HIV and AIDS in South Asia: An Economic Development Risk

HIV and AIDS in South Asia: An Economic Development Risk

HIV and AIDS in South Asia: An Economic Development Risk

HIV and AIDS in South Asia: An Economic Development Risk

Overview

'HIV and AIDS in South Asia: An Economic Development Risk' offers an original perspective on HIV and AIDS as major development issues for the region. Although the impact of HIV and AIDS on economic growth appears to be very small, three risks to development are associated with HIV and AIDS in South Asia: the risk of escalating concentrated epidemics, the economic welfare costs, and the fiscal costs of scaling up treatment. As the authors show, South Asian countries have relatively low estimated national HIV prevalence rates, but prevalence is growing rapidly among vulnerable groups at high risk, such as sex workers and their clients, men having sex with men, and injecting drug users and their partners. The cost benefits of targeted prevention programs are high, and the financing of prevention measures such as comprehensive harm reduction and condom use is a sound economic investment in low-prevalence countries with concentrated epidemics. Interventions that reduce the risks and stigma associated with HIV and AIDS have benefits beyond the cost of lives saved; they improve the welfare of those who are at risk and those who fear contracting HIV. Treatment for AIDS in South Asia is limited at present, with weak health systems contributing to low access to and use of services. The challenges of a comprehensive scaling up of antiretroviral treatment are substantial, underscoring the crucial role of effective prevention today. The authors conclude that the limited ability of many households to pay 'catastrophic' health expenses associated with treatment, as well as the negative consequences associated with poor adherence to treatment, suggest a large and central role for the public sector in the provision of antiretroviral therapy. 'HIV and AIDS in South Asia: An Economic Development Risk' will be of particular value to readers with interests in the areas of economic policy, microfinance, public health, and epidemiology.

Product Details

ISBN-13: 9780821378007
Publisher: World Bank Publications
Publication date: 02/19/2009
Series: Directions in Development - Human Development
Pages: 272
Product dimensions: 5.90(w) x 8.90(h) x 0.70(d)

Table of Contents

Foreword xiii

Acknowledgments xv

Executive Summary xvii

Part I The Epidemiology of HIV and Prevention Strategies 1

Chapter 1 Dynamics of the HIV Epidemic in South Asia David Wilson Mariam Claeson 3

Introduction 3

The Global Context 4

HIV Transmission Patterns in South Asia 12

What Works-Lessons from HIV Prevention Interventions and Programs 27

Conclusions: Prevention Priorities for South Asia 32

References 36

Chapter 2 Responding to HIV in Afghanistan Jed Friedman Edit V. Velenyi 41

Introduction 41

The State of the Epidemic in Afghanistan 42

Evidence on the Effectiveness and Cost-Effectiveness of HIV Prevention 47

HIV Prevention in Afghanistan-An Economic Perspective 50

Conclusions 56

Notes 65

References 66

Part II The Economic and Development Impacts of HIV and AIDS 73

Chapter 3 Development Impact of HIV and AIDS in South Asia Markus Haacker 75

Introduction 75

Health and Demographic Impacts of HIV and AIDS 77

The Economic Impact of HIV and AIDS: Aggregate Approaches 84

Beyond Aggregate Measures of the Impact of HIV and AIDS 90

Economic Development Aspects of the Response to HIV and AIDS 99

Summary and Conclusions 112

Notes 114

References 117

Chapter 4 Economic Cost of HIV and AIDS in India Sanghamitra Das Abhiroop Mukhopadhyay Tridip Ray 123

Introduction 123

Context 125

A Survey of Households Affected by HIV and AIDS 127

Outline of the Model 141

Estimating the Costs of HIV and AIDS 143

Concluding Remarks 147

Notes 149

References 151

Part III The Burden of HIV and AIDS on the Health Sector 155

Chapter 5 The Fiscal Burden of AIDS Treatment on South Asian Health Care Systems Mead Over 157

Introduction157

Overview of AIDS Cases and Treatment in South Asia 158

Future Growth of South Asian Treatment Costs 163

Health Care Financing in South Asian Countries 167

Access to Private Health Care and the Risk of Poverty 170

Quality of Private vs. Public ART 175

Conclusions 177

Notes 187

References 189

Chapter 6 Recurrent Costs of India's Free ART Program Indrani Gupta Mayur Trivedi Subodh Kandamuthan 191

Introduction 191

India's Free ART Program 193

Methodology and Data Collection 196

Overview of the Selected Sites 201

Key Assumptions and Parameters 205

Costs of the ART Program 210

Out-of-pocket Expenditure 216

Projected Costs of India's Free ART Program 218

Discussion of Findings 220

Outlook 223

Notes 234

References 236

Index 239

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