HIV/AIDS is among the deadliest diseases in the world in recent times. This has particularly been the case for developing countries, especially African Countries. In fact, the World Health Organization reported in 2005 that HIV/AIDS was the fourth most deadliest disease (after Ischaemic heart disease, cerebrovascular disease and lower respiratory infections in that order). It accounted for about 2.8million deaths across the globe in 2004.

Describing HIV/AIDS as the most devastating epidemic in recent history, Whiteside (2002) noted that the disease had killed 100million people, whilst infecting nearly 58million by year 2000.

Of the 40million people with the disease in the world in 2005, 26million of them were in Africa, where the prevalence rate was 7.2 % (Canning, 2006). Indeed, the regional figures often mask substantial national variations, particularly in Africa. For instance, whilst many countries in Africa have a prevalence rate of over 20%, including Swaziland, Botswana, Lesotho, Zimbabwe, Namibia, and South Africa, others such as Ghana have a significantly low prevalence rate. It was 3.1% in 2003 (HJ Kaizer, 2005), and dropped to 1.7% in 2008 in Ghana.

*Epidemiology, Prevention, and Treatment*

Canning (2006) discusses the epidemiology, prevention and treatment of HIV/AIDS. He argues that HIV virus creates a U-shaped path for infection and infectiousness in that the risk of causing a new infection is highest in the first two and half months after infection, and in the last 24 months of life of the victim. He also argues that in developing countries, transmission of the disease is mainly through heterosexual sex, through mother-to-child transmission before or during birth, or through breastfeeding.

He then provides some prevention options for the disease. These options are directly related to the causal avenues for the virus and disease, and include two broad categories: sexual and nonsexual pathways. Nonsexual pathways include transmission from mother-to-child, blood transmission, and through breastfeeding. Sexual preventive options include changes in sexual activity/behavior, promoting abstinence, reducing the number of partners, and the use of condoms. One of the most widespread HIV/AIDS prevention campaigns that swept across Africa, and which Canning points out was able to chalk some considerable success in Uganda, is the *ABC* approach: Abstain, Be faithful, and Condom Use.

Treatment of the disease is typically through antiretroviral therapy. Patients visit a clinic once a month to get a new supply of drugs, discuss the symptoms, and to take medical tests. However, this has been shown to prolong the victims’ life by a maximum of 4 years. Indeed, Canning (2006) contends that studies show a dollar spent on prevention is about 28 times more effective than for treatment. Hence low income countries should target prevention, not treatment. Prevention is better (than cure)! But where an individual has already contracted the disease, one of the ways of pacing its adverse effects down is to ensure the prevention of opportunistic infections (typically tuberculosis in Africa)

*HIV/AIDS and Economic Growth*

The role of human capital in the growth of countries cannot be overemphasized. Health and education both go into the human capital function. HIV/AIDS therefore affects the productivity of the average worker. People with ill-health, *ceteris paribus,* would tend to be less productive than their healthy counterparts. In like manner, people with more education tend to have more set of skills that make them more productive than their less educated colleagues.

By rendering its victims unhealthy and often weak, therefore, HIV/AIDS tends to reduce their productivity. It also drops young people out of school. Hence, intuitively, HIV/AIDS should tend

to impact negatively on the economic growth of countries whose populations are hit hardest.

Canning states that studies have shown very little evidence of HIV/AIDS impacting on per capita

incomes. However, some studies show that HIV/AIDS prevalence affects economic growth. For instance, Bonnel(2000) contends that HIV/AIDS reduces the stock of human and physical capital because it affects the adult population, and tends to “kill” the incentive to save and invest. Of course, if one contracts the disease, and knows that he/she is not going to live long, the desire to work hard, save and invest is obviously dampened. In some countries where the prevalence rate is very high, HIV/AIDS tends to consume a considerably huge chunk of GDP. A typical example is Kenya (Canning, 2006)

*HIV/AIDS and Poverty*

There tends to be a relationship between many communicable disease epidemics, and poverty (Whiteside, 2002). And HIV/AIDS has not been spared this relationship. The disease has the potential to increase poverty due to reduced motivation to work hard, discouraged savings and investments, among others. The relationship between the disease and poverty, albeit direct, is sometimes a little murky. Some countries have buoyant economies with high per capita incomes, yet very high HIV/AIDS prevalence rates. For instance, Botswana has the highest per capita income in Africa, yet has highest level of infection (Whiteside, 2002).

*What Can Be Done?*

To the extent that HIV/AIDS leads to premature death, imposes burdens on the victims, their family, community, nation, and the world, there is the need to act. Whilst policy making bodies, governments and non-governmental organizations, and research institutions have varied approaches to the way we can deal with the issues, their ultimate goals converge. The two common approaches are through prevention and treatment.

Canning (2006) makes a compelling case for prevention as opposed to treatment. Cost-effectiveness analysis, proposed by economists, has been roundly rejected by international organizations’ policy-making about HIV/AIDS in developing countries. These organizations seem to prefer treatment options, which economists believe are the least cost-effective ways to deal with it. The cost-effectiveness bottom line as proposed by Canning is this: that media messages are highly cost effective at changing behavior and reducing transmission; peer education, condom distribution, and treatment of sexually transmitted diseases for commercial sex workers are also highly cost effective; but the least cost effective interventions are treatment using antiretroviral therapy.

*Conclusion*

Due to binding resource constraints, prevention is better than treatment. Hence, it is better for Governments and institutions in developing countries to focus on preventive measures before going on to treatment options.

*Iddisah Sulemana *

*(iddisah@gmail.com)*

*The author is a Graduate Student at the Department of Economics, University of Akron, Ohio, USA*