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Cost Implications of the Prevalence of HIV/AIDS on the
Economic Development of Nigeria

(r. )*u+% (o,inic% #sa-uo+ien% E.ans S./.
(epart,ent of Econo,ics and (e.elop,ent Studies% /o.enant 0ni.ersit1% #ta% #gun State% Nigeria.

(r. Nwau-ani% #2ec+u2wu #.% 0gwuan1i% 3enedict E.
(epart,ent of Social Science Education% 0ni.ersit1 of Nigeria% Nsu22a% Enugu State Nigeria.

Abstract
4I$5)I(S e,erged in t+e last t+ree decades as .isi-le t+reat to +ealt+ and t+e socio-econo,ic conditions of
de.eloping countries including Nigeria. )gainst t+is -ac2ground% t+is stud1 soug+t to deter,ine t+e cost
i,plications of t+e pre.alence of 4I$5)I(s on t+e econo,ic de.elop,ent of Nigeria. 6+e stud1 adopted ,ainl1
7ualitati.e approac+ sourced fro, National 3ureau of Statistics-(N3S and /entral 3an2 of Nigeria-(/3N
statistical 3ulletin respecti.el1 for anal1sis. 8indings see, to support clai,s t+at t+e incidence of 4I$5)I(S
e9ert serious negati.e influences on t+e econo,ic growt+ of Nigeria. 6+is is due to t+e fact t+at 4I$5)I(S
reduces to a large e9tent t+e proportion of t+e wor2ing population wit+ its +uge corresponding cost i,plications%
w+ic+ in turn affect econo,ic resources in t+e countr1. 6+e polic1 inter.entions strategies reco,,ended for
ste,,ing t+e scourge of 4I$5)I(S include: pre.ention of new infections% cost reduction of treat,ents for
patients% positi.e ad;ust,ents of patients to e,plo1,ent en.iron,ent and de.elop,ent of acti.ities li2e p1c+o-
educational progra,,e to ,oti.ate and foster 4I$5)I(S pre.ention and ,anage,ent -e+a.iours a,ong t+e
Nigeria populace especiall1 t+e 1out+.
Keyor!s< /ost% Econo,ic =rowt+: E,plo1,ent% 4I$5)I(S% Producti.it1

Intro!"ction
6+e 4u,an I,,une $irus and )c7uired I,,une (eficienc1 S1ndro,e epide,ics are -ot+ glo-al p+eno,ena
t+reatening t+e +ealt+ of .arious peoples% culture and population in t+e world. 6+e Su--Sa+aran )frica (SS)
wit+ a-out 1&> of t+e world?s population +as o.er two t+ird of t+e people li.ing wit+ 4I$. 6+e first cases of
4I$ and )I(S were reported in 1@!1. 6wo decades later% it +ad alread1 infected '& ,illion people worldwide
out of w+ic+ 2!.5 ,illion (appro9i,atel1 75> reside in )frica (0N(P% 2&&'.
4I$ ,eans 4u,an I,,une $irus. It is a .irus t+at attac2s% destro1s and continues to deplete +u,an i,,une
s1ste,. 6+e acron1, )I(s ,eans )c7uired I,,une (eficienc1 S1ndro,e. 6+is suggests t+at t+e condition or
illness is not in+erited -ut ac7uired fro, possi-le en.iron,ent factors suc+ as .irus infections. Si,ilarl1%
i,,une deficienc1 ,eans t+at t+e .iruses +a.e graduall1 caused deficient i,,unit1 as clearl1 ,anifested in
poor nutrition and low resistance to opportunistic infections (/o9% 1@@7. 4I$ and )I(s are interrelated -ecause
)I(s is -elie.ed to -e an ad.anced for, of 4I$ infection. 6+us% )I(s is a se.ere i,,unological disorder
caused -1 4I$% resulting in a defect in cell-,ediated i,,une response causing increased suscepti-ilit1 to
opportunistic infections li2e fe.er% tu-erculosis% s2in ras+es and so on w+ic+ ulti,atel1 lead to deat+ ()g+ulor%
2&1&.
6+ere are at least two strains of t+e .iruses t+at cause )I(S and )I(S related conditions na,el1 4I$-1 and
4I$-2. 4I$-1 is t+e ,ost co,,on cause of )I(S world wide e9cept in Aest )frica w+ere t+e 4I$-2 (w+ic+ is
less .irulent is co,,on. Ait+out dou-t caring for so,e-od1 infected wit+ 4I$5)I(s is alwa1s a +erculean tas2
as it de,ands a lot of ,one1% ti,e% energ1% ris2 and loss of ,an +ours t+at would +a.e -een used in production
of goods and ser.ices. 4I$5)I(s entails a lot of alternati.e forgone or cost to t+e Nigerian econo,1. It was
esti,ated -1 e9perts in 2&&5 t+at 4I$ infection will rise a-o.e 1&& ,illion and -1 2&1&% life e9pectanc1 will
-egin to decrease% especiall1 in )frica w+ere t+e -runt of t+e infection is felt ,ost (National )ction /o,,ittee
on )I(S% N)/)% 2&&7.
