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orewordThe Regional Human DevelopmentReport on “HIV/AIDS and HumanDevelopment in South Asia 2003” is thefirst report prepared under the aegis ofUNDP’s Asia Pacific Regional Initiativeon Human Development Reports(HDRC) and the Regional Programmeon HIV and Development (REACHBeyond Borders).This Report builds upon an extensivecorpus of research on humandevelopment in South Asia, pioneeredby the late Dr Mahbub-ul-Haq andstrengthened by successive national andsub-national HDRs. The challenge of HIVin South Asia has been examined inseveral documents prepared by UNorganizations, national Governments,research institutions, NGOs, activistsworking with HIV programmes andpositive people’s networks.It is heartening that this complex anddifficult issue is being addressed by a largenumber of people who recognise thepressing importance of fighting thisepidemic before it reaches catastrophicproportions. We do not have the luxuryof waiting for a crisis to be thrust uponus before we devise solutions for it.The Report argues that just as HIV canreverse the gains of human developmentin the region, largely through thevector of life expectancy, morbidityand prejudice, the lack of humandevelopment can also trump the fightagainst HIV. This Report is the first attemptto examine the dynamics of HIV andhuman development through a commonlens, and suggests possible arenas foraction that may lie outside a strictlyepidemiological approach. It is also truethat a classic public health response thatfocuses upon “disease control”,important as that is, may not be adequategiven the fact that there is thus far novaccine against HIV and the health careinfrastructure in the region is in need ofever greater reform and rejuvenation.The analysis in the Report indicates thatthe two-way relationship between illhealthand poverty holds particularly truein South Asia. In this context, humandevelopment concerns, particularlythose of social security, livelihood andhuman dignity are required to bemainstreamed into efforts to combatthe epidemic. As a corollary, it wouldbe essential to include HIV concernsinto policies and programmes forhuman development. A comprehensiveresponse cannot be a mere catch-word orslogan, it needs to become a living reality —on this hinges the success of the struggleagainst human deprivation and theepidemic in South Asia.Hafiz PashaUN Assistant Secretary GeneralUNDP Assistant AdministratorDirector, Regional Bureau for Asia and the Pacificiii
OverviewGlobally, the Human DevelopmentReports (HDRs) have placed people at thecentre of development discourse andflagged the urgency of focused public actiontowards international development goals.Several regional, national, and indeed subnationalHDRs pioneered in India havecontributed to a worldwide alliance towiden people’s choices and meet thechallenges of poverty, ill-health andignorance.The Regional HDR on HIV/AIDS andDevelopment in South Asia examines thecomplex interplay between disease anddeprivation in a scenario where majorsuccesses in human development areundermined by persistent challenges. TheReport brings together for the first timean analysis of HIV and humandevelopment under a common lens inSouth Asia. The linkages between the twoare mutually reinforcing in the sense thatHIV can undo gains of humandevelopment, and the lack of humandevelopment can trump any strategyagainst HIV.The Report assesses the adverse impactof HIV on the Human Development Index(HDI) and also the parameters of the HDIviz. literacy, school enrollment, lifeexpectancy and per capita income. It alsopoints out that successful humandevelopment in terms of improvedliteracy, a more functional health systemand enhanced livelihoods make for a moreeffective response to the epidemic inSouth Asia.It is vital that dialogue in the region,between statesmen, governments andcivil society, be harnessed to focus uponcooperation in arenas such as affordabledrugs and treatment through tradeagreements, sharing best practices inharm reduction and an enabling policyenvironment where the struggle againstthe epidemic is an integral part of the roadmap for human development.The Report documents the price of inertiain the fight against HIV and showsthat the micro-level impacts at thelevel of individuals, households andcommunities are more significant thanthe macro-level impact, given the currentrates of HIV prevalence. It points out thatthe impact of HIV on firms and businessesaffects not only corporate profits but alsothe livelihoods of workers and theprospects of social security for organisedand unorganised workers.The case is made in the Report thatsuccessful outcomes for HIV may alsorequire an enabling framework whererights of people living with HIV/AIDS(PLWHA) are guaranteed and stigma anddiscrimination are minimised. Itanalyses the legislative and judicialframework of HIV in South Asiaand argues for a closer integrationwith mainstream constitutional and rightto development mandates andinstitutions.The Report examines the debate overprevention versus treatment andiv
Page 1 and 2: It is now well accepted that HIV/AI
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Page 7 and 8: AcknowledgementsCombating HIV/AIDS
Page 9 and 10: The TeamHDRC: K. Seeta Prabhu, Sura
Page 11 and 12: ContentsCHAPTER 1Introduction1.1 Th
Page 13 and 14: Contents3.2 African AIDS is not a s
Page 15 and 16: GlossaryAIDSAcquired Immuno-deficie
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Page 31 and 32: Nexus between Human Development and
