TRIPS, Public Health Systems and Free Access
Edited by Benjamin Coriat
Chapter 10: ‘Fragility’: A Macro-dynamic Motive to Offer Quick and General Access to ART in LDC
10. ‘Fragility’: a macro-dynamic motive to oﬀer quick and general access to ART in LDC Bruno Ventelou, Yann Videau and Jean-Paul Moatti INTRODUCTION Until recently, evidence of the economic impact of the HIV/AIDS pandemic in the most aﬀected countries has presented a contradictory picture. On the one hand, microeconomic studies in many Sub-Saharan countries have systematically described the catastrophic consequences of the epidemic on speciﬁc agents (private ﬁrms, households, local communities and so on) and economic sectors (whole industries like mining, the agricultural commercial sector, the private and public provision of certain services such as education and so on). For example, in the education sector (Shaeﬀer, 2000), the supply of teachers may be reduced by illness (teachers unable to work or to be replaced), death (evidence from UNESCO suggests that levels of mortality may rise from about 0.4 to 2.7 per cent of the cohort aged 20 to 40), and absenteeism (funerals of colleagues and family, and the need, especially for female staﬀ, to care for family members). On the other hand, macroeconomic models seeking to measure the overall impact of the epidemic on economic development have tended to conclude that this impact was not likely to be devastating for longer-term growth and development (Bloom and Mahal, 1997; Young, 2005). On average, early macroeconomic estimations forecast a rather modest one-point reduction in the rate of growth of national wealth for countries with HIV prevalence above 5 per cent. However, these studies were based on an ad...
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