The Long-run Economic Costs of AIDS : Theory and an Application to South Africa

Bell, Clive ; Devarajan, Shantayanan ; Gersbach, Hans

World Bank, Washington, DC

关键词: ACQUIRED IMMUNE DEFICIENCY SYNDROME;    DISEASE BURDEN;    HUMAN CAPITAL DEVELOPMENT;    ECONOMIC CONTRACTION;    DISEASE CONTROL & PREVENTION;   

DOI  :  10.1596/1813-9450-3152
RP-ID  :  WPS3152

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Most existing estimates of themacroeconomic costs of AIDS, as measured by the reduction inthe growth rate of gross domestic product, are modest. ForAfrica-the continent where the epidemic has hit thehardest-they range between 0.3 and 1.5 percent annually. Thereason is that these estimates are based on an underlyingassumption that the main effect of increased mortality is torelieve pressure on existing land and physical capital sothat output per head is little affected. The authors arguethat this emphasis is misplaced and that, with a moreplausible view of how the economy functions over the longrun, the economic costs of AIDS are almost certain to bemuch higher. Not only does AIDS destroy existing humancapital, but by killing mostly young adults, it also weakensthe mechanism through which knowledge and abilities aretransmitted from one generation to the next. The children ofAIDS victims will be left without one or both parents tolove, raise, and educate them. The model yields thefollowing results. In the absence of AIDS, thecounterfactual benchmark, there is modest growth, withuniversal and complete education attained within threegenerations. But if nothing is done to combat the epidemic,a complete economic collapse will occur within threegenerations. With optimal spending on combating the disease,and if there is pooling, growth is maintained, albeit at asomewhat slower rate than in the benchmark case in theabsence of AIDS. If pooling breaks down and is replaced bynuclear families, growth will be slower still. Indeed, ifschool attendance subsidies are not possible, growth will bedistinctly sluggish. In all three cases, the additionalfiscal burden of intervention will be large, whichreinforces the gravity of the findings.