Proceedings of the German Development Economics Conference, Berlin 2011 35
The costs of HIV/AIDS programs are significant from a macroeconomic or fiscal perspective in a number of countries. Assessing the fiscal implications is complicated by the long lags between infection and the need for HIV/AIDS-related services, and the long duration over which these services (notably treatment) are required. The paper interprets the fiscal costs of HIV/AIDS programs as quasi-liabilities, which are incurred by HIV infections and are paid off as HIV/AIDS-related services are delivered. On the microeconomic level, the analysis yields estimates of the costs incurred by single HIV infections, which - together with other criteria - can be used in assessing the effectiveness of HIV/AIDS program allocations. On the macroeconomic level, the analysis highlights the large magnitude of the HIV/AIDS quasi-liability (according to criteria for the sustainability of public debt), and quantifies the fiscal savings achieved or projected as a consequence of declining HIV incidence.
HIV/AIDS health shocks health expenditures social expenditures fiscal space debt sustainability quasi-liabilities Africa Botswana South Africa Swaziland Uganda