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Nexus between Human Development and HIV/AIDS“AIDS is devastatingin terms of creatingand deepening poverty,reversing achievementsin education anddiverting meagre healthbudgets away fromother priorities. And bycutting deep into allsectors of society,HIV/AIDS underminesvital economic growth:”Mark Malloch Brown,UNDP Administrator,African Developmentorum, December 2000Chapter 2Nexus between HumanDevelopment and HIV/AIDS2.1 IntroductionThis chapter brings out the mutuallyreinforcing relationship between thevulnerability to HIV and the persistenceof human deprivation and the manner inwhich the HIV/AIDS epidemic shapes,and is, in turn, shaped by the patterns ofdevelopment in South Asia. “Thesituation is worst in regions and countrieswhere poverty is extensive, genderinequality is pervasive, and public servicesare weak. In fact, the spread of HIV/AIDSat the turn of the twenty-first century is asign of maldevelopment-an indicatorof the failure to create more equitableand prosperous societies over large partsof the world.” 1Conventionally, the analyses of theepidemic and human development inSouth Asia have been done in a segregatedmanner. The former has focusedprimarily on the identification ofvulnerable groups, seropositivityestimates and concomitant socioeconomicprofiles of ‘people at risk’. TheHDRs, for their part, have analysedliteracy, vital statistics and indicators ofincome, employment and poverty,albeit within an integrated framework.There is, however, a growingrecognition that HIV/AIDS is not just ahealth issue but a fundamental issueunderlying the sustainability of humandevelopment. This has widened the scopeof the present discourse.2.1.1 Status and trends ofHIV/AIDS and humandevelopment in South AsiaWhere do the countries in the region rankin terms of development achievements?Tables 2.1 and 2.2 shed light on some of thecomponents of HDI, and HIV prevalence.There appears to be considerablevariation in achievement, in terms ofaggregate indicators such as the HDI andGDI and in individual components ofHDI, across even this small group of ninecountries. Sri Lanka, Maldives and Iranare at the upper end of the spectrum, withIndia in the middle and the others(Bangladesh, Bhutan, Nepal and Pakistan)at the lower end.The same appears to hold true for SouthAsia’s economic indicators such as theproportion of population living below theinternational poverty line of $1 (1993PPP), with the exception of Sri Lanka.These already low levels of developmentindicators are likely to be furtheraffected by HIV, with recent gains indevelopment reversed.Table T1 (see Technical Note B) highlightschanges in some of the indicators ofhuman development in the last twoRegional Human Development ReportHIV/AIDS and Development in South Asia 2003 15