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close this bookBriefs for Food, Agriculture, and the Environment - 2020 Vision : Brief 1 - 64 (IFPRI)
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View the document2020 BRIEF 1 - AUGUST 1994: ECONOMIC GROWTH AND DEVELOPMENT
View the document2020 BRIEF 2 - AUGUST 1994: WORLD SUPPLY AND DEMAND PROJECTIONS FOR CEREALS, 2020
View the document2020 BRIEF 3 - AUGUST 1994: WORLD PRODUCTION OF CEREALS, 1966-90
View the document2020 BRIEF 4 - AUGUST 1994: SUSTAINABLE FARMING: A POLITICAL GEOGRAPHY
View the document2020 BRIEF 5 - OCTOBER 1994: WORLD POPULATION PROJECTIONS, 2020
View the document2020 BRIEF 6 - OCTOBER 1994: MALNUTRITION AND FOOD INSECURITY PROJECTIONS, 2020
View the document2020 BRIEF 7 - OCTOBER 1994: AGRICULTURAL GROWTH AS A KEY TO POVERTY ALLEVIATION
View the document2020 BRIEF 8 - OCTOBER 1994: CONSERVATION AND ENHANCEMENT OF NATURAL RESOURCES
View the document2020 BRIEF 9 - FEBRUARY 1995: THE ROLE OF AGRICULTURE IN SAVING THE RAIN FOREST
View the document2020 BRIEF 10 - FEBRUARY 1995: A TIME OF PLENTY, A WORLD OF NEED: THE ROLE OF FOOD AID IN 2020
View the document2020 BRIEF 11 - FEBRUARY 1995: MANAGING AGRICULTURAL INTENSIFICATION
View the document2020 BRIEF 12 - FEBRUARY 1995: TRADE LIBERALIZATION AND REGIONAL INTEGRATION: IMPLICATIONS FOR 2020
View the document2020 BRIEF 13 - APRIL 1995: THE POTENTIAL OF TECHNOLOGY TO MEET WORLD FOOD NEEDS IN 2020
View the document2020 BRIEF 14 - APRIL 1995: AN ECOREGIONAL PERSPECTIVE ON MALNUTRITION
View the document2020 BRIEF 15 - APRIL 1995: AGRICULTURAL GROWTH IS THE KEY TO POVERTY ALLEVIATION IN LOW-INCOME DEVELOPING COUNTRIES
View the document2020 BRIEF 16 - APRIL 1995: DECLINING ASSISTANCE TO DEVELOPING-COUNTRY AGRICULTURE: CHANGE OF PARADIGM?
View the document2020 BRIEF 17 - MAY 1995: GENERATING FOOD SECURITY IN THE YEAR 2020: WOMEN AS PRODUCERS, GATEKEEPERS, AND SHOCK ABSORBERS
View the document2020 BRIEF 18 - MAY 1995: BIOPHYSICAL LIMITS TO GLOBAL FOOD PRODUCTION
View the document2020 BRIEF 19 - MAY 1995: CAUSES OF HUNGER
View the document2020 BRIEF 20 - MAY 1995: CHINA AND THE FUTURE GLOBAL FOOD SITUATION
View the document2020 BRIEF 21 - JUNE 1995: DEALING WITH WATER SCARCITY IN THE NEXT CENTURY
View the document2020 BRIEF 22 - JUNE 1995: THE RIGHT TO FOOD: WIDELY ACKNOWLEDGED AND POORLY PROTECTED
View the document2020 BRIEF 23 - JUNE 1995: CEREALS PROSPECTS IN INDIA TO 2020: IMPLICATIONS FOR POLICY
