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The long-run economic costs of AIDS : theory and an application to South Africa

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Author Info
Clive Bell
Shantayanan Devarajan
Hans Gersbach

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Abstract

Most existing estimates of the macroeconomic costs of AIDS, as measured by the reduction in the growth rate of gross domestic product, are modest. For Africa-the continent where the epidemic has hit the hardest-they range between 0.3 and 1.5 percent annually. The reason is that these estimates are based on an underlying assumption that the main effect of increased mortality is to relieve pressure on existing land and physical capital so that output per head is little affected. The authors argue that this emphasis is misplaced and that, with a more plausible view of how the economy functions over the long run, the economic costs of AIDS are almost certain to be much higher. Not only does AIDS destroy existing human capital, but by killing mostly young adults, it also weakens the mechanism through which knowledge and abilities are transmitted from one generation to the next. The children of AIDS victims will be left without one or both parents to love, raise, and educate them. The model yields the following results. In the absence of AIDS, the counterfactual benchmark, there is modest growth, with universal and complete education attained within three generations. But if nothing is done to combat the epidemic, a complete economic collapse will occur within three generations. With optimal spending on combating the disease, and if there is pooling, growth is maintained, albeit at a somewhat slower rate than in the benchmark case in the absence of AIDS. If pooling breaks down and is replaced by nuclear families, growth will be slower still. Indeed, if school attendance subsidies are not possible,growth will be distinctly sluggish. In all three cases, the additional fiscal burden of intervention will be large, which reinforces the gravity of the findings.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 3152.

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Date of creation: 01 Oct 2003
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Handle: RePEc:wbk:wbrwps:3152

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Keywords: Economic Theory&Research Public Health Promotion Labor Policies Health Monitoring&Evaluation Decentralization Health Monitoring&Evaluation Population&Development Economic Theory&Research Street Children Adolescent Health

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  1. Bell, Clive & Gersbach, Hans, 2001. "Child Labor and the Education of a Society," IZA Discussion Papers 338, Institute for the Study of Labor (IZA). [Downloadable!]
  2. Basu, Kaushik & Van, Pham Hoang, 1998. "The Economics of Child Labor," American Economic Review, American Economic Association, vol. 88(3), pages 412-27, June.
  3. David E. Bloom & David Canning & Jaypee Sevilla, 2001. "The Effect of Health on Economic Growth: Theory and Evidence," NBER Working Papers 8587, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Anne Case & Christina Paxson & Joseph Ableidinger, 2002. "Orphans in Africa," NBER Working Papers 9213, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  1. Bruhns, Ramona, 2006. "The Long-run Effects of HIV/AIDS in Kenya," MPRA Paper 952, University Library of Munich, Germany. [Downloadable!]
  2. Raouf, BOUCEKKINE, 2007. "A theory of dynamics and inequalities under epidemics," Université catholique de Louvain, Département des Sciences Economiques Working Paper 2007022, Université catholique de Louvain, Département des Sciences Economiques. [Downloadable!]
    Other versions:
  3. Harsha Thirumurthy & Joshua Graff-Zivin & Markus Goldstein, 2005. "The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya," NBER Working Papers 11871, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  4. Raouf Boucekkine & Raouf Boucekkine, 2006. "Medium term dynamics and inequalities under epidemics," Computing in Economics and Finance 2006 209, Society for Computational Economics. [Downloadable!]
  5. Bernard Walters, 2007. "The Fiscal Implications of Scaling up ODA to Deal with the HIV/AIDS Pandemic," Conference Paper 3, International Poverty Centre. [Downloadable!]
  6. Glenn-marie Lange, 2004. "Wealth, Natural Capital, and Sustainable Development: Contrasting Examples from Botswana and Namibia," Environmental & Resource Economics, European Association of Environmental and Resource Economists, vol. 29(3), pages 257-283, November. [Downloadable!] (restricted)
  7. Clive Bell & Hans Gersbach, 2006. "The Macroeconomics of Targeting: The Case of an Enduring Epidemic," IZA Discussion Papers 2393, Institute for the Study of Labor (IZA). [Downloadable!]
    Other versions:
  8. Scott McDonald & Jennifer Roberts, 2004. "Aids and Economic Growth: A Human Capital Approach," Working Papers 2004008, The University of Sheffield, Department of Economics, revised Aug 2004. [Downloadable!]
    Other versions:
  9. Das, J. & Dercon, S. & Habyarimana, J. & Krishnan, P., 2004. "Teacher Shocks and Student Learning: Evidence from Zambia," Cambridge Working Papers in Economics 0514, Faculty of Economics, University of Cambridge. [Downloadable!]
    Other versions:
  10. Alwyn Young, 2004. "The Gift of the Dying: The Tragedy of AIDS and the Welfare of Future African Generations," NBER Working Papers 10991, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  11. Kenneth Harttgen, 2007. "The Impact of HIV on Children´s Welfare," Ibero America Institute for Econ. Research (IAI) Discussion Papers 157, Ibero-America Institute for Economic Research. [Downloadable!]
  12. Johannes G. Hoogeveen & Berk Özler, 2005. "Not Separate, Not Equal: Poverty and Inequality in Post-Apartheid South Africa," William Davidson Institute Working Papers Series wp739, William Davidson Institute at the University of Michigan Stephen M. Ross Business School. [Downloadable!]
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  13. Clive Bell & Hans Gersbach, 2006. "Growth and Enduring Epidemic Diseases," CESifo Working Paper Series CESifo Working Paper No. , CESifo GmbH. [Downloadable!]
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  14. Michael A. Clemens, 2004. "The Long Walk to School: International education goals in historical perspective," Development and Comp Systems 0403007, EconWPA. [Downloadable!]
    Other versions:
  15. Michael Grimm & Denis Cogneau, 2004. "AIDS and income distribution in Africa. A micro-simulation study for Cˆote d’Ivoire," Labor and Demography 0408006, EconWPA. [Downloadable!]
    Other versions:
  16. T. S. Jayne & Marcela Villarreal & Prabhu Pingali & Günter Hemrich, 2004. "Interactions between the Agricultural Sector and the HIV/AIDS Pandemic: Implications for Agricultural Policy," International Development Papers 25, Department of Agricultural Economics, Michigan State University. [Downloadable!]
    Other versions:
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