Wednesday, June 12, 2013

The economic cost of HIV/AIDS in Uganda

There is hardly a Ugandan who has not been touched by AIDS. It may have been a parent, a brother, a cousin, a friend, an old boy, a neighbour or the main bread winner in a family. We have all had our share of the grief and pain that AIDS visits upon us. The emotional strain and social face of HIV and AIDS is visible and tangible. Seeing your loved one painfully and helplessly waste away before your very eyes, feeling the pain and anguish of looking after the ill and subsequently attending that funeral with the mixed emotions of loss and a guilty relief-it is all over. For the patient and for you; the long suffering caregiver. AIDS is no longer only a human loss but a substantially economic one, which poses a serious threat to economic growth, development prospects and poverty alleviation in Uganda. In Uganda,the HIV prevalence rate has risen from 6.4% in 2005 to 7.3% in 2012, with even higher rates shown in some longitudinal studies in Masaka and Rakai, the direct and indirect economic costs of the epidemic are set to become greatly compounded. According to UNDP, Uganda has 130,000 new HIV infections every year. This equates to around 10,000 people being newly infected with HIV every month, which is a worrying trend. Surprisingly, there have not been many recent empirical studies on the economic impact of the epidemic in Uganda as compared to say, South Africa, where several studies and models have been developed. The reasons for this differ not least of which is that macro-economic models for estimating the economic toll of the epidemic vary, and there has been debate on their accuracy of findings (how do you isolate HIV from other factors?) but the economic impact of HIV is undeniable. A Ministry of Finance and Uganda AIDS Commission study (Assessing the Macro Economic impact of HIV/AIDS in Uganda) funded by UNDP shows that Uganda’s economic growth rate will slow by 1.2% due to the impact of HIV on Uganda’s labour force and the costs households incur in treating their infected members. The report, released in November 2008, estimates that by 2025 Uganda’s economy will be reduced by up to 39% on account of the epidemic. The same study shows that HIV and AIDS raise the overall poverty rate in Uganda by 1.4% every year. Times this by ten years and the cumulative effect becomes mind boggling. ‘’When a poor family is affected by HIV/AIDS, it increases poverty by 2% on individual homes across the country,” says Dr Keith Jeffries who led the study. Other studies now show that the HIV pandemic has resulted in socio economic reversals that cut off 4% on national economic growth rates in Sub Saharan African countries. The World Bank shows that in Uganda the economic impact of HIV-related deaths is stronger than other types of deaths such as malaria since households spend their savings on prolonged treatment and funerals. From an individual perspective, the economic toll is evident. The costs of prolonged hospitalizations, buying drugs, depleting personal savings for treatment costs, loss of productive hours while caring for the sick and those notoriously expensive Ugandan funerals push individuals and households down the poverty ladder. In Botswana, according to a 2006 UNAIDS study it was estimated that, on average, every income earner was likely to acquire one additional dependent over the next five years due to the AIDS epidemic. “We will see a ripple effect from the individual to firstly, households; secondly, businesses and communities, and lastly the welfare system,” said George Gavin, research fellow at the Health Economics and AIDS Research Division of the University of KwaZulu-Natal in South Africa. A 2002 study estimates that households suffer a decline in income of between 48 percent and 78 percent when a member of their household is lost to HIV, excluding the costs of funerals. Household expenditure on funerals can be as much as seven times their total monthly household incomes as reported by some families in some studies in South Africa. The loss of young adults due to prolonged illness and of course death in the most productive age group of 25-54 reduces the country’s labour supply and productivity. In the Uganda Railways Corporation, the loss in productivity per employee on account of AIDS is $300 according to a recent study. Ugandan businesses’ competitiveness and profitability has been impacted by HIV due to employee absenteeism on account of illness, expenditures on employee medical care, staff funeral expenses and attendance and training costs to replace departed workers. In Ethiopia, a World Bank Study on 25 rural households found the average cost of treatment, funeral and mourning expenses totaled several times the average household incomes. In a Henry Kaiser Foundation study conducted in South Africa in 2002, poor households with members living with HIV and AIDS were reducing spending on necessities. Households were likely to cut spending on clothing by 21% and on electricity by 16%. Even expenditure on food was reduced among 6% of the households affected by HIV with nearly a half of all households reporting not having enough to eat at some point. Neither is agriculture spared by HIV. A study by the Zimbabwe Farmers’ Union revealed that the AIDS-related death of a breadwinner led to a reduction in Maize production in the small holder farming sector by as much as 61%. HIV and AIDS has diminished the available agricultural production workforce in Southern African by between 14-20%, compromising food security at household and national levels. Ironically, those on antiretroviral therapy need lots of food due to the toxic nature of antiretroviral drugs. The education sector does not remain unscathed. A reduction in enrolment is one of the effects of the epidemic as pupils stay at home to look after sick parents and pupils drop out due to sick parents’ inability to raise fees. There has also been a reported direct loss of teachers to the epidemic. In Swaziland, a 2002 UNAIDS report shows that school enrolment dropped by 25-30% on account of AIDS 2000. Although antiretroviral therapy (ART) has been shown to reduce the economic impact of HIV, prevention remains the greatest hope of responding to the pandemic as treatment efforts are hopelessly outpaced by the increasing prevalence rates. A 2011 UNAIDS report estimates that for every patient put on antiretroviral therapy, two are newly infected in their place. Source: Key Correspondents » Login to post comments Pri

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