6+e i,pact of 4I$5)I(S e9tends -e1ond t+ose li.ing wit+ t+e .irus. 6+is is -ecause as fa,ilies struggle wit+
po.ert1 w+en t+e1 lose a -read winner or +a.e t+e added e9penses of caring for econo,icall1 disa-led fa,il1
,e,-ers w+o ,a1 die sooner or later% +ouse+old sa.ings tend to decrease leading ulti,atel1 to wider financial
depreciation. It also e9erts i,pact on ot+er ,e,-ers of t+e +ouse+old (usuall1 daug+ters or wi.es w+o ,a1
,iss sc+ool or wor2 in order to ta2e care of t+e sic2 person. Si,ilarl1% people infected wit+ )I(S usuall1 suffer
fro, co,-ination of se.ere weig+t loss% different t1pes of infections and w+ereas t+at end in deat+ one or two
1ears after initial diagnosis and full occurrence of -lown )I(S (/o9% 1@@7.
4I$5)I(S is contagious and can -e trans,itted ,ainl1 t+roug+ se9ual intercourse% intra.enous drug usage%
-lood transfusion during surger1% pregnanc1 and c+ild -irt+ (3oler B )rc+er% 2&&!. =enerall1 )I(S patients
are .ulnera-le to opportunistic infections w+ic+ ta2e undue ad.antage of da,aged i,,une s1ste, to t+ri.e.
Incidentall1 )I(S +as no care.
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6+e nu,-er of people li.ing wit+ 4I$5)I(S (PCA4) as well as nu,-er of deat+s as a result of t+e epide,ic
+as increased across t+e glo-e (0N)I(S% 2&&1. 6+is is e.en ,ore alar,ing as ,a;orit1 affected are adults and
wo,en w+o are t+e 2e1 co,ponents of t+e la-our force% w+ic+ +as serious i,plications for econo,ic
de.elop,ent. In Nigeria% it is esti,ated t+at 3.2 to 3.! ,illion people are li.ing wit+ 4I$% w+ic+ i,plies t+at one
out of se.en )fricans li.ing wit+ 4I$ is a Nigerian. #n t+e w+ole% alt+oug+ t+e o.erall percentage of adults
infected see,s to +a.e re,ained sta-le o.er t+e last few 1ears% t+e nu,-er of people li.ing wit+ 4I$ is still on
t+e increase wit+ t+e poor 1out+s% c+ildren and pregnant wo,en -eing t+e ,ost .ulnera-le (3oler B )rc+er%
2&&!.
).aila-le literature s+ow t+at t+e pre.alence rate of 4I$5)I(S in Nigeria is still +ig+ across t+e geograp+ical
*ones e.en t+oug+ it +as narrowed down significantl1 -etween ur-an and rural areas. )ccording to National
)ction /o,,ittee on )I(S-N)/) (2&&7 t+e nation is at t+e t+res+old of se.ere and widespread growt+ of t+e
epide,ic. 6+e 2&&1 National 4I$5S1p+ilis Sentinel Sur.e1 esti,ated a national 4I$ pre.alence rate of 5.!>.
Degional pre.alence rates are +ig+ t+oug+ .aried fro, a +ig+ of 7.7> in Sout+-Sout+ to low of 3.3> in t+e
Nort+-Aest (8ederal Einistr1 of 4ealt+-8E#4% 2&&1: National Population /o,,ission-NP/% 2&&'. 6+is
,eans t+at 4I$ is spreading t+roug+ t+e general population rat+er t+an -eing confined to populations at +ig+er
ris2% na,el1 se9 wor2ers and drug users.
In Nigeria t+e disease is spread ,ainl1 t+roug+ co,,ercial se9 wor2ers% long ,o.ing truc2 dri.ers% wandering
fe,ale +aw2ers% unscreened -lood transfusion and +ost of ot+er deep rooted un+ealt+1 cultural practices ()*u+%
1@@@. 6+e stig,a associated wit+ people li.ing wit+ 4I$ and )I(S and t+ose affected -1 )I(S lead to furt+er
isolation and ,ental +ards+ip. Cosses in producti.it1 created -1 deat+s and illnesses associated wit+ 4I$ and
)I(S can result in slowing down of growt+ and ot+er de.elop,ental o-;ecti.es (0nited Nations (e.elop,ent
Progra,,e% 0N(P% 2&&'.
) +ealt+1 wor2 force is funda,ental to an industrious% .i-rant and prosperous nation. )c7uired I,,une
(eficienc1 S1ndro,e ()I(S% constitutes a serious c+allenge not onl1 to t+e +ealt+ sector -ut also t+e econo,1
wit+ see,ing cost i,plications ()2erele% 2&&5. 6+is is largel1 so -ecause t+e epide,ic is li2el1 to affect t+e
wor2ing population w+ic+ is predo,inatel1 1out+s. 6+us% alt+oug+ 4I$ infects all age groups in Nigeria% t+e
pre.alence rate +as -een +ig+er a,ong 1oung adults (2&-2@ 1ears w+o are at t+e pri,e of t+eir li.es. In.aria-l1
t+e epide,ic is li2el1 to ta2e its greatest toll on t+e 1oung seg,ent of t+e population w+ere t+e ,a;orit1 of new
infections occur wit+in t+e 15-2@ 1ears age -rac2ets. 6+e +ig+ ,or-idit1 and ,ortalit1 a,ong t+ese age groups
could +a.e serious i,plications not onl1 on t+e population structure% life e9pectanc1 at -irt+ -ut also t+e gains of
econo,ic growt+.