View the document2020 BRIEF 24 - JUNE 1995: REVAMPING AGRICULTURAL R&D
View the document2020 BRIEF 25 - AUGUST 1995: MORE THAN FOOD IS NEEDED TO ACHIEVE GOOD NUTRITION BY 2020
View the document2020 BRIEF 26 - AUGUST 1995: PERSPECTIVES ON EUROPEAN AGRICULTURE IN 2020
View the document2020 BRIEF 27 - AUGUST 1995: NONDEGRADING LAND USE STRATEGIES FOR TROPICAL HILLSIDES
View the document2020 BRIEF 28 - AUGUST 1995: EMPLOYMENT PROGRAMS FOR FOOD SECURITY IN SUB-SAHARAN AFRICA
View the document2020 BRIEF 29 - AUGUST 1995: POVERTY, FOOD SECURITY, AND THE ENVIRONMENT
View the document2020 BRIEF 30 - JANUARY 1996: RISING FOOD PRICES AND FALLING GRAIN STOCKS: SHORT-RUN BLIPS OR NEW TRENDS?
View the document2020 BRIEF 31 - APRIL 1996: MIDDLE EAST WATER CONFLICTS AND DIRECTIONS FOR CONFLICT RESOLUTION
View the document2020 BRIEF 32 - APRIL 1996: THE TRANSITION IN THE CONTRIBUTION OF LIVING AQUATIC RESOURCES TO FOOD SECURITY
View the document2020 BRIEF 33 - JUNE 1996: MANAGING RESOURCES FOR SUSTAINABLE AGRICULTURE IN SOUTH ASIA
View the document2020 BRIEF 34 - JUNE 1996: IMPLEMENTING THE URUGUAY ROUND: INCREASED FOOD PRICE STABILITY BY 2020?
View the document2020 BRIEF 35 - JULY 1996: SOCIOPOLITICAL EFFECTS OF NEW BIOTECHNOLOGIES IN DEVELOPING COUNTRIES
View the document2020 BRIEF 36 - OCTOBER 1996: RUSSIA'S FOOD ECONOMY IN TRANSITION: WHAT DO REFORMS MEAN FOR THE LONG-TERM OUTLOOK?
View the document2020 BRIEF 37 - OCTOBER 1996: UNCOMMON OPPORTUNITIES FOR ACHIEVING SUSTAINABLE FOOD AND NUTRITION SECURITY - An Agenda for Science and Public Policy
View the document2020 BRIEF 38 - OCTOBER 1996: WORLD TRENDS IN FERTILIZER USE AND PROJECTIONS TO 2020
View the document2020 BRIEF 39 - OCTOBER 1996: REDUCING POVERTY AND PROTECTING THE ENVIRONMENT: THE OVERLOOKED POTENTIAL OF LESS-FAVORED LANDS
View the document2020 BRIEF 40 - OCTOBER 1996: POLICIES TO PROMOTE ENVIRONMENTALLY SUSTAINABLE FERTILIZER USE AND SUPPLY TO 2020
View the document2020 BRIEF 41 - DECEMBER 1996: STRUCTURAL CHANGES IN THE DEMAND FOR FOOD IN ASIA
View the document2020 BRIEF 42 - MARCH 1997: AFRICA'S CHANGING AGRICULTURAL DEVELOPMENT STRATEGIES
View the document2020 BRIEF 43 - JUNE 1997: THE POTENTIAL IMPACT OF AIDS ON POPULATION AND ECONOMIC GROWTH RATES
View the document2020 BRIEF 44 - JUNE 1997: LAND DEGRADATION IN THE DEVELOPING WORLD: ISSUES AND POLICY OPTIONS FOR 2020
