Global summary of the HIVAIDS epidemic, December 2003

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Human Capital, HIV-AIDS and the Demographic
Dividend
Stephen A. Vosti
Center for Natural Resources Policy Analysis, UC
Davis
July 2004
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Population Quality Human and Social Capital

• Health and nutritional status
• protein/calorie deficiencies
• vitamin A deficiencies
• micronutrient deficiencies
• Education
• basic skills
• Job skills
• Social skills

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Investments in Human Capital Do They Pay
Off?Returns to Investments in Education, by
Level ()
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Investments in Human Capital Do They Affect
Fertility Decisions

• Reductions in of children a female can have
• Reductions in desired family size
• Achieving desired family size

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Global summary of the HIV/AIDS epidemic,
December 2003
Number of people living with HIV/AIDS Total 40
million (34 46 million) Adults 37 million (31
43 million) Children under 15 years 2.5
million (2.1 2.9 million) People newly infected
with HIV in 2003 Total 5 million (4.2 5.8
million) Adults 4.2 million (3.6 4.8
million) Children under 15 years 700 000 (590
000 810 000) AIDS deaths in 2003 Total 3
million (2.5 3.5 million) Adults 2.5 million
(2.1 2.9 million) Children under 15 years 500
000 (420 000 580 000)
The ranges around the estimates in this table
define the boundaries within which the actual
numbers lie, based on the best available
information. These ranges are more precise than
those of previous years, and work is under way to
increase even further the precision of the
estimates that will be published mid-2004.
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Regional HIV/AIDS statistics and features, end of
2003
The proportion of adults 15 to 49 years of
age living with HIV/AIDS in 2003, using 2003
population numbers
The ranges around the estimates in this table
define the boundaries within which the actual
numbers lie, based on the best available
information. These ranges are more precise than
those of previous years, and work is under way to
increase even further the precision of the
estimates that will be published mid-2004.
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Global estimates for adults and childrenend 2003
40 million 34 46 million 5 million 4.2 5.8
million 3 million 2.5 3.5 million

• People living with HIV/AIDS
• New HIV infections in 2003
• Deaths due to HIV/AIDS in 2003

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Adults and children estimated to be living with
HIV/AIDS as of end 2003
Eastern Europe Central Asia 1.2 1.8 million
Western Europe 520 000 680 000
North America 790 000 1.2 million
East Asia Pacific 700 000 1.3 million
North Africa Middle East 470 000 730 000
Caribbean 350 000 590 000
South South-East Asia 4.6 8.2 million
Sub-Saharan Africa 25.0 28.2 million
Latin America 1.3 1.9 million
Australia New Zealand 12 000 18 000
Total 34 46 million
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Estimated number of adults and childrennewly
infected with HIV during 2003
Eastern Europe Central Asia 180 000 280 000
Western Europe 30 000 40 000
North America 36 000 54 000
East Asia Pacific 150 000 270 000
North Africa Middle East 43 000 67 000
Caribbean 45 000 80 000
South South-East Asia 610 000 1.1 million
Sub-Saharan Africa 3.0 3.4 million
Latin America 120 000 180 000
Australia New Zealand 700 1 000
Total 4.2 5.8 million
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Estimated adult and child deaths from HIV/AIDS
during 2003
Eastern Europe Central Asia 23 000 37 000
Western Europe 2 600 3 400
North America 12 000 18 000
East Asia Pacific 32 000 58 000
North Africa Middle East 35 000 50 000
Caribbean 30 000 50 000
South South-East Asia 330 000 590 000
Sub-Saharan Africa 2.2 2.4 million
Latin America 49 000 70 000
Australia New Zealand lt100
Total 2.5 3.5 million
13
Children (lt15 years) estimated to be living with
HIV/AIDS as of end 2003
Eastern Europe Central Asia 9 000 15 000
Western Europe 5 000 7 000
North America 8 000 12 000
East Asia Pacific 6 000 12 000
North Africa Middle East 31 000 49 000
Caribbean 19 000 31 000
South South-East Asia 110 000 190 000
Sub-Saharan Africa 2.0 2.2 million
Latin America 37 000 50 000
Australia New Zealand lt 200
Total 2.1 2.9 million
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Estimated deaths in children (lt15 years) from
HIV/AIDS during 2003
Eastern Europe Central Asia lt 100
Western Europe lt 100
North America lt 100
East Asia Pacific 1 000 3 000
North Africa Middle East 6 000 10 000
Caribbean 4 000 8 000
South South-East Asia 20 000 39 000
Sub-Saharan Africa 400 000 540 000
Latin America 4 000 6 000
Australia New Zealand lt 100
Total 420 000 580 000
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Estimated number of children (lt15 years) newly
infected with HIV during 2003
Eastern Europe Central Asia 800 1 200
Western Europe lt 500
North America lt 500
East Asia Pacific 2 500 5 000
North Africa Middle East 8 000 12 000
Caribbean 5 000 9 000
South South-East Asia 32 000 58 000
Sub-Saharan Africa 580 000 660 000
Latin America 8 000 12 000
Australia New Zealand lt 100
Total 590 000 810 000
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About 14 000 new HIV infections a day in 2003

