EndnotesEndnotesChapter 11 While HIV infection rates may bestabilising in sub-Saharan Africa, home to70 per cent of those infected with thevirus, mainly because relatively few highriskindividuals remain uninfected, theepidemic is still growing in other parts ofthe world. Russia saw nearly a 50 percent increase in HIV infections in 2001,and the number of cases in Eastern Europeand Central <strong>Asia</strong> has risen by more thanone-third (UNAIDS/WHO, 2000, 2001).Concerns have also been voiced overcomplacency in the West (with thenumbers among some groups of youngmen in the <strong>United</strong> States now reported tobe infected with HIV rising rapidly) and in<strong>Asia</strong>.2 WHO, 2001; Kaul, Grunberg & Stern,19993 Mahbub-ul-Haq Human Development<strong>Centre</strong>, 2001.4 Indeed, HIV prevalence rates amongadults in some of the sub-Saharan Africancountries are extremely high, as, forexample, in Botswana with 38.8 per centand South Africa with 20 per cent(UNAIDS/WHO, 2002).5 It has been pointed out that figurespertaining to the magnitude of HIV/AIDSare, at best, estimates and not exactcalculations. There is one main point tobe made about data. The extent of HIV/AIDS in India is not really known andthere are only reports from a number ofsurveillance centres. The true prevalenceand incidence figures could be different.An estimate of the US NationalIntelligence Committee projects a veryhigh number in the near future. However,it is a controversial issue.6 NACO (India), 20007 UNAIDS/WHO, 20028 World Bank, 2002a9 Purohit, 2001; Gertler and Hammer,1997; Jain et al., 200010 Human poverty is more than incomepoverty. It is the denial of choices andopportunities for living an acceptable life(<strong>UNDP</strong> Human Development <strong>Report</strong>,1997)11 WHO, 200012 <strong>UNDP</strong>, 2001b13 Bloom and Mahal, 1997; Bonnel, 2000;Macarlan and Sgherri, 2001; Over, 199214 Barnett and Blaikie, 1992; Bharat, 1999;Bloom and Mahal, 1995; Mahal, 1996;Pyne, 1998, Barks-Ruggles, 2001Chapter 21 Collins and Rau, 20002 <strong>UNDP</strong>, 20023 UNICE, 20014 A study by Pitayanon et al. 1997 inThailand finds that “the economic impactof an adult AIDS death is sizeable andsignificant despite all the copingstrategies employed. The least able tocope were the poorest and least educatedhouseholds engaged in agricultural work.The economic impact of an adult AIDSdeath was more severe than the impact ofdeath from other causes. This is largelybecause AIDS infects a specificpopulation, mainly those alreadydisadvantaged and less able to cope withthe resulting adversity”.5 Bloom and Mahal, 1996; p.396 Bloom and Mahal, 1996 and Bloom andGlied, 19937 Dhaliwal, 20028 Middle East Times, 4 January 20019 Hodges-Aeberhard, 200010 Dhaliwal, 2002; Hodges-Aeberhard, 200011 Middle East Times, 4 January 200112 Bharat,1999; Verma et al., 200213 Bloom et al., 1997, p.19714 Varma, 199715 Mahal, 199616 See http://www.aidsnet.ch<strong>Regional</strong> Human Development <strong>Report</strong>HIV/AIDS and Development in South <strong>Asia</strong> 2003 139
