1. Methoden und Konzepte der Internationalen Entwicklungszusammenarbeit Vorlesung WS 2005/6 HIV/AIDS - IMPAKT

2. Literatur zur Vorlesung l UNDP; Bericht über die menschliche Entwicklung (HDR) 2003 (Handbibliothek) und 2005 www.undp.orgwww.undp.org l UNICEF, MI: Damage Assessment Report www.unicef.orgwww.unicef.org l UNICEF: Facts for Life www.unicef.orgwww.unicef.org l UNAIDS/WHO: Report on the Global AIDS Epidemic 2004 www.unaids.orgwww.unaids.org l UNAIDS: Sexual behaviour change for HIV: Where have theories taken us? 1999 UNAIDS Best Practice Collection www.unaids.orgwww.unaids.org l Barnett, T. & A. Whiteside: AIDS in the Twenty-First Century. Disease and Globalisation. 2002 (Handbibliothek) l Worldbank: Confronting AIDS. Public Priorities in a Global Epidemic. 1999 Revised Edition. www.worldbank.org (Handbibliothek)www.worldbank.org l Todaro, M: Economic Development (8. Ausgabe) 2003 (Handbibliothek)

3. Auswirkungen von HIV/AIDS Auf die Menschliche Entwicklung 1. Lebenserwartung

4. Adults and children estimated to be living with HIV as of end 2004 Total: 39.4 (35.9 – 44.3) million Western & Central Europe 610 000 [480 000 – 760 000] North Africa & Middle East 540 000 [230 000 – 1.5 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] Eastern Europe & Central Asia 1.4 million [920 000 – 2.1 million] South & South-East Asia 7.1 million [4.4 – 10.6 million] Oceania 35 000 [25 000 – 48 000] North America 1.0 million [540 000 – 1.6 million] Caribbean 440 000 [270 000 – 780 000] Latin America 1.7 million [1.3 – 2.2 million] East Asia 1.1 million [560 000 – 1.8 million]

5. 00002-E-5 – 1 December 2003 Changes in life expectancy in selected African countries with high and low HIV prevalence: 1950-2005 with high HIV prevalence: Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision 30 35 40 45 50 55 60 65 Life expectancy (years) 1950– 1955 1955- 1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980 1980- 1985 1985- 1990 1990- 1995 1995- 2000 2000- 2005

6. 010203040506070 Cambodia Haiti Mozambique Rwanda Côte d'Ivoire Zambia Kenya South Africa Zimbabwe Botswana Life expectancy at birth (years) Predicted life expectancyLoss in life expectancy due to HIV/AIDS Predicted loss in life expectancy due to HIV/AIDS in children born in 2000 Source: U.S. Census Bureau, 2000

7. Projected population structure with and without the AIDS epidemic, Botswana, 2020 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 020406080100120140020406080100120140 MalesFemales Deficits due to AIDS Projected population structure in 2020 Population (thousands) Age in years Source: US Census Bureau, World Population Profile 2000

8. Auswirkungen von HIV/AIDS Auf die Menschliche Entwicklung - verschiedene Ebenen

9. Impact of HIV/AIDS on urban households, Côte d’Ivoire General population Families living with AIDS Monthly income per capita Monthly income per capita Monthly consumption per capita Monthly consumption per capita 0 0 5 000 10 000 15 000 20 000 25 000 – 5 000 30 000 Francs CFA Savings/Disavings Source: Simulation-based on data from Bechu, Delcroix and Guillaume, 1997

10. Impact of HIV/AIDS on agricultural production in Ethiopia Hours spent by women on agricultural tasks: HIV/AIDS affected households: 11.6 - 16.4 hours/week Non-HIV/AIDS affected households: 33.6 hours/week Source: A. Baryoh, 1994, unpublished.

11. Reduction in production in a household with an AIDS death, Zimbabwe Source: Stover & Bollinger, 1999 CropsReduction in output Maize Cotton Vegetables Groundnuts Cattle owned 49% 37% 29% 47% 61%

12. Impact at the Household Level Production & earnings Investment and consumption Household health and composition Psychic costs  Reduced income  Reduced productivity  Reallocation of labour & land  Medical costs  Funeral costs  Legal fees  Dissavings  Changes in consumption & investment  Health maintaining activities reduced  Loss of deceased  Poor health of survivors  Dissolution of household  Disutility to individual  Grief of survivors Source: Terminology - S. Kongsin, 2000