0ni.ersal co.erage wit+ respect to +ealt+ related ,atters i,plies t+at e.er1one s+ould -e a-le to +a.e access to
7ualit1 +ealt+ ser.ices wit+out -eing in+i-ited -1 financial +indrances (A4#% 2&1&. 6+us% uni.ersal +ealt+
co.erage pro,otes two co,,on aspirations na,el1 pro.iding financial ris2s for all (1&&> fro, t+e costs of
+ealt+ care and ena-ling access to needed +ealt+ care for all (1&&> financial and geograp+ic access
(#nwu;e2we% 2&13. 3asicall1 uni.ersal co.erage pro,otes afforda-le 4ealt+ care ser.ices t+roug+ ,alaria
4I$5)I(S inter.ention and ot+er related 4u,an Desource 4ealt+ Eanage,ent Infor,ation S1ste,.
0ni.ersal /o.erage (0/ -eca,e part of t+e glo-al agenda in 2&&5 w+en t+e Aorld 4ealt+ related )sse,-l1
adopted a resolution re7uesting ,e,-er States to pursue uni.ersal co.erage in +ealt+ and ot+er related ,atters
(A4#% 2&&5. 6+e ,a;or part of t+is resolution was to Freduce t+e reliance on out-of-poc2et pa1,ent and to
pro,ote pre-pa1,ent +ealt+ care financing ,ec+anis,sG (#nwu;e2we% 2&13<1'. Incidentall1% Nigeria +as not
,ade an1 .isi-le progress in 0ni.ersal /o.erage since t+e adoption of t+e resolution in 2&&5. )s argued -1
#nwu;e2we (2&13 Ft+e co.erage le.els wit+ ,ost +ealt+ ser.ices (including free ser.ices and pre-pa1,ent
financing ,ec+anis,s are .er1 lowG p'. 8or instance% +e furt+er o-ser.ed t+at less t+an 5> of t+e population is
co.ered -1 financial ris2s protection ,ec+anis,s suc+ as +ealt+ insurance. 6+is current low uni.ersal co.erage
in Nigeria undou-tedl1 could -e attri-uted to wea2 +ealt+ s1ste, w+ere F,ore t+an H&> of +ealt+-care
financing co,es fro, +ouse+olds? out-of-poc2et pa1,entsG (#nwu;e2we% 2&13< p'. 6+is +as far-reac+ing
i,plications on econo,ic growt+.
Indeed% Nigeria +as t+e resources needed to ac+ie.e uni.ersal +ealt+ co.erage -ut needs ot+er sustaina-le
,easures and related inter.ention policies to ensure ade7uate wor2ing of e7uita-le +ealt+ deli.er1 s1ste,
wit+out w+ic+ cost of treating% ,aintaining or ,anaging 4I$5)I(S will -e .er1 +ig+ and per+aps econo,icall1
attracti.e. 6+is position is -ased on t+e pre,ise t+at access to +ealt+ care is a funda,ental +u,an +ealt+ rig+t
w+ic+ is ens+rined in ,an1 glo-al resolutions and declarations and e.en in t+e Nigerian constitution (8ederal
Depu-lic of Nigeria% 2&11: #-ia;ulu% 2&&@. 6+e )l,a-)ta (eclaraion-1@77% sees +ealt+ as funda,ental +u,an
rig+t and ,ost i,portant world wide social goal. It is according to t+e Aorld 4ealt+ #rgani*ation (A4# cited
in #2ei-unor (2&11: p.5 Fa state of co,plete p+1sical% ,ental and social well--eing and not ,erel1% t+e a-sence
of disease or infir,it1G. Si,ilarl1% #nwu;e2we (2&13 sees +ealt+ as a state of t+e +u,an -od1 and ,ind and
+ealt+ care as pertaining to t+ose c+e,icals% de.ices and ser.ices utili*ed -1 people to i,pro.e t+eir +ealt+. )
+ealt+ s1ste, t+erefore includes all t+e organi*ations% institutions and resources w+ose ,a;or function is to
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i,pro.e +ealt+ and related ser.ices ranging fro, ser.ice deli.er1 to polic1-,a2ing and i,ple,entation (A4#%
2&1&. 6+us% a .ia-le +ealt+ s1ste, needs to pro,ote ser.ices w+ic+ are not onl1 responsi.e to needs -ut also
generall1 accessi-le and afforda-le in ter,s of cost (#2ei-unor% 2&11. In.aria-l1 e9pectations fro, good +ealt+
s1ste, include% i,pro.ed +ealt+ status (i,pro.ed +ealt+ efficac1 good +ealt+ at low cost% e7uit1 (accessi-ilit1%
afforda-ilit1% responsi.eness% uni.ersal co.erage and financial ris2s protection (A4#% 2&&5.
