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Tropical Medicine and International Health. 2008 Oct; 13(10):1245-56.OBJECTIVE: To estimate recurrent costs per patient and costs for a national HIV/AIDS treatment programme model in Rwanda. METHODS: A national HIV/AIDS treatment programme model was developed. Unit costs were estimated so as to reflect necessary service consumption of people living with HIV/AIDS (PLWHA). Two scenarios were calculated: (1) for patients/clients in the year 2006 and (2) for potential increases of patients/clients. A sensitivity analysis was conducted to test the robustness of results. RESULTS: Average yearly treatment costs were estimated to amount to 504 US$ per patient on antiretroviral therapy (ART) and to 91 US$ for non-ART patients. Costs for the Rwandan HIV/AIDS treatment programme were estimated to lie between 20.9 and 27.1 million US$ depending on the scenario. ART required 9.6 to 11.1 million US$ or 41-46% of national programme costs. Treatment for opportunistic infections and other pathologies consumed 7.1 to 9.3 million US$ or 34% of total costs. CONCLUSION: Health Care in general and ART more specifically is unaffordable for the vast majority of Rwandan PLWHA. Adequate resources need to be provided not only for ART but also to assure treatment of opportunistic infections and other pathologies. While risk-pooling may play a limited role in the national response to HIV/AIDS, considering the general level of poverty of the Rwandan population, no appreciable alternative to continued donor funding exists for the foreseeable future.
Genus. 2005 Jul-Dec; 61(3-4):91-110.This paper will deal with some of the issues that create demographic uncertainty and some of the trends which are likely to shape demographics in the future. World population has dramatically swelled to over 6 billion people today, more than double the number in 1950, when it was about 2.5 billion people. But population growth has not been linear over time. During the last half of the XX century, the annual growth rate of world population has been at first increasing to the value of almost 2% around the end of the 1950s, then decreasing until the beginning of the 1960s. It reached the pick of 2.19% in 1963. Afterwards it started an endless downward trend. In 2004 it was estimated to be 1.4%. World population is likely to keep on increasing through the first decades of the XXI century, although at a less rapid pace. The United Nations Population Division has acknowledged the lack of continuity in the population growth rate since the mid-1990s by periodically adjusting its estimates of population growth to 2050. Why the uncertainty? This paper will first quickly consider some of the reasons which cause the demographic uncertainty - economic and political changes, consequences of the HIV/AIDS pandemic and of the improvements in girls' education levels. Second it will tackle some of the issues we should watch for in relation to population - aging populations, growing youth bulges in many countries, increasing urbanization in the developing world, spreading infectious diseases and rising consumption. It will end up providing reflections upon some prospective challenges for world population. (excerpt)
World Watch. 2004 Sep-Oct; 14-17.A generation ago, human population growth became an explosive issue. Since then, it has largely disappeared from the media. But the consequences of still-rising population colliding with fast-rising resource consumption have in some respects worsened, and are bringing a whole new set of concerns. Forty years ago, the world's women bore an average of six children each. Today, that number is just below three. In 1960, 10-15 percent of married couples in developing countries used a modern method of contraception; now, 60 percent do. To a considerable extent, these simple facts sum up the change in the Earth's human population prospects, then and now. In the mid-1960s, it was not uncommon to think about the human population as a time bomb. In 1971, population biologist Paul Ehrlich estimated that if human numbers kept increasing at the high rates of the time, by around 2900 the planet would be teeming with sixty million billion people (that's 60,000,000,000,000,000). But the rate of population rise actually peaked in the 1960s and demographers expect a leveling-off of human numbers this century. (excerpt)
[Unpublished] 2002 Jun 7. 18 p.The models measuring the macroeconomic impact of HIV/AIDS are heterogeneous : each one relies on a specific theoretical background. Nevertheless, there are at least, three main common limits to those approaches : the authors concentrate on the impact on the labour market ; they neglect the potential implications on the capital market ; and they do not model some essential microeconomic impacts such as the change in the agents' economic behaviour. More specifically, the analysis of the impact of HIV/AIDs on savings takes into account direct costs such as health expenditures, seldom indirect costs like the anticipation of funeral costs and they do not model di¤ered indirect costs. The paper proposes an analysis of this last kind of implications through the impact of the epidemic on the saving behaviour. This paper focuses on the uncertainty of life expectancy and is based on two frameworks: the Galí (1990) model which considers the life cycle theory with a ...nite horizon at the aggregate level and the Moresi (1999) model which specifies a peculiar consumption utility function through uncertain lifetime. The calibaration and simulations of our model reveal a significant drop in future saving rate in South Africa under the hypothesis of a virus evolution similar to the one given by the UN Population Division : the saving rate in 2015, under those hypothesis, should be at least 5 percentage points inferior to the estimated saving rate that would then prevail in the absence of the epidemic. (author's)