View the document2020 BRIEF 45 - JUNE 1997: AGRICULTURE, TECHNOLOGICAL CHANGE, AND THE ENVIRONMENT IN LATIN AMERICA: A 2020 PERSPECTIVE
View the document2020 BRIEF 46 - JUNE 1997: AGRICULTURE, TRADE, AND REGIONALISM IN SOUTH ASIA
View the document2020 BRIEF 47 - AUGUST 1997: THE NONFARM SECTOR AND RURAL DEVELOPMENT: REVIEW OF ISSUES AND EVIDENCE
View the document2020 BRIEF 48 - FEBRUARY 1998: CHALLENGES TO THE 2020 VISION FOR LATIN AMERICA: FOOD AND AGRICULTURE SINCE 1970
View the document2020 BRIEF 49 - APRIL 1998: NUTRITION SECURITY IN URBAN AREAS OF LATIN AMERICA
View the document2020 BRIEF 50 - JUNE 1998: FOOD FROM PEACE: BREAKING THE LINKS BETWEEN CONFLICT AND HUNGER
View the document2020 BRIEF 51 - JULY 1998: TECHNOLOGICAL OPPORTUNITIES FOR SUSTAINING WHEAT PRODUCTIVITY GROWTH TOWARD 2020
View the document2020 BRIEF 52 - SEPTEMBER 1998: PEST MANAGEMENT AND FOOD PRODUCTION: LOOKING TO THE FUTURE
View the document2020 BRIEF 53 - OCTOBER 1998: POPULATION GROWTH AND POLICY OPTIONS IN THE DEVELOPING WORLD
View the document2020 BRIEF 54 - OCTOBER 1998: FOSTERING GLOBAL WELL-BEING: A NEW PARADIGM TO REVITALIZE AGRICULTURAL AND RURAL DEVELOPMENT
View the document2020 BRIEF 55 - OCTOBER 1998: THE POTENTIAL OF AGROECOLOGY TO COMBAT HUNGER IN THE DEVELOPING WORLD
View the document2020 RESUMEN No. 56 - OCTUBRE DE 1998: AYUDA A LA AGRICULTURA EN LOS PAÍSES EN DESARROLLO: INVERSIONES EN LA REDUCCIÓN DE LA POBREZA Y NUEVAS OPORTUNIDADES DE EXPORTACIÓN
View the document2020 BRIEF 57 - OCTOBER 1998: ECONOMIC CRISIS IN ASIA: A FUTURE OF DIMINISHING GROWTH AND INCREASING POVERTY?
View the document2020 BRIEF 58 - FEBRUARY 1999: SOIL DEGRADATION: A THREAT TO DEVELOPING-COUNTRY FOOD SECURITY BY 20207
View the document2020 BRIEF 59 - MARCH 1999: AGRICULTURAL GROWTH, POVERTY ALLEVIATION, AND ENVIRONMENTAL SUSTAINABILITY: HAVING IT ALL
View the document2020 BRIEF 60 - MAY 1999: CRITICAL CHOICES FOR CHINA'S AGRICULTURAL POLICY
View the document2020 BRIEF 61 - MAY 1999: LIVESTOCK TO 2020: THE NEXT FOOD REVOLUTION
View the document2020 BRIEF 62 - OCTOBER 1999: NUTRIENT DEPLETION IN THE AGRICULTURAL SOILS OF AFRICA
View the document2020 BRIEF 63 - NOVEMBER 1999: PROSPECTS FOR INDIA'S CEREAL SUPPLY AND DEMAND TO 2020
View the document2020 BRIEF 64 - FEBRUARY 2000: OVERCOMING CHILD MALNUTRITION IN DEVELOPING COUNTRIES: PAST ACHIEVEMENTS AND FUTURE CHOICES
View the document2020 BRIEF 65 - MARCH 2000: COMBINING INTERNAL AND EXTERNAL INPUTS FOR SUSTAINABLE INTENSIFICATION