8ro, -ot+ +u,an capital5resources and econo,ic perspecti.e% good +ealt+ generates wealt+ +ence t+e popular
la1ing t+at F+ealt+ is wealt+G. Indeed wit+ respect to econo,ic cost% +ealt+care is seen as a special good and
s+ould -e accorded co,,ensurate attention in order to ensure 0ni.ersal 4ealt+ /o.erage. 6+is is particularl1 so
-ecause no one is certain a-out w+en illness will occur and t+e en.isaged related e9penditure t+at could -e
incurred. )ccording to t+e Aorld 4ealt+ #rgani*ation% A4# (2&&5 a strong or good +ealt+ s1ste, contri-utes
to good +ealt+ -ecause it caters for all interests (econo,ic% political% racial and religion and seg,ents of t+e
population especiall1 t+e poor and per+aps t+e ,ost .ulnera-le and disad.antaged groups. )-o.e all% it de.elops
+u,an resources (strong econo,ic capital t+roug+ in.est,ent and financial ser.ices t+at are responsi.e to
pre.ailing +ealt+-care needs suc+ as 4I$5)I(S.
Incidentall1% t+e Aorld 4ealt+ #rgani*ation ran2ed t+e Nigeria 4ealt+ s1ste, 1!7
t+
out of 1@1 countries
sur.e1ed (A4#% 2&&&. 3asicall1% a ,a;or criterion used in t+e ran2ing Fwas t+e issue of poor le.els of financial
access to +ealt+ care ser.icesG (#nwu;e2we% 2&13< p7. 6+is i,plies t+at +ealt+ care s1ste, s+ould -e organi*ed
-ased on t+e principle of 0ni.ersal /o.erage w+ic+ pro.ides t+at e.er1 citi*en regardless of inco,e% socio-
econo,ic status% residenc1% gender% etc s+ould -e e,powered to access t+e sa,e range of ser.ices according to
needs and preferences (#2ei-unor% 2&11% Ear,ot et al 2&&!. 6+ese e9pectations are predicated on t+e Aorld
4ealt+ #rgani*ations? proposed four target indicators for countries% towards ac+ie.ing uni.ersal +ealt+ co.erage.
6+ese indicators e,p+asi*e t+at<
(1 6otal +ealt+ e9penditure s+ould -e at least '>-5> of t+e gross do,estic product:
(2 #ut-of-poc2et spending s+ould not e9ceed 3&-'&> of total +ealt+ e9penditure
(3 #.er @&> of t+e population is co.ered -1 pre-pa1,ent and ris2 pooling sc+e,es: and
(' /lose to 1&&> of population wit+ social assistance and safet1-net progra,,e (A4#% 2&1&% #2oli% 2&11.
#nwu;e2we et al 2&&H argue t+at ine7ualit1 to and use of +ealt+ care ser.ices could actuall1 result fro,
differences in distri-ution across socio-econo,ic status and geograp+ic groups and ot+er factors. 6+at is
particularl1 so -ecause t+e +ouse+old as t+e lowest socio-econo,ic status5group% apart fro, e9periencing t+e
possi-ilit1 of increased e9posure to diseases (due largel1 to +ig+ po.ert1 le.el are usuall1 less li2el1 to purc+ase
and access +ealt+care ser.ices. 4owe.er% e.en if it does% it leads to depletion of +ouse+old resources ,eant for
ot+er -asic +ouse+old needs suc+ as food and education (National 3ureau Statistics: 2&&7% #2ei-unor% 2&11
Indeed% o.er t+e 1ears% t+e o.erall perfor,ance of t+e Nigerian +ealt+ s1ste, +as -een disappointingl1 low
(National Population /o,,ission% 2&&@: #2olo B /learl1% 2&11. 8or instances% 2&13 -udgetar1 allocation of
5.7> to +ealt+ falls s+ort of t+e e9pected funds re7uired to ac+ie.e t+e +ealt+ related ,illenniu, de.elop,ent
goals% especiall1 wit+ respect to re.ersal of +ig+ infant ,ortalit1 rate% ,aternal deat+ and spread of 4I$5)I(S
and ot+er diseases t+at afflict +u,anit1 -1 2&15 (#nwu;e2we% 2&13 conse7uentl1 Fpu-licl1 financed +ealt+
ser.ices -arel1 reac+ t+e poor raising t+e need for o.er dependence on out-of poc2et spendingG (p. 1@. 6+is
suggests e.identl1 t+at Nigeria will not -e a-le to ac+ie.e t+e +ealt+-related E(=s in 2&15.
Si,ilar e.idence a-ound to support t+e a-o.e clai,s wit+ respect to declining state of +ealt+ care s1ste, in
Nigeria despite purported increased -udgetar1 allocation. 8or instance% t+e total +ealt+ e9penditure is &.7> of
=(P instead of t+e A4# reco,,ended '>-5>: out-of-poc2et spending is ,ore t+an H&> of total +ealt+
e9penditure instead of A4# reco,,ended 3&-'&>: less t+an 5> of t+e population is co.ered -1 pre-pa1,ent
and ris2 pooling sc+e,e instead of A4# reco,,ended @&> and less t+an 2> co.erage of population wit+
social assistance and safet1 progra,,e instead of A4# reco,,ended 1&&> (#nwu;e2we% 2&13. 6+is trend is
also supported -1 )nnual De.iew (8ederal Einistr1 of 4ealt+ 2&12 w+ic+ s+ows t+at t+ere are still low le.el of
access to +ealt+ care ser.ices% poor +ealt+ indicators% rising po.ert1% e7uit1 and +ow le.el of co.erage and use of
IP6 on t+e w+ole w+ile t+ere see,ed to -e increased i,,uni*ation co.erage and increased I6Ns #wners+ip
('2>. 6+is position or trend calls to 7uestion not onl1 t+e .ia-ilit1 of t+e Nigerian +ealt+ polic1 and 4ealt+ care
s1ste, in ac+ie.ing uni.ersal co.erage% -ut also t+e cost i,plications for citi*ens li.ing wit+ 4I$5)I(S and
econo,ic de.elop,ent in general.

