Economic Aspects Of Aids And Hiv Infection

From the early days of its recognized occurrence, AIDS has been per ceived as posing tremendous threats, burdens and challenges to human beings. Individuals, societies and, in a global point of view, mankind are affected by the effects of the HN infection, the nature and extent of which is still unclear in many ways. In the beginning only biomedical and epidemiological analyses of the problem were the top research priori ties, the former laden with great hopes that it may soon be possible to stop the spread of the disease and to overcome its physical impact. Yet it soon became clear that AIDS would be something to be reckoned and coped with on a long-term basis, making a thorough investigation of its impact absolutely mandatory. AIDS has serious economic consequences. Taken seriously, they can not be confined to predictions of costs intended to support the AIDS issue in the struggle for resources. Besides cost calculations - a method ologically tricky and wide-ranging topic in itself -and their application to cost-effectiveness and other analyses, economic issues include identify ing and assessing patterns of care, analyzing problems of financing, exploring impacts on markets other than health care, and modelling scenarios for future developments and strategies. At present, the eco nomic aspects of AIDS still constitute a very recent topic in European health economics and health systems research. Many projects are just about to start, and there must be a better exchange of information between research groups.

AIDS has serious economic consequences. Taken seriously, they cannot be confined to predictions of costs intended to support the AIDS issue in the struggle for resources. Besides cost calculations - a methodologically tricky and wide-ranging topic in itself - and their application to costeffectiveness and other analyses, economic issues include identifying and assessing patterns of care, analyzing problems of financing, exploring impacts on markets other than health care, and modelling scenarios for future developments and strategies. At present, the economic aspects of AIDS still constitute a very recent topic in European health economics and health systems research. On behalf of the Concerted Action Committee (COMAC) on Health Services Research, the GSF-Institut fuer Medizinische Informatik und Systemforschung convened an international conference in Munich, March 1989. The focus of the COMAC conference and of this book is on the exploration of economic aspects, on empirical approaches, on case studies, and, last but not least, on modelling techniques for economic scenarios.

This book explains how, and why, economics has been applied to a terrible pandemic, using a range of examples mostly drawn from the region most affected, sub-Saharan Africa. Part I shows that microeconomic approaches have found fertile ground in a public health approach that ‘blames’ individual choices for HIV transmission. Despite their attractiveness, however, these approaches fail to explain contemporary patterns of HIV prevalence, illustrating the importance of factors that are excluded from the standard micro-economic approach. Part II of the book looks at our problems in understanding the economic impact of AIDS, and explains why economists cannot agree if epidemic disease is a good or bad thing for economic development. In both sections of the book, the potential for alternative approaches is shown, and the book ends by arguing that a political economy approach can bring meaningful insights to our understanding of the spread and impact of HIV/AIDS.

The global response to HIV/AIDS has been a major aspect of global health and development policy over the last three decades. The book illustrates the devastating health impacts of the epidemic, with life expectancy in some countries falling to the lowest levels observed anywhere, and the remarkable success of the global HIV/AIDS response in reversing such extreme outcomes. Concerns about the implications of HIV/AIDS for economic development have played a role in motivating the global HIV/AIDS response. However, evidence on the impacts of HIV/AIDS on economic growth or poverty is weak, and the magnitude and relevance of such economic effects appears trivial compared to the consequences for life and health. Because of the success in extending access to treatment globally, HIV/AIDS has effectively transitioned into a chronic disease. This means that HIV/AIDS absorbs not only a substantial chunk of current global and national financial resources, but that these spending needs are projected to persist over decades. The costs of the HIV/AIDS response thus resemble a long-term financial liability, shaped by past and current policies. Relatedly, the calculus of cost-effectiveness of HIV/AIDS interventions has changed. People who become infected with HIV can now expect to not die because of AIDS; at the same time, each HIV infection results in medical needs and expenditures extending over decades. The book presents a framework for integrating these financial consequences and the transmission dynamics of HIV in the analysis of cost-effectiveness of HIV/AIDS interventions and in the design of HIV/AIDS programs.

HIV is the leading cause of premature death in Thailand. Since the first case of AIDS was reported in 1984 more than one million Thais have been infected. The social, human and economic costs of this burden are enormous. The Thai government has shown a strong commitment to providing care and support to persons living with HIV/AIDS by launching the National Access to Care Program (NAPHA) in 2003, which provides for publicly financed antiretroviral therapy (ART) to all HIV-infected people. This book documents through interviews how ART has radically changed the lives of those living with HIV. In the words of an HIV positive 29-year old man, ART is a "miracle." The book then develops an innovative analytical framework and uses it to show how the future sustainability and cost-effectiveness of this ambitious program depend critically on Thai government choices of AIDS treatment policy, HIV prevention policy and AIDS drug pricing. For the most likely assumptions, the book estimates that ART will save years of healthy life at a cost of between $700 and $2,400 per year. Successful AIDS treatment accumulates ever-increasing numbers of patients who need subsidized ART. Despite the magnitude of the resulting fiscal burden, the authors judge this expenditure to be a worthwhile public health investment for Thailand, However, they show that the future sustainability of the program will hinge critically on how well the government manages the quality of ART service delivery, on whether it is able to sustain its past successes in HIV prevention and on its negotiations with multinational pharmaceutical manufacturers on the prices of new AIDS drugs.

This volume contains a selection of key contributions to the discussion on the psychological and social implications on HIV infection. It contains up-to-date and authoritative papers by senior practitioners and researchers in the field of the psychological and social aspects of HIV infection. The book will appeal to those involved in providing care for people with HIV infections, be they physicians and nurses or psychologists, social workers and psychiatrists, as well as those involved in preventing the spread of the HIV infection. From the start of the HIV epidemic, the psychological and social aspects of the AIDS infection have been recognized. What could have been regarded simply as an infectious disease was soon acknowledged as a global problem that raised important issues about its transmission and prevention; economic, ethical and legal questions regarding the mental health consequences and the need for access to medical and social care.

The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.