AEGiS-14IAC: Risks and macro-economic impacts of HIV/AIDS in the Middle East and North Africa: why waiting to intervene can be costly.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Risks and macro-economic impacts of HIV/AIDS in the Middle East and North Africa: why waiting to intervene can be costly.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeE9050)

Robalino D, Jenkins C, El Maroufi K
World Bank, Washington, United States

BACKGROUND: In MENA countries, continued low levels of case detection through mostly mandatory screening, the lack of appropriate behavioral data, and over-confidence in the protective effects of social and cultural conservatism have dictated low priority for HIV/AIDS. This paper is a first attempt to evaluate the risks of an epidemic in 9 MENA countries and its potential economic costs, while at the same time assessing the welfare implications of two preventive interventions.

METHODS: Model of optimal growth that incorporates an HIV/AIDS diffusion component where the virus transmission occurs through sexual intercourse and the exchange of infect needles among IDUs. Simulation design takes into account that the economy and the epidemic create a complex system that is structurally unpredictable. We explore large regions of the parameter space and characterize the ensemble of plausible futures given countries' initial conditions.

RESULTS: Only in 16% of the cases explored the prevalence rates in year 2015 would be below 1%; in 50% of the cases prevalence rates would be above 3%. On average, GDP losses across countries for the period 2000-2025 could approximate 35% of today's GDP. In all countries it is possible to observe scenarios where losses surpass today's GDP. We show that interventions such as expansing condom use and access to safe needles act as an insurance policy that increases social welfare. We also show that delaying action for 5 years can cost the equivalent of 6 percentage points of today's GDP.

CONCLUSIONS: i) the risk of an increase in the HIV/AIDS prevalence rate in MENA countries is real; ii) expected costs over the next 25 years could be considerable; iii) there are preventive actions that can be implemented and the costs of these actions would be more than compensated by the savings they generate; and iv) the time to act is today when prevalence rates are still low.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, HIV Seropositivity, Prevalence, Africa, Northern, Middle East, Disease Outbreaks, Costs and Cost Analysis, Mandatory Testing, economics

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