#$ %heoretical &rameor' an! (evie of (elate! )iterat"re
6+e t+eoretical perspecti.e of t+is stud1 re.ol.es around classical econo,ist position w+ic+ percei.e +ealt+ as a
product of t+e de.elop,ental process. 6+at is wealt+% and i,pro.ed +ealt+ are intricatel1 interwo.en. 6+e
t+eor1 +olds t+at in a glo-al de.elop,ent% inco,e s+ould increase for +ealt+ to i,pro.e (=iorgianni% =ra,a B
Scipioni% 2&&2. In t+is regard% w+en people +a.e ,one1 (inco,e t+e1 could afford to pa1 for goods and
ser.ices% ot+er t+ings -eing e7ual% t+is would ,a2e t+e, +ealt+1 -ecause t+e1 can access -etter food% clean
water suppl1% efficient sanitation s1ste, and ,edical care.
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6o t+e classical econo,ists% a ro-ust econo,1 +as a ,a;or influence on i,pro.ing and ,aintaining t+e +ealt+ of
co,,unities and nations. 8or indi.iduals wit+ little disposa-le inco,e% insufficient inco,e ,a1 li,it t+e a-ilit1
to recei.e t+e care t+e1 need or place t+e, in situation wit+ additional +ealt+ ris2s. 6+oug+ classical econo,ists
.iew +ealt+ as a product of de.elop,ent process% ot+ers suc+ as Eeers et al (2&&3 argued t+at t+e direction of
causation -etween +ealt+ and wealt+ re,ains an open issue. 8or instance% )frican (e.elop,ent 8oru,-)(8
(2&&& reported t+at ,ore recent researc+es +a.e -egun to esta-lis+ t+at countries wit+ +ealt+1 population tend
to grow faster t+an t+e contrar1. 6+is ,eans t+at +ealt+ of a population is t+e ,ost relia-le indicator of future
econo,ic growt+ (=iorgianni et al 2&&&.
6+e issue of +u,an capital de.elop,ent is of great i,portance in an1 econo,1 particularl1 de.eloping econo,1
li2e Nigeria. 6+e twentiet+ centur1 +as -eco,e t+e +u,an capital centur1. People and s2ills ,atter a lot -ecause
t+e wealt+ of a nation is e,-odied in its people especiall1 t+e acti.e or wor2ing population. 6+e 4I$ infection is
t+erefore capa-le of pro.o2ing ,onu,ental crisis -1 arresting e.er1 inde9 of de.elop,ent and depleting rapidl1
t+e resources -adl1 needed to contain it. 4u,an capital co.ers a -road range of concepts -ut t+e ,ost essential
feature is increase in production t+roug+ s2illed and +ealt+1 e,plo1ees.
)ccording to 0N(P (2&&'% 4u,an (e.elop,ent is a process of enlarging people?s c+oices -1 raising -ot+ t+e
2nowledge and s2ills ac7uisition le.el of t+e citi*ens of a gi.en countr1. Enlarging people?s c+oices is ac+ie.ed
-1 e9panding +u,an capa-ilities. )t all le.els of de.elop,ent% t+e t+ree essential capa-ilities for +u,an
de.elop,ent are for people to lead long and +ealt+1 li.es% to -e 2nowledgea-le and to +a.e a decent standard of
li.ing. If t+ese -asic capa-ilities are not ac+ie.ed% ,an1 c+oices are si,pl1 not a.aila-le and ,an1 opportunities
re,ain inaccessi-le. 6+e real, of +u,an de.elop,ent goes furt+er< to include essential areas of c+oice +ig+l1
.alued -1 people% ranging fro, political% econo,ic and social opportunities w+ic+ are re7uire,ent for -eing
creati.e as well as +a.ing sense of -elonging in a co,,unit1. )t present pace of 4I$5)I(S pre.alence t+ere
could -e enor,ous cost on +ealt+% +u,an capital and largel1 on econo,ic de.elop,ent of Nigeria.
/ost to econo,ists in.ol.es not onl1 t+e ,one1 spent in -u1ing or producing so,et+ing -ut also t+e alternati.e
forgone in order to ac7uire5satisf1% purc+ase or produce a gi.en ite,. It is si,pl1 t+e no,inal ,one1 .alue paid
or used to purc+ase an ite, or as t+e ,one1 .alue paid out or gi.en up5sacrificed in t+e process of production.
6+e (ictionar1 of Eodern Econo,ics (1@!5 defined cost as a ,easure of w+at ,ust -e surrendered or gi.en up
in order to ac7uire% o-tain or produce an ite,.
