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The Fiscal Dimensions of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda (Paperback)
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The Fiscal Dimensions of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda (Paperback)
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"HIV/AIDS continues to take a tremendous toll on the populations of
many countries, especially in sub-Saharan Africa. In some countries
with high HIV prevalence rates, life expectancy has declined by
more than a decade and in a few cases by more than two decades.
Even in countries with HIV prevalence of around 5 percent (close to
the average for sub-Saharan Africa), the epidemic can reverse gains
in life expectancy and other health outcomes achieved over one or
two decades. This volume highlights work conducted under the
umbrella of a World Bank work program on "The Fiscal Dimension of
HIV/AIDS," including country studies on Botswana, South Africa,
Swaziland, and Uganda. It covers four aspects of the fiscal
dimensions of HIV/AIDS: First, it aims for a comprehensive analysis
of the fiscal costs of HIV/AIDS, with a wider scope than a costing
analysis focusing on only the policy response to HIV/AIDS. Second,
it embeds the analysis of HIV/AIDS costs in a discussion of the
fiscal context, and interprets these costs as a quasi-liability,
not a debt de jure, but a political and fiscal commitment that
binds fiscal resources in the future and cannot easily be changed,
and very similar to a pension obligation or certain social grants
or services. Third, it develops tools to assess the (fiscal
dimensions of) trade-offs between HIV/AIDS policies and measures
that take into account the persistence of these spending
commitments. Fourth, most of the fiscal costs of HIV/AIDS are
ultimately caused by new infections, and this study estimates the
fiscal resources committed (or saved) by an additional (or
prevented) HIV infection. Building on these estimates, the analysis
here is able to assess the evolving fiscal burden of HIV/AIDS over
time."
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