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Time is costly: modelling the macroeconomic impact of scaling-up antiretroviral treatment in sub-Saharan Africa

Ventelou, Brunoa,b; Moatti, Jean-Paula,c; Videau, Yanna; Kazatchkine, Micheld

doi: 10.1097/QAD.0b013e3282f1d49f
Epidemiology and Social

Background: Macroeconomic policy requirements may limit the capacity of national and international policy-makers to allocate sufficient resources for scaling-up access to HIV care and treatment in developing countries.

Method: An endogenous growth model, which takes into account the evolution of society's human capital, was used to assess the macroeconomic impact of policies aimed at scaling-up access to HIV/AIDS treatment in six African countries (Angola, Benin, Cameroon, Central African Republic, Ivory Coast and Zimbabwe).

Results: The model results showed that scaling-up access to treatment in the affected population would limit gross domestic product losses due to AIDS although differently from country to country. In our simulated scenarios of access to antiretroviral therapy, only 10.3% of the AIDS shock is counterbalanced in Zimbabwe, against 85.2% in Angola and even 100.0% in Benin (a total recovery). For four out of the six countries (Angola, Benin, Cameroon, Ivory Coast), the macro-economic gains of scaling-up would become potentially superior to its associated costs in 2010.

Conclusion: Despite the variability of HIV prevalence rates between countries, macro-economic estimates strongly suggest that a massive investment in scaling-up access to HIV treatment may efficiently counteract the detrimental long-term impact of the HIV pandemic on economic growth, to the extent that the AIDS shock has not already driven the economy beyond an irreversible ‘no-development epidemiological trap’.

Author Information

aFrom the Inserm Research Unit 379 - ORSPACA, Marseille, France

bGreqam CNRS, Marseille, France

cFaculty of Economics, University of the Mediterranean, Marseille, France

dFaculty of Medicine, University René Descartes & Ministry of Foreign Affairs, Paris, France.

Received 8 June, 2006

Revised 5 June, 2007

Accepted 13 June, 2007

Correspondence to Dr Bruno Ventelou, CNRS - INSERM - ORS paca, 23 rue Stanislas Torrents, 13006 Marseilles, France. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.