Development Challenges of HIV/AIDS in Small States

Development Challenges of HIV/AIDS in Small States

Experiences from the Pacific, Southern Africa and the Caribbean You do not have access to this content

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Karl Theodore, Mahendra Reddy, Happy Kufigwa Siphambe
11 Oct 2011
9781848591110 (PDF)

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Development Challenges of HIV/AIDS in Small States provides an up-to-date and comprehensive analysis of the economic impacts of the epidemic in the Pacific, Southern Africa and the Caribbean. The authors examine specific features of these three regions that contribute towards the spread of HIV/AIDS and identify the responses by various local and external stakeholders. What is clear from the research is that small states must see in the epidemic opportunities for modernisation and, with external support, put emphasis on strengthening policy design and implementation in key areas to strengthen the development effort so urgently needed by their populations.

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  • Contributors and Acknowledgements

    Mahendra Reddy is a renowned economist and academic in the Pacific region. He has established a reputation as one of the country’s leading economists, and this reputation is widely acknowledged, in government circles and in higher education sector. Dr Reddy has researched and authored or co-authored a wide array of papers and articles that have had, and continue to have, an effect on economic policy and practice in Fiji Islands and the greater South Pacific region. In 2005, his qualities of management and leadership were recognised by his appointment as the President of the Association of the University of the South Pacific Staff, and in 2008 as Head of the School of Economics in the Faculty of Business and Economics. In October 2008, Dr Reddy joined the Fiji Institute of Technology to take up the position of the Dean of the Faculty of Commerce, Hospitality and Tourism Studies. In March 2009, recognising his capability, the Government of Fiji appointed Dr Reddy as the Chair of Fiji’s Commerce Commission. Dr Reddy continues to serve in both the roles.

  • Abbreviations and acronyms
  • Preface

    This is a text about the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) and about the experience of the epidemic in small countries. The intention has been to provide a reasonably detailed picture of the impact of the epidemic and the response to it in circumstances where the countries, because of their small size, cannot afford to play host to this crippling pandemic. While it is obvious that in a small country environment the impact of an epidemic of this variety will not be insignificant, it is important to know what the scale and the nature of the impact is if the policy response is to be appropriate. Recent literature on vulnerability has highlighted the special circumstances of small states, and has pointed to the importance of building resilience as a countervailing force. The rationale for this text is that in small countries, HIV/AIDS adds another dimension to economic and social vulnerability as a result of the way in which it can disproportionately affect output and productivity, and also because of the real threat of extinction. Specifically with resilience in mind, the depiction of the impact of the epidemic in the small countries of Southern Africa, Fiji Islands and the Caribbean is policy focused. The analysis presented presumes that there have been specific responses to the epidemic, but recognises the need to strengthen the calibre of these responses by proffering a more in-depth understanding of the character and the course of the epidemic.

  • Introduction

    Developing countries in the African, Caribbean and Pacific regions have been struggling for decades to meet the traditional developmental challenges they faced alongside a rapidly increasing population. In more recent decades a new challenge has arrived on the scene which at first was not fully recognised for the threat that it was. This challenge was the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). HIV causes AIDS, a disease that causes a slow and progressive collapse of the immune system. The focus of this book will be on the impact of the HIV/AIDS epidemic on the small countries of the three regions. While there is no universally accepted definition of a small country, since the work of Jalan (ed., 1982) it is customary to measure size by population or land area. The Commonwealth Secretariat uses a population of 1.5 million.

  • The Economics of HIV/AIDS in the Southern Africa Region

    Since the 1990s and into the beginning of the new millennium, dealing with HIV/AIDS and its effects has become a major public policy issue in most African countries, especially in Southern Africa. While the epidemic was previously interpreted as fundamentally a health issue, the impact of HIV/AIDS goes far beyond health because of its widespread human, social and economic effects. The hardest hit geographical region is Africa. According to statistics, of the 33.4 million people who were living with HIV/AIDS at the end of 2008, 24 million or 66 per cent were residents of Africa (UNAIDS, 2009). UNAIDS (2008) notes that sub-Saharan Africa disproportionately leads the share of global HIV: 35 per cent of HIV infections and 38 per cent of AIDS deaths in 2007 occurred in the sub-region. Altogether, 67 per cent of all the people living with HIV/AIDS live in sub-Saharan Africa. The trend in HIV infection shows that median HIV/AIDS prevalence increased from 20.3 per cent in 1997–1998 to 25.7 per cent in 2001–2002. During the same period, prevalence rates declined slightly for East Africa, from 13.7 to 11.4 per cent, and remained stable in West Africa at 4.35 per cent (Shisana and Letlapa, 2004).

  • The Economics of HIV/AIDS in Small States: Evidence from Pacific Island Countries

    The Pacific island economies are made vulnerable by a number of geographical and economic factors. Although we acknowledge the importance of geographical factors, this chapter will focus on the economic factors, arguing that the surge of HIV/AIDS has added a new dimension to the vulnerability of these fragile states.

  • HIV/AIDS in the Caribbean: Economic Issues, Economic Impact and Financing the Response

    The HIV/AIDS epidemic is now well into its third decade of existence and it remains the most serious of infectious disease challenges to public health systems (UNAIDS, 2009). The disease is still spreading at an alarming rate, killing exponentially and threatening to frustrate the process of economic development in many countries and regions, the Caribbean being no exception. This is despite efforts to contain the spread of the disease through regional and national response programmes. However, today much more is understood about the HIV/AIDS than when it first surfaced and as such there are many lessons to be learnt from various country experiences.

  • HIV/AIDS: The Challenges and the Opportunity for Small Countries

    The regional studies presented in the previous chapters clearly demonstrate that, despite the differences among countries from various regions of the world, the HIV/AIDS epidemic follows a pattern in which its impact is so similar that it can be discussed independent of any region or country. In examining the three previous chapters, there are some clear similarities. Indeed, the framework and scope of all three focus on the impact HIV/AIDS has had on the economies of countries in each respective geographic location. It is interesting that the fight against the spread of the disease employs virtually similar tactics. What is more, the impact of the epidemic was shown to have similar implications for all regions although they are practically poles apart. We can classify the impact of HIV/AIDS under three main areas, which were clear from the information presented, and outline the similarities that emerge from each region. These are discussed in the following sections.

  • Appendix
  • Index
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