Epidemiological transition and the wealth of nations: the case of HIV/AIDS in a microsimulation model

Yves Arrighi and Bruno Ventelou
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Yves Arrighi: LEM - Lille économie management - UMR 9221 - UA - Université d'Artois - UCL - Université catholique de Lille - Université de Lille - CNRS - Centre National de la Recherche Scientifique

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Abstract: This paper aims at quantifying the effect of healthcare programs on economic outcomes in the context of developing countries experiencing epidemiological transitions. It is widely accepted in the literature that treatment programs result in production gains among ill-health workers. However, these programs have the additional effect of modifying both the size and the composition of the working population by increasing the proportion of chronically-ill individuals. First, we define the theoretical conditions under which this macro-epidemiological phenomenon outweighs the positive effect of an increase in production. Second, we decompose the economic consequences of access to antiretroviral treatments against HIV in three sub-Saharan African countries. Forecasts of an individual's health status, depending on whether he or she has access to medication, are generated using a microsimulation model. We use the model to generate a counterfactual (as if the adverse epidemiological effect did not exist), which allows decomposing the total impact of the HIV-medicines program into two different effects: positive and negative. We find that the positive effect of treatment procurement outweighs the negative epidemiological effect. Of course, this approach is only an indicator of economic performance and should in no way constitute a decision-making criterion about the ethical necessity of access to health care.

Keywords: Demographic changes; treatment programs; macroeconomic indicators; microsimulation; HIV/AIDS; Changements démographiques; programmes de traitement; indicateurs macroéconomiques; VIH-SIDA (search for similar items in EconPapers)
Date: 2019-10
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Published in Revue d'économie politique, 2019, 129 (4), pp.591-618. ⟨10.3917/redp.294.0591⟩

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Journal Article: Epidemiological Transition and the Wealth of Nations: the Case of HIV/AIDS in a Microsimulation Model (2019)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02475615

DOI: 10.3917/redp.294.0591

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