Econo,ic de.elop,ent refers to -ot+ 7uantitati.e and 7ualitati.e increase in a countr1?s output of goods and
ser.ices% a ,ore e7uita-le distri-ution of inco,e% a rise in per capita inco,e and standard of li.ing coupled wit+
a fall in cost of li.ing% people?s access to -asic necessities and infrastructure and so on. (e.elop,ent is a social
construct t+at can -e anal1sed fro, different perspecti.es. It can -e applied to t+e indi.idual% social group%
econo,ic% political% tec+nological points of .iew and so on. 6+is is w+1 aut+orities usuall1 refer to de.elop,ent
as a ,ulti-di,ensional or ,ulti-faceted p+eno,enon. (e.elop,ent as it applies to t+e indi.idual is t+e process
-1 w+ic+ t+e indi.idual increases +is5+er s2ills and capacit1% self-discipline% creati.it1% freedo, and ,aterial
well--eing. )t t+e social group le.el% de.elop,ent is an attac2 on t+e c+ief e.ils of t+e world toda1. 6+ese
include ,alnutrition% diseases% po.ert1% illiterac1% une,plo1,ent% inflation% slu,s and ine7ualit1 (3ul1a% 2&11.
6+us% according to Seers as cited in 3ul1a (2&11 de.elop,ent occurs a,ongst a people if po.ert1% disease%
une,plo1,ent% inflation% illiterac1 and ine7ualit1 +a.e declined fro, +ig+ le.els to low le.els. (e.elop,ent is
also percei.ed as a process t+roug+ w+ic+ societ1 ,o.es fro, a gi.en de.eloping socio-econo,ic condition to
anot+er ,ore desira-le condition as a conse7uence of education. 8or an1 gi.en countr1 to witness de.elop,ent%
all sectors of t+e econo,1 of suc+ a countr1% for e9a,ple social% econo,ic% political% cultural% tec+nological%
ps1c+ological% scientific% ,ilitar1 and industrial ,ust -e seen to grow.

*$ Statement of the Problem
6+e pre.alence of 4I$5)I(s in Nigeria constitute a cog in t+e w+eel of de.elop,ent -ecause -1 2&&7% 17&% &&&
Nigerians +a.e died% w+ile 2.H ,illion people were alread1 li.ing wit+ t+e disease. 8urt+er,ore% 1.2 ,illion
Nigerians were alread1 orp+ans due to t+e epide,ic ()2poc+afo% 2&1&. (educti.el1% 4I$5)I(s ta2es a -ig toll
on +u,an li.es in Nigeria and possi-l1 t+e econo,1. 6+is could +a.e corresponding conse7uences on t+e +u,an
capital stoc2 in Nigeria as well as potential la-our force or ,anpower of t+e nation. In addition% catering for t+e
people li.ing wit+ 4I$5)I(s (PCA) could ta2e awa1 a lot of in.esti-le funds fro, -ot+ indi.idual (t+e
infected% relations and friends and go.ern,ent for su-sidi*ing and pro.iding of drugs for t+e infected citi*ens.
In t+e sa,e .ein% t+e countr1 could also lose a lot of ,an +ours of -ot+ t+e infected and t+eir care-gi.ers. Indeed
t+e pro-a-le cost of 4I$5)I(s in ter,s of -ot+ +u,an and capital resources could -e enor,ous especiall1 in
Nigeria wit+ .er1 fluid and .ulnera-le econo,1. 6+e cost of 4I$5)I(S on t+e i,plications on t+e econo,ic
de.elop,ent of Nigeria constitute t+e pro-le, of t+is stud1.

+$ (esearch ,"estions
6+e following researc+ 7uestions guided t+e stud1<
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1. A+at are t+e general cost i,plications of t+e 4I$5)I(S pre.alence in NigeriaI
2. 6o w+at e9tent can t+e pre.alent trend of 4I$5)I(S deter,ine econo,1 growt+ in NigeriaI

-$ .etho!ology an! ,"alitative Presentation of Data/&in!ings
Secondar1 data were sourced fro, National 3ureau of Statistic (N3S% 2&&5 and /entral 3an2 of Nigeria (/3N
Statistical 3ulletin (2&&7 for t+e purpose of answering researc+ 7uestions 1 and 2 respecti.el1. 6+ese rele.ant
data were presented in ta-les 1 and 2. 6a-le 1 presents infor,ation on 4I$5)I(S pre.alence wit+ deducti.e cost
i,plications. (6a-le 1.
4I$5)I(S +as .er1 serious i,pact on t+e epide,iological and de,ograp+ic profiles of t+e countr1 as well as on
+ealt+ deli.er1 s1ste, and ,anpower de.elop,ent. A+en an e,plo1ee?s +ealt+ is t+reatened -1 sic2ness and
disease% +is general output or contri-utions to producti.it1% econo,ic de.elop,ent and nation?s growt+ would
fall. 6+us% )I(S reduces t+e +u,an de.elop,ent potentials and at ,acro le.el it will i,pact significantl1 on
econo,ic growt+ negati.el1.
%able I/ HIV/AIDS an! Economic 0roth in Nigeria 123345#6678
HIV/AIDS Per Capita (eal
9EA( CASES 0DP A)):CA%I:N %: HEA%H SEC%:( 1;8
1@@H 3H7.&& 3H31.11 3.'H
1@@7 '7!.&& 3'5'.5! 2.2H
1@@! 11!@.&& 3'H5.27 3.!'
1@@@ 1H&!.&& 3335.H& 5.3@
2&&& 2H33.&& 35&5.@@ 2.11
2&&1 3371.&& 35!7.1@ '.53
2&&2 7&52.&& 3@12.H@ 2.!7
2&&3 !@1!.&& 3@55.2& H.&7
2&&' 552@.&& '&@@.&& 5.'!
