1992 Reports

Who is Bearing the Cost of the AIDS Epidemic in Asia?

Glied, Sherry A. M.; Bloom, David E.

This chapter infers the distribution of AIDS costs in India, Indonesia, and Thailand from data on the costs of detecting and treating AIDS and from information on the nature of different countries health care finance systems and related institutions. The main finding is that the AIDS epidemic will contribute to increased economic inequality in these countries because (a) it is disproportionately affecting low-income groups and (b) public and private institutions that could spread the costs of the epidemic (for example, health, life, disability, and social welfare insurance) are relatively limited and do not reach the majority of the populations. The chapter also develops a new approach to measuring AIDS medical care costs that yields estimates of US $738 per case in India and US $1490 per case in Indonesia. Finally, the chapter discusses the political economy of HIV prevention and speculates that more effective control of the epidemic may result from a system in which the government pays for the medical care costs of AIDS than one in which individuals with AIDS and their families bear most of the costs.