• More than 95 are in low and middle income
  countries
• Almost 2000 are in children under 15 years of age
• About 12 000 are in persons aged 15 to 49 years,
  of whom
• almost 50 are women
• about 50 are 1524 year olds

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End-2003 global HIV/AIDS estimatesChildren (lt15
years)

• Children living with HIV/AIDS
• New HIV infections in 2003
• Deaths due to HIV/AIDS in 2003

2.5 million 2.1 2.9 million 700 000 590 000
810 000 500 000 420 000 580 000
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HIV prevalence among pregnant women,selected
provinces, South Africa, 19901997
HIV prevalence ()
30
KwaZulu Natal
25
Free State
20
Gauteng
15
Eastern Cape
10
5
0
1990
1991
1992
1993
1994
1995
1996
1997
Source Department of Health, South Africa
98036-E-19 15 July 1998
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Projected changes in life expectancy in selected
African countries with high HIV prevalence,
19952000
65 60 55 50 45 40 35
Average life expectancy at birth, in years
Botswana
Zimbabwe
Zambia
Uganda
Malawi
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Source United Nations Population Division, 1996
98036-E-23 15 July 1998
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Estimated impact of AIDS on under-5 child
mortality rates Selected African countries, 2010
with AIDS
per 1000 live births
250 200 150 100 50 0
without AIDS
Botswana
Kenya
Malawi
Tanzania
Zambia
Zimbabwe
Source US Bureau of the Census
98036-E-25 15 July 1998
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Increase in mortality among men 1560 between
1986 and 1997, based on household reports
(sibling histories), selected African countries
Probability of dying from all causes ()
80
1995/96
70
60
1994
1993
50
1991
1990/91
1995
1989
40
1986
30
1990
1988
20
10
Country and survey date
0
Zimbabwe
Tanzania
Malawi
Uganda
Zambia
Source Timaeus I, London School of Hygiene and
Tropical Medicine, from Demograhic and Health
Survey data
98036-E-27 15 July 1998
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Proportion of adult mortality attributable to
HIV,various community studies in Africa,
19901996
small town Uganda (HIV 21)
rural Uganda (HIV 8)
Death rates among HIV-negatives
Excess deaths due to HIV
small town Tanzania (HIV 7)
rural Tanzania (HIV 4)
Deaths per 1,000 person-years
0
5
10
15
20
25
30
35
40
Source Boerma T et al., in The Socio-Demographic
Impact of AIDS in Africa, IUSSP, 1997
98036-E-28 15 July 1998
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Economic Effects of AIDS

• Direct Effects
• Treating the Sick
• Lost Productivity of the Sick

• Indirect Effects
• Reductions in Education
• Lost Productivity of those Tending to the Sick
• Forgone Investments in Productive Capital

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Country Lowa Meana Higha Ratio GNP
per Capita of costs to GNP/capita (
US) (1992 US) Zaire
(1987-88)b 132 n.a 1,585 Tanzania
(1987-88)b 104 n.a 631 1/5.7 110 Tanzania
(1990) n.a 290 n.a 2.9 110 Tanzania
(1996)g 414 0.7 591 South Africa
(1991)c 2,857 n.a 7,143 1/2.7 2,670 Malawi
(1989)d n.a 210 n.a 1 210 Kenya
(1992)d n.a 938 n.a 3 310 Jamaica
(1987)d n.a 1,807 n.a 1.4 1,340 Zimbabwe
(1991) 64 614 2,574 0.1/1.1/4.5 570 Thailand
(1993)e 987 n.a 1,524 0.5/0.82 1,840 Thailand
(1996)g n.a 2516 n.a 0.4 6290 Korea
(1993) n.a 2,010 n.a 0.3 6,790 Malaysia
(1993)f n.a 3,000 n.a 1.1 2,790 Rwanda
(1989-90) n.a 358 n.a 1.4 250 Cote dIvoire
(1996) n.a 2335 n.a 1.7 1373 Mexico
(1996)g n.a 13868 n.a 2.0 6934 Brazil
(1996)g,h n.a 27639 n.a 3.0 9213
Direct Costs of AIDS, per case, Selected Countries
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Indirect Costs per case of HIV Infection in Zaire
and Tanzania (1985 US)
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Demographic Dividend

• What is it?
• How large might it be?
• How can a developing country cash it in?

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Proportion of Population of Working Age