2&&5 5@37.&& ''7H.'& 3.!!
2&&H n.a. '33@.2@ 5.!2
2&&7 n.a '5&1.11 5.7@


6+e data in 6a-le1 points out t+at t+e cases of 4I$5)I(S reported in Nigeria +a.e -een increasing o.er t+e
1ears wit+ t+e +ig+est .alue of !%@1@ in 2&&3. 6+oug+ it so,e+ow fell in 2&&'% it later increased in t+e following
1ear. #n t+e ot+er +and% t+e .alue of t+e per capita real gross do,estic product (PD=(P is increasing at a .er1
slow pace. 6+is interaction -etween increasing incidence of 4I$5)I(S and slow growt+ of PD=(P depicts t+e
negati.e i,plication of t+e epide,ic in Nigeria?s econo,ic growt+. 6a2ing t+e argu,ent furt+er% t+e federal
allocation to t+e +ealt+ sector as presented in 6a-le1 clearl1 s+ow t+at t+e sector +as not recei.ed sufficient
attention fro, t+e go.ern,ent. In t+is ta-le% t+e allocation to t+e sector ranges fro, low .alues of 2.11> in 2&&&
to H.&7> in 2&&3. 6+e i,pact of 4I$5)I(S is seriousl1 felt -1 t+e +ealt+ sector. 6+e effects in.ol.e direct costs
suc+ as e9penditure on ,edical treat,ents% suppl1% and personnel% a,ong ot+ers and indirect costs suc+ as
reduction in t+e nu,-er of ,edical pro.iders and increasing strain on t+e +ealt+ sector. Si,ilarl1% people li.ing
wit+ 4I$5)I(S (PCA4) +a.e wide range of +ealt+ needs suc+ as pri,ar1 care% -asic treat,ent%
+ospitali*ation and ps1c+o-social counseling t+at are to -e ,et. 4owe.er% t+e paltr1 a,ount allocated to t+e
sector can +ardl1 +andle it.
6+e relations+ip -etween PD=(P and 4I$5)I(S incidence -eco,es ,uc+ clearer w+en one ta2es a loo2 at t+e
line grap+ as presented in 8igure 1.&. 6+e figure s+ows t+at t+e per capita real =(P is ,ore or less constant o.er
t+e period (1@@H-2&&7% w+ereas t+e incidence of 4I$5)I(S in t+e countr1 2eeps on rising e.en far -e1ond w+at
t+e per capita real =(P can contain. 6+e .er1 low and undulating national +ealt+ -udget w+ic+ +ad +ig+est .alue
of paltr1 H> of t+e total -udget allocation is una-le to ,eet t+e growing -urden e.en if 4I$5)I(S usurp all t+e
-udgetar1 allocation of t+e sector. 6+us% it can -e argued t+at t+e low co,,it,ent -1 t+e go.ern,ent as well as
low infor,ation -ase of t+e populace on t+e epide,ic +as serious i,plication on t+e econo,ic growt+ of t+e
countr1. 6+is is -ecause t+e inade7uate +ealt+ sector allocation will put untold pressure on t+e acti.ities of t+e
sector w+ic+ can worsen t+e alread1 +eated situation. 6+is finding calls for urgent inter.ention t+at will curtail
t+e surge of t+e epide,ic-4I$5)I(S.

So"rce/ National 3ureau of Statistics-N3S (2&&5 and /entral 3an2 of Nigeria-/3N Statistical 3ulletin (2&&7
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4$ Disc"ssion of &in!ings
Ait+ regards to 4I$5)I(S occurrence% it could -e said t+at t+e initial orientation of acade,ic and polic1
researc+ was to see t+e epide,ic as a pu-lic +ealt+ pro-le,% not a de.elop,ental one as suc+. 4owe.er% t+ere is
now general agree,ent t+at relations+ip -etween 4I$5)I(S and econo,ic de.elop,ent e9ist. It -e argued t+at
t+ere is a relations+ip -etween +ealt+ and wealt+ (Sen. 2&&'. 4I$5)I(S +as a negati.e effect on t+e econo,1
and t+e econo,1 in turn affects t+e le.el of distri-ution of 4I$. 8or instance% Jassalow (2&&1 e9plained t+at
i,pro.e,ent in +ealt+ and nutrition were a,ong t+e ,a;or forces dri.ing 3ritain?s stead1 wealt+.
4I$5)I(S is a .er1 serious +ealt+ and social t+reat capa-le of affecting econo,1 in ,an1 wa1s. 8or instance%
poor returns of +u,an capital could render t+e +ealt+ of t+e acti.e la-our force ineffecti.e t+ere-1 leading to
-ot+ a reduction in t+e 7ualit1 and 7uantit1 of la-our force and a corresponding rise in t+e +ealt+ care cost of
treating patients. #t+er possi-le wa1s include c+anging t+e structure of population against t+e la-our force%
s+ortening t+e e9pectation of life% reduction in -ot+ returns to pri.ate and pu-lic in.est,ent in +u,an capital and
+ence econo,ic de.elop,ent would -e affected.
