How Governments Can Cope with the Impact of HIV/AIDS on Health Care and Poverty

Although the specifics of the impacts on health and poverty differ, the analysis leads to broadly similar conclusions in both areas. Special government assistance for people infected with HIV/AIDS and their survivors must be weighed carefully against the many other pressing needs that governments face. Well-intentioned government efforts to assist individuals with HIV/AIDS and their families may divert resources from other families that have not been afflicted by HIV/AIDS but are nonetheless suffering from illness, poverty, or both. In particular, HIV-infected patients should be responsible for the same portion of the cost of their care as other patients with similar income and likelihood of infecting others.

Because of HIV’s long incubation period, governments may initially underestimate the cost of programs to provide special assistance to those affected by HIV/AIDS. As the number of people who get sick and die from the disease increases, these programs will absorb a growing share of resources that could have been used to address other problems. Because AIDS may divert resources from other pressing problems and commit governments to expenditures from which it will later be politically difficult to withdraw, policymakers in developing countries should be wary of programs that provide special assistance to people with HIV and their families solely on the basis of an HIV diagnosis. At a minimum, they should consider the long-term cost of such programs based on a range of likely assumptions about the course of the epidemic.