Endnotes17 Bandhu, 200218 UNAIDS/WHO, 200219 Tallis, 199820 The analyses, while very similar to anearlier work by Bloom et al. (1996), marka significant leap forward, in terms of thelarger number of countries for which dataare available, the increased length of thetime period over which the impacts of theepidemic can be assessed, and theavailability of better estimates of HIVprevalence and AIDS cases.21 Unfortunately, lack of good sentinelsurveillance data for HIV proved ahindrance in obtaining AIDS caseestimates for Nepal.22 The Hausman specification tests (seeTechnical Note B) reject the nullhypothesis of no reverse effect runningfrom life expectancy to HIV/AIDS.23 Our results are unchanged even if weexclude the sub-Saharan African countriesfrom our sample.24 Indeed, the same results hold even if theadult literacy rate variable is replaced byprimary and/or secondary enrolment rates,or by mean years of schooling in thepopulation aged 15 years and above.25 Stillwaggon, 200226 Bloom et al., 199727 Rao et al., 200128 Bloom, Mahal, Sevilla and River PathAssociates, 200129 Recent research in Cambodia, the countrywith the most advanced epidemic in <strong>Asia</strong>,demonstrates the poorest segments ofsociety have much less knowledge of howAIDS is transmitted and prevented. Peoplefrom this class are more likely to havesex at a younger age and use condomsless frequently. A study in Brazil showedthat three-quarters of people newlydiagnosed with HIV in the early 1980shad a university or secondary education,but by the early 1990s this share hadfallen to one-third.30 Bharat, 199931 World Bank, 200032 UNPA, 200033 <strong>UNDP</strong>, 200034 Lawyers’ Collective, 200035 UNIEM, 200136 The Behavioural Surveillance System(BSS) conducted by NACO of India revealsthat the poorest awareness was amongrural women in some states such as Bihar(20.6 per cent) and Uttar Pradesh (29.4per cent). (BSS survey, NACO, 2001)37 Zierler et al., 2000 find evidence from thestate of Massachusetts in the <strong>United</strong>States that economic deprivation has astrong positive association with theincidence of AIDS.38 Bloom et al., 199739 CPA media, 2001, p.1.40 Jeffreys, 2001; Kukis, 2001; WorldHealth Organization, 2001a41 Phongpaichit, 1982; Micaller, 200242 MAP 2001, p.2343 Wilson, 1999, p.1; Bryan, isher andBenziger, 200144 Wawer et al., 199645 ord and Koetsawang, 199146 National AIDS/STD Program, Bangladesh,200147 Bloom et al, 1997; National AIDS/STDProgram, Bangladesh, 2001, PakistanAIDS Prevention Society 2001; <strong>UNDP</strong>,2001; World Bank, 200048 Singh, 200149 MAP, 2001, p.2750 The research of Estebanez, itch andNajera (1993, pp.406-7) lends furthersupport to this conclusion by noting thefailure of methods focusing on isolationand imprisonment in order to controlsyphilis in the early twentieth century.51 Mahal, 1995; Canadian HIV/AIDS LegalNetwork, 200252 Philipson and Posner, 1995, p.83753 Bloom et al., 1997; Over, 200154 Gini co-efficient is an indicator of incomeinequality reflecting the distribution ofincome throughout the population. Ifincome is distributed equally across thepopulation, the co-efficient is equal tozero and if a few individualspredominantly hold the wealth, the coefficientis close to one.55 or more details, see Technical Note B56 Bloom et al., 199757 Bloom et al., 199758 Guinness and Alban, 2000, p.1059 Shepard, 1998, p.24760 Barnett et al., 200161 Bloom et al., 199762 Bloom, Mahal and River Path Associates,200263 Guinness and Alban 2000, and referencescited therein64 Barnett and Blaikie, 1992; Guinness andAlban, 2000, pp.7-865 Kwaramba, 199766 Bloom, Mahal and River Path Associates200267 Bloom, Mahal and River Path Associates2002, p.768 Bloom and Mahal, 1996 and referencescited therein; Giraud, 199369 Kanjilal and orsythe, 199770 Bollinger, Stover and Kibirige, 199971 Mahal, 200272 Bloom et al., 199773 World Bank, 199374 Kaplan and O’ Keefe, 1993; Over andPiot, 1993<strong>Regional</strong> Human Development <strong>Report</strong>140 HIV/AIDS and Development in South <strong>Asia</strong> 2003