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The political economy of development
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 Introduction

 Income Poverty

Social Indicators:

Health: 

Health status and health care services for the poor

Health: the problem of AIDS

Education

Water and sanitation

  What the Poor Say


Social Indicators

Health: the problem of AIDS

UNAIDS has estimated that in 1999 there were 2.6 million deaths due to AIDS, the highest global total since the beginning of the epidemic, and 5.6 million newly infected individuals. In all, 33.6 million individuals are estimated to be living with HIV/AIDS. The vast majority of these are in Africa and South and South-East Asia: almost 70 percent of the people living with HIV/AIDS (23.3 million) are in Sub-Saharan Africa, and about 20 percent (6 million) are in South and South-East Asia; over two-thirds of the new infections of HIV in 1999 (3.8 million) were in Sub-Saharan Africa alone (Table 14).

A recent World Bank Study (Confronting AIDS: Public Priorities in a Global Epidemic) showed that in a country such as Côte d’Ivoire the prevalence rate which is as high as 14 percent and predicted to rise to 16 percent by 2010 with the current strategies, could be halved to almost 8 percent by 2000 if condom use could be increased to 80 percent among sex workers and 20 percent among others with many partners.

The Human Immunodeficiency Virus (HIV) has so far been unique among infectious diseases in that it strikes rich people in the same proportion, or larger proportions, than it strikes poor people. Nevertheless, AIDS is a disease of poverty (see Confronting AIDS):

  • AIDS is a disease of poverty in the sense that most people with HIV/AIDS are poor. The disease struck very hard in poor countries: 90 percent of infected people are in the developing world, and a full two-thirds are in Sub-Saharan Africa. Moreover, although infection rates are declining in the developed world, they are stable or rising in most developing countries.
  • Recent studies in developed countries have shown AIDS incidence to be highest among the very poor. At the moment, there are no data to assess the precise proportions of poor and non-poor people who are infected in developing countries, but if trends for developed countries are replicated worldwide, the poor will be more likely to become infected than the non-poor.
  • AIDS deepens and spreads poverty. Poor households are more adversely affected by an AIDS death of a prime-age adult than other households because they have fewer assets to draw on to cope with medical expenses and the loss of income and services that a prime-age adult typically provides.
  • AIDS is also likely to increase poverty through the rise in the number of children who lose one or both parents. Evidence shows that orphans have significantly lower enrollment rates and are more likely to be malnourished than non-orphans. Lack of schooling and inadequate nutrition will make it more difficult for orphans to escape poverty.

Table 14. The distribution of HIV/AIDS around the world

Region

New HIV/infections during 1999

People living with HIV/AIDS as of end 1998

Adult HIV/AIDS Prevalence Rate a

Number

Percent

Number

Percent

Percent

Sub-Saharan Africa 3,800,000

67.67

23,300,000

69.51

8.0

South and South-East Asia 1,300,000

23.15

6,000,000

17.90

0.7

Latin America 150,000

2.67

1,300,000

3.88

0.6

East Asia and Pacific 120,000

2.14

530,000

1.58

0.1

East. Europe and Central Asia 95,000

1.69

360,000

1.07

0.1

Caribbean 57,000

1.02

360,000

1.07

2.0

North Africa and Middle East 19,000

0.34

220,000

0.66

0.1

North America 44,000

0.78

920,000

2.74

0.6

Western Europe 30,000

0.53

520,000

1.55

0.3

Australia and New Zealand 500

0.01

12,000

0.04

0.1

Total 5,615,500

100.00

33,522,000

100.00

1.1

Source: UNAIDS, Aids Epidemic Update: December 1999.
Note: a The Adult Prevalence Rate is the proportion of adults (15 to 49 years of age) living with HIV/AIDS in 1999.


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