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Nexus between Human Development and
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The HIV/AIDS Epidemics of South Asi
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Human Rights and HIV/AIDS“An impo
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Human Rights and HIV/AIDSincrease t
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Human Rights and HIV/AIDSsupport an
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Human Rights and HIV/AIDSBox 4.3Sti
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Human Rights and HIV/AIDSBox 4.5Bad
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Human Rights and HIV/AIDSnumber of
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Human Rights and HIV/AIDSnegotiate
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Human Rights and HIV/AIDSBox 4.6Ind
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Human Rights and HIV/AIDSTable 4.2I
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Human Rights and HIV/AIDSsociety in
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Human Rights and HIV/AIDSReforms co
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Human Rights and HIV/AIDSSource: WH
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Human Rights and HIV/AIDSBox 4.12Me
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Human Rights and HIV/AIDSclients an
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Human Rights and HIV/AIDSand develo
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Human Rights and HIV/AIDSparticular
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Human Rights and HIV/AIDSTable 4.5S
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Human Rights and HIV/AIDSBox 4.16Th
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Human Rights and HIV/AIDSBox 4.17Hu
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Human Rights and HIV/AIDSnuisance.
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Human Rights and HIV/AIDSand autono
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The Way orwardRegional Human Develo
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The Way orward“The social andpoli
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The Way orwardis not a desirable on
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The Way orwarddevelopment, divert s
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The Way orwardProviding ARV treatme
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The Way orward5.5 Adolescent Sexual
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The Way orwardwomen’s lives are t
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The Way orwardcomprehensive guidanc
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The Way orwardInvolving religious l
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The Way orwardconcerns and extended
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The Way orwardlInvolvement of gover
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The Way orwardfor people who are an
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Endnotes17 Bandhu, 200218 UNAIDS/WH
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Endnotes56 Pradhan, 199857 Malla, 2
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Endnoteson Economic, Social and Cul
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Annexure IRegional Human Developmen
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Annexure ICountry Treaty Concluding
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Annexure IAnnexure IIInternational
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Technical Note - ATechnical Note -
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Technical Note - A(EDEP) is calcula
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Technical Note - Bvalue is to the u
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Technical Note - Bsubstantial degre
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Technical Note - Bthe rate of growt
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Technical Note - BThe full list of
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Technical Note - B(13) H =(α∗ρ
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Technical Note - BTable T1Human dev
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Technical Note - BTable T3(b)HIV/AI
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Technical Note - BTable T7HIV/AIDS
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Technical Note - BDominican Republi
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Statistical TablesStatistical Table
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Statistical TablesTable 3Profile of
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Statistical TablesRegional Human De
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Country act SheetsRegional Human De
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Country act SheetsBANGLADESHIndicat
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Country act SheetsINDIAIndicator Ye
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Country act SheetsMALDIVESIndicator
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Country act SheetsPAKISTANIndicator
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Country act SheetsRegional Human De
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