The Political Economy of HIV/AIDS in Developing Countries
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The Political Economy of HIV/AIDS in Developing Countries

TRIPS, Public Health Systems and Free Access

Edited by Benjamin Coriat

The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.
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Chapter 10: ‘Fragility’: A Macro-dynamic Motive to Offer Quick and General Access to ART in LDC

Bruno Ventelou, Yann Videau and Jean-Paul Moatti


10. ‘Fragility’: a macro-dynamic motive to offer quick and general access to ART in LDC Bruno Ventelou, Yann Videau and Jean-Paul Moatti INTRODUCTION Until recently, evidence of the economic impact of the HIV/AIDS pandemic in the most affected countries has presented a contradictory picture. On the one hand, microeconomic studies in many Sub-Saharan countries have systematically described the catastrophic consequences of the epidemic on specific agents (private firms, households, local communities and so on) and economic sectors (whole industries like mining, the agricultural commercial sector, the private and public provision of certain services such as education and so on). For example, in the education sector (Shaeffer, 2000), the supply of teachers may be reduced by illness (teachers unable to work or to be replaced), death (evidence from UNESCO suggests that levels of mortality may rise from about 0.4 to 2.7 per cent of the cohort aged 20 to 40), and absenteeism (funerals of colleagues and family, and the need, especially for female staff, to care for family members). On the other hand, macroeconomic models seeking to measure the overall impact of the epidemic on economic development have tended to conclude that this impact was not likely to be devastating for longer-term growth and development (Bloom and Mahal, 1997; Young, 2005). On average, early macroeconomic estimations forecast a rather modest one-point reduction in the rate of growth of national wealth for countries with HIV prevalence above 5 per cent. However, these studies were based on an ad...

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