4I$5)I(S can also lead to low do,estic capital for,ation. 6+is is -ecause t+e rate of sa.ings -1 +ouse+olds%
-usinesses and go.ern,ent underta2ings lead to poor capital for,ation. )s de,ands for -ot+ curati.e and
pre.enti.e +ealt+ care rises as a result of 4I$5)I(S related ,or-idit1% ,ore financial resources are c+anneled to
+ealt+ care e9penses. 6+is will lower t+e le.el of ,arginal propensit1 to sa.e and t+e long-run effect is reduction
on do,estic capital for,ation. In.aria-l1 t+ere is an erosion of potenc1 to sa.e and in.est in econo,ic acti.ities
(producti.e .entures due to t+e priorit1 gi.en to 4I$5)I(S epide,ic treat,ent. 6+e situation +inders t+e
capacit1 for future econo,ic growt+.
In addition% 4I$5)I(S +as significant i,pact on go.ern,ent finances as a result of declining producti.it1 and
inco,es of -ot+ indi.iduals% pu-lic and pri.ate organi*ations. 6+is would lead to recurring fiscal deficit wit+ its
attendant conse7uence of +ig+ inflation and gi.en t+e relations+ip -etween inflation and growt+% t+e real out
co,e would decline w+ile growt+ would -e co,pro,ised. In order words% it affects ,acroecono,ic sta-ilit1
and growt+ t+roug+ effects on la-our suppl1 leading directl1 to a reduction in sectoral output in ,ost econo,ic
sectors.
8urt+er,ore% t+e nature of relations+ip -etween +ealt+ and wealt+ +as -een in ,ost cases a dialectical one.
4owe.er% t+e1 could -e intricatel1 and un7uestiona-l1 related (4a,,oudi and Sac+s 1@@@. 6+us% it could -e
noted t+at depending on t+e o.erall polic1 en.iron,ent% t+e relations+ip -etween t+e +ealt+ and wealt+ could
eit+er produce a Fvirtuous circleG in w+ic+ i,pro.ed +ealt+ pro,ote econo,ic growt+ or a Fvicious circleG in
w+ic+ poor +ealt+ and po.ert1 -eco,e ,utuall1 reinforcing. In t+is case% a lin2 can -e drawn on +ow good
+ealt+ could produce rapid econo,ic growt+ t+roug+ t+e for,ation of ro-ust +u,an capital ,ade possi-le -1 t+e
a-ilit1 of indi.iduals to access good +ealt+ facilities. 6+is is de,onstrated in 8igure 1a.
#n t+e ot+er +and% t+e influence of li,ited access to +ealt+ facilities as a result of po.ert1 (low inco,e le.el
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would produce low +u,an capital and conse7uentl1 low le.el of econo,ic growt+% as represented in 8igure 1a.
6+e =-! at t+e #2inawa su,,it in June 2&&' pre,editated w+en t+e1 declare. F4ealt+ is 2e1 to prosperit1% and
good +ealt+ contri-utes directl1 to econo,ic growt+ w+ilst poor +ealt+ dri.es a countr1 into po.ert1G.

4I$5)I(S +as posed a great c+allenge to t+e entire world since its cure re,ains a ,irage (#gwu B 6se-a,%
2&11. 6+is situation is worsened -1 t+e fact t+at ,ost teac+ers in t+e pu-lic sc+ools +a.e little or no in-dept+
2nowledge a-out t+e 4I$5)I(S epide,ic and its conse7uences. )gain% ,ost of t+e c+ildren in pu-lic sc+ools
and t+e c+ildren wit+ special needs% -ot+ t+e .isuall1 and +earing i,paired are ignorant of t+e conse7uences of
to1ing wit+ t+e disease. 6+is calls fort+ t+e need for 4I$5)I(S education and infor,ation% especiall1 as t+e
+earing i,paired are t+e ,ost acti.e a,ong t+e people wit+ disa-ilit1. 6+e pro.ision of t+is re7uisite education
de,ands% e9tra funding to t+e education sector. #f course% t+is re7uired e9tra -udgetar1 allocation to -ot+ t+e
+ealt+ and education sectors will -e at t+e opportunit1 cost of in.est,ent in )griculture and5or ot+er producti.e
sectors of t+e econo,1. 6+is is -ecause t+e -attle against 4I$5)I(S +as -ot+ +ealt+ and educational
i,plications for t+e future of t+is countr1.

7$ Policy Implications an! (ecommen!ations
6+e issues raised and discussed +erein in t+is paper +a.e so,e nota-le i,plications t+at de,and t+e attention
and consideration of t+e federal go.ern,ent. So,e of t+e, include<
6+e Nigerian +ealt+ sector is not ade7uatel1 e7uipped5prepared and supported to -e a-le to cope or
grapple wit+ t+is dreaded epide,ic of 4I$5)I(S. 3ot+ t+e +ealt+ and education sectors s+ould -e
gi.en -igger -udgetar1 allocation and support.
6+at 4I$5)I(S is silentl1 spreading5affecting t+e Nigerian populace w+ile t+e Nigerian go.ern,ent is
-oasting and pro,ising to -e fig+ting against and controlling t+e spread of t+e dreaded .irus.
) state of e,ergenc1 s+ould -e declared on 4I$5)I(S epide,ic in Nigeria.
6+at t+e 4I$5)I(S is not onl1 ta2ing an alar,ing toll on t+e +ealt+ and li.es of Nigerians -ut +as now
constituted a cog in t+e w+eel of econo,ic growt+ and de.elop,ent of t+e Nigerian econo,1 -1
sapping in.esti-le funds5resources fro, -