2020 BRIEF 43 - JUNE 1997: THE POTENTIAL IMPACT OF AIDS ON POPULATION AND ECONOMIC GROWTH RATES

Lynn R. Brown

Lynn R. Brown is a research analyst in the Food Consumption and Nutrition Division of the International Food Policy Research Institute.

The Joint United Nations Programme on HIV/AIDS estimated that at the end of 1996 some 21.8 million adults and more than three-quarters of a million children were infected with human immunodeficiency virus (HIV), the agent that causes the deadly acquired immune deficiency syndrome, or AIDS. In almost all cases those infected by HIV develop AIDS, which is inevitably fatal. The likely result of these infections is nearly 22 million adult deaths over the next 5 to 10 years and three-quarters of a million children who will not see their fifth birthday. Fourteen million of these deaths will occur in Sub-Saharan Africa, and a further 5.2 million in South and Southeast Africa.

AIDS is a human tragedy and a major health problem. The scale of the disease is so large that it now raises questions about the impact of AIDS on the future development path of many of the world's poorest developing countries. Through its effects on population levels and growth rates and on macroeconomic growth, AIDS may influence the prospects for achieving food security in the developing world by the year 2020.

REPORTED INCIDENCE OF AIDS

AIDS is most prevalent in Sub-Saharan Africa, where by the mid-1990s it had surpassed both measles and malaria to become the second leading cause of child mortality. AIDS is believed to be the leading cause of mortality between the ages of 15 and 39 in Botswana, Malawi, Uganda, Zambia, and Zimbabwe.

Two serotypes of the virus are currently recognized: HIV1 and HIV2. Generally, the prevalence of HIV1 in high-risk urban population groups is highest (above 40 percent) in a belt of countries running through East and Central Africa - Burundi, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia. In the same high-risk population groups, rates above 40 percent are also found in Cd'Ivoire, Cameroon, and Mali in West Africa.

HIV2 infection is largely concentrated in West Africa. More than 12.5 percent of the adult population in Angola, Cd'Ivoire, and Mali is infected.

Apart from Africa, the spread of HIV continues unabated into many areas that were previously unaffected. In mid-1993, Asia had just 1 percent of AIDS cases worldwide, but just 12 months later it had 6 percent of the global total - a shift driven mainly by the rapid growth of AIDS in South and East Asia. Newly reported AIDS cases quadrupled in Thailand, tripled in Myanmar, and almost doubled in India between 1992 and 1993.

Data are scarce, but experts believe that by the year 2000 most new HIV infections will occur in Asia. The spread of the disease is particularly alarming in India. Among prostitutes in Vellore, India, HIV incidence rose from 0.5 percent in 1986 to 34.5 percent in 1990. Many experts believe that if the Indian epidemic continues on its present course, the consequences could be disastrous.

THE DEMOGRAPHIC IMPACT OF AIDS

At the world level, AIDS is unlikely to suppress population size or growth rates. However, the impact of AIDS may be felt by some individual countries. For example, the U.S. Bureau of the Census predicts that in some countries populations in 2020 will be considerably smaller as a result of the AIDS pandemic - 45 percent smaller in Uganda, 35 percent in Rwanda, and 30 percent in Malawi. Yet, even with this impact, most forecasts project that the populations of nearly all of the worst-affected African countries (Burkina Faso, Burundi, Central African Republic, Congo, Cd'Ivoire, Kenya, Malawi, Rwanda, Tanzania, Uganda, Zaire, and Zambia) will at least double between 1990 and 2020. Although Zimbabwe has a high prevalence of AIDS, its population is predicted to grow by less than 50 percent by 2020.

One of the greatest potential tragedies of the AIDS epidemic will be the reversal in many African countries of hard-won downward trends in infant and child mortality rates. In Zimbabwe, the U.S. Bureau of the Census predicts that AIDS will cause infant mortality rates to more than double and child mortality rates to more than quadruple by 2010. Most forecasts also predict a significant decline in life expectancy as a result of AIDS.

THE ECONOMIC IMPACT OF AIDS

AIDS imposes both direct and indirect costs on national economies. The cost of treating individuals infected with HIV and AIDS varies tremendously and exceeds per capita gross national product in a number of countries (Table 1).

AIDS also weakens economies indirectly, striking several key areas at once. For example:

· When a worker becomes too sick to work, his or her earnings are lost to the economy. In addition, the savings from those earnings, which could have gone to investments in economic growth, are lost. In Kenya, it is estimated that 10 years of productive life are lost with each new case of AIDS.

