Table of Contents

Setting Priorities for HIV/AIDS Interventions

Setting Priorities for HIV/AIDS Interventions

A Cost–Benefit Approach

Robert J. Brent

HIV/AIDS is much too complex a phenomenon to be understood only by reference to common sense and ethical codes. This book presents the cost–benefit analysis (CBA) framework in a well-researched and accessible manner to ensure that the most important considerations are recognized and incorporated.

Chapter 16: Impact of HIV on Agricultural Households

Robert J. Brent

Subjects: development studies, development economics, economics and finance, development economics, health policy and economics, public finance, social policy and sociology, health policy and economics

Extract

Even if one may doubt that hunger is the main cause of HIV transmission in Africa, it is clear to all that a major consequence of HIV/AIDS in SSA is hunger for many of those remaining alive. HIV affects prime age adults. So when these adults die (and 2 million adults died of AIDS in 2007 alone) this adversely affects the food consumption of others. We look at a typical downward spiral initiated by an HIV infection in an agricultural household and use this to help identify the main groups affected. From there we take these groups and show how they are adversely affected so that one can get a handle on ways to mitigate the harmful effects of the deaths from AIDS. A TYPICAL DOWNWARD SPIRAL FOR AN AGRICULTURAL HOUSEHOLD INFECTED WITH HIV Gillespie et al. (2001) have compiled a list of the typical steps in the progression of the HIV disease on an agricultural household, which is the main social grouping in SSA. These steps are: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Adult becomes sick and he or she reduces work. Replacement labor is “imported”. Adults work longer hours on the farm. Health care expenditures rise and household food consumption is reduced. Switch to labor-extensive crops and farming systems. Nutritional status deteriorates. Adult stops work and increased care given to sick adult. Divisible assets disposed of, for example, livestock. Debts increase and children drop out of school. Adult dies and funeral expenses...

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