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HIV/AIDS and the Caribbean Response. Roger Mc Lean The Health Economics Unit University of the West Indies. Format of Presentation. Caribbean Profile Challenges - Vulnerabilities HIV/AIDS and its impact Response to the Epidemic Prerequisites for an Effective Response Caribbean Response
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HIV/AIDS and the Caribbean Response Roger Mc Lean The Health Economics Unit University of the West Indies
Format of Presentation • Caribbean Profile • Challenges - Vulnerabilities • HIV/AIDS and its impact • Response to the Epidemic • Prerequisites for an Effective Response • Caribbean Response • Summary & Conclusion
Caribbean Profile • The population is predominantly young, but the demographic transition to an older population distribution has begun. • No significant difference in population distribution by sex
Caribbean Profile • History based on plantation slavery and indentureship • Economies characterised by • Non dynamic responses to changes in external environment • Dependency on natural resources for export earning • Small open, export led economies • Mono-crop • initially with agriculture today with mineral exports, tourism, offshore financial services and information processing
Profile of Caribbean EconomiesMacroeconomic Volatility • Volatility as a result of vulnerability due to: • High degree of openness • Highly concentrated exports in a few products • Limited diversification of domestic economy • Susceptibility to natural disasters
Macroeconomic Volatility • Volatility typically reflected in a high level of variability in GDP • Impacting on Gov’t Spending in public goods • Delivery of state’s Social programme consistently
Profile of Caribbean Economies There are certain structural constraints that are characteristic of Caribbean Economies
Additional Factors Affecting VolatilityExternal Factors • Collapse of Preferential Arrangements for Agriculture Products • Adjusting to Liberalization and Globalization
Additional Factors Affecting VolatilityInternal Factors • Unemployment • Poverty & Inequity • Crime • Drugs • HIV/AIDS
HOW DOES HIV/AIDS IMPACT ON VULNERABILITY Care Giver Educator Income Earner Purchaser of Goods and Services Illness (lost Labour) Influence on market Death (lost Labour) User of health & welfare services Savings (Lost Labour) Taxpayer Service to Community Leadership Support to Community Impact on Individuals/Household Family Member Consumer Individual Producer Community Member
Actual HealthExpenditure Supply of Labour Saving/Capital HOW DOES HIV/AIDS IMPACT ON VULNERABILITY HIV/AIDS AND THE ECONOMIC SYSTEM RequiredHealth Expenditure GovernmentExpenditure Social Capital GDP Illness or Death HIV/AIDS Prevention and Treatment
Macroeconomic Impact of HIV on Key Variables by 2005:via The Productive Channels (Low Case Scenario) Impact Variables Average GDP - 5.3 % Savings -16.9 % Investment -16.5 % Empl. In Agric - 4.4 % Empl. In Mfg - 4.4 % Empl. In Services - 7.5 % Labour Supply - 6.3 % HIV/AIDS Exp. +30.3%
HIV/AIDS & Volatility The impact of HIV/AIDS related morbidity and mortality threaten to exacerbate macroeconomic and microeconomic volatility in Caribbean states
Path to a Successful Response A Successful Response Depends on: • A Good Plan • Adequate Resources
Path to a Successful Response Characteristics of a Good Plan: • Evidence-based Research • Strategically Structured (informed by understanding of dimensions of the problem and its impact) • Sustainable (mainstreaming) • Clear division of labour (id stakeholders for lead and support roles) • Coordinating function • Endorsed and accepted
Path to a Successful Response Adequate Resources : • A separate but comprehensive mobilisation plan
Caribbean Response • Regional Structure - PANCAP • Regional Strategic Plan (RSP) • National Strategic Plans informed and guided by the RSP
Caribbean Response • PANCAP is a broad coalition of institutions and groups in the region operating at different levels and among different sectors, complementing one another with a shared and coordinated strategic agenda
Caribbean Response Six priority areas of the Regional Strategic Plan: § Advocacy, policy development and legislation § Support of people living with HIV/AIDS § Prevention of HIV transmission, focusing on young people § Prevention of HIV transmission among especially vulnerable groups § Prevention of mother to child transmission of HIV § Strengthening national and regional response capability
Summary The Effectiveness of a response to the epidemic lies in : • Recognition of the key causal factors driving the epidemic • Understanding factors driving the demand side • Basis for an expanded response– (case for mainstreaming) • Recognition of the structural constraints on Caribbean Economies (weak institutional capacity)
Summary The Effectiveness of a response to the epidemic lies in : • The Importance of an Evidence-based response • Recognition of the importance of A COORDINATED RESPONSE
Key Points: The impact of HIV/AIDS related morbidity and mortality, if left unattended, threatens to exacerbate macroeconomic and microeconomic volatility in Caribbean states
Key Points: • A well developed regional response can be the blueprint for a Caribbean Response to any threat to the Region’s Development