· Resources are shifted from productive investment to health sector expenditures and health care. For example, shifting funds to combat AIDS may lower investment in both education and primary health care, with consequences for future economic growth. By shortening life spans, AIDS also lowers the returns to public investment in both health and education.

· As AIDS reduces economic growth, the competition intensifies for both national and international resources. Investment in agricultural research, health (to tackle diseases other than AIDS), education, safe water, and sanitation is likely to fall. AIDS is particularly devastating to economic growth because the disease strikes adults in their most productive years. Furthermore, in the early years the epidemic seemed to spread fastest among people with above-average education and skills, further sharpening the economic impact.

In the 1980s in Rwanda, women whose partners had higher income levels and worked in higher-paid and higher-skilled occupations were also more likely to be HIV-positive than women whose partners were less well off. Similarly, in Uganda, men and women with secondary education were more than twice as likely to be HIV-positive as men and women with no education. In Kenya, the average annual income of a worker with AIDS was estimated to be 31 percent higher than the average national income.

Despite the higher initial impact of AIDS on urban elites, in the long run AIDS will hit the poor hardest. Richer people will be more receptive to education campaigns through the mass media, more able to purchase condoms, and more likely to live in environments that encourage condom use. AIDS will worsen the poverty of poor people by depriving them of their only productive resource - their labor.

Table 1 - Direct cost of AIDS, per case

Country

Average direct cost

GNP per capita


(US$)

(1992 US$)

Kenya (1992)a

938

310

Korea (1993)

2,010

6,790

Malawi (1989)a

210

210

Malaysia (1993)

3,000

2,790

Rwanda (1989-90)

358

250

Tanzania (1990)

290

110

Zimbabwe (1991)

614

570

Sources: M. Ainsworth and M. Over, "AIDS and African Development," The World Bank Research Observers, no. 2 (1994): 203-240; S. Forsythe, D. Sokal, L. Lux, and T. King, An Assessment of the Economic Impact of AIDS in Kenya (Washington, D.C.: Family Health International/AIDSCAP, 1993); B.-M. Yang, "The Economic Impact of AIDS on the Republic of Korea," in Economic Implications of AIDS in Asia, ed. D. E. Bloom and J. V. Lyons (New Delhi: United Nations Development Programme, 1993); United Nations Development Programme, AIDS and Asia: A Development Crisis (New York: UNDP, 1993).

Note: Average estimates are based on type and quality of treatment sought.

a1991 dollars.

AIDS AND FOOD SECURITY

HIV/AIDS is intimately connected to food security in a cyclical relationship. The consequences of food insecurity, specifically inadequate intake of calories and nutrients, render individuals more susceptible to HIV infection and cause them to progress faster from HIV infection to AIDS and, ultimately, to death. HIV/AIDS, in turn, hinders countries' ability to achieve national food security through its effects on population and economic growth.

For most of the African economies considered in this study, population growth rates are unlikely to fall below 2 percent by 2020, unless the onslaught of AIDS continues unchecked. Thus, it seems that AIDS will do relatively little, by way of reductions in population growth, to reduce the demand for food.

At the same time, AIDS will diminish the potential to increase domestic food production in order to improve food security. Governments under pressure to cover rising health care costs are likely to sacrifice spending on budget items such as agricultural research, which is a key factor in the development of new agricultural technology. In addition, governments are likely to focus their health spending at the tertiary level in cities rather than at the primary level in rural areas, making rural inhabitants more vulnerable to disease. Finally, by imposing heavy costs on national economies, AIDS will make it more difficult for developing countries to import the food they need to feed their people.

No country can afford to be complacent in the face of apparently low HIV seroprevalence levels. Many African countries can testify to the cost of ignoring the spread of HIV infection in the early stages. To arrest the AIDS pandemic in Africa, and to prevent fledgling epidemics in South and East Asia from becoming pandemics, the broader development community, not just the health sector, must address the scourge of AIDS.