13. Household Impact: Caring for Orphans l A study from Uganda shows that 25% of households are providing for an orphan Source: Lyons, M. 1997 l A study from Tanzania shows that 21% of the families in Bukoba district were fostering an orphan Source: Rugalema, 1999 l A study from Uganda shows that 25% of households are providing for an orphan Source: Lyons, M. 1997 l A study from Tanzania shows that 21% of the families in Bukoba district were fostering an orphan Source: Rugalema, 1999

14. Percentage of workforce lost to AIDS by 2005 and 2020 in selected African countries 0 10 20 30 40 50 % 2005 2020 Botswana Cameroon CAR Côte d’Ivoire Ethiopia Guinea-Bissau Mozambique Nigeria South Africa Togo UR Tanzania Zimbabwe Sources: ILO (2000) POPILO population and labour force projection; UN Department of Economic and Social Affairs, Population Division (1998) World Population Prospects: the 1998 Revision

15. Newly diagnosed AIDS cases and medical expenditure on an agricultural estate in Kenya, 1989 to 1997 0 20 40 60 80 100 120 Number of newly diagnosed AIDS cases 0 5 10 15 20 25 Medical expenditure (KSh millions) 198990919293949596 1997 new AIDS cases medical spending Source: Rugalema et al. HIV/AIDS and the commercial agricultural sector of Ken UNDP/FAO, 1999

16. Hours lost to Sickness and Funerals, Chilanga-Works(Source Ministry of Health- Zambia)

17. HIV prevalence in military personnel in Africa l Nigeria: 11% among peacekeepers returning from Sierra Leone and Liberia vs 5% in adult population l South Africa: 60-70% in military vs 20% in adult population Source: Nigeria AIDS bulletin No 15, May 20, 2000; The Mail & Guardian, Pretoria, March 31, 2000; UNAIDS/WHO 1999 estimate

18. Economic Growth Impact of HIV (1990-97) Figure 2: Growth Impact of HIV (1990-97) (80 developing countries) -1.6 -1.4 -1.2 -0.8 -0.6 -0.4 -0.2 0 05101520253035 HIV Prevalence Rate (%) Reduction in growth rate GDP per capita (%, per year) Source: R. Bonnel (2000) Economic Analysis ofHIV/AIDS, ADF2000 Background paper, World Bank

19. Estimated impact of AIDS on under-5 child mortality rates, selected African countries, 2010 Botswana Kenya Malawi Tanzania Zambia Zimbabwe 0 50 100 150 200 250 Deaths per 1,000 live births Without AIDS With AIDS Source: US Census Bureau

20. Projected reduction in size of primary-school-age population by 2010, in selected African countries 0 5 10 15 20 25 30 ZimbabweZambiaKenyaUganda % reduction Source: World Bank, 2000

21. Success stories

22. 00002-E-22 – 1 December 2003 Trends in HIV prevalence among pregnant women in Kampala, Uganda: 1991-2000 Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report 0 10 20 30 40 1991199219931994199519961997199819992000 Percentage

23. Prevalence among pregnant women in major urban areas, Uganda Source: Uganda National AIDS Programme 0 5 10 15 20 25 30 35 198586878889909192939495969798992000 Prevalence

24. HIV prevalence rate among 13 to 19-year-olds Masaka, Uganda, 1989 to 1997 Source: Kamali et al. AIDS 2000, 14: 427-434 0 1 2 3 4 5 1989/901990/911991/921992/931993/941994/951995/961996/97 Girls Boys HIV prevalence (%)

25. Increase in reported condom use with non-regular partners in selected districts in Uganda: 1996-2000 Source: STD/AIDS Control Programme, Uganda (2001) HIV/AIDS Surveillance Report 0 20 40 60 80 % condom use 19971999199619991997200019972000 MbaraMpigiMasindiPallisa

26. 00002-E-26 – 1 December 2003 Condom use among men with non-regular partners in selected sub-Saharan African countries: 1994-2000 Source: Macro International (1994-2000) Demographic and Health Surveys; Measure Evaluation 20 30 40 50 60 199419951996199719981999 2000 Malawi United Rep. of Tanzania Uganda Zambia % 70 10 0

27. 00002-E-27 – 1 December 2003 Scenario of the epidemic in Thailand, had there been no intervention through 2020, and observed epidemic curve 0 2,000 4,000 6,000 8,000 10,000 Number of HIV infections (thousands) 1985199019952000200520102020 2015 Observed No Intervention Source: Division of AIDS, Ministry of Public Health in Thailand; Thai Working Group on HIV/AIDS Projection (2001) HIV/AIDS Projections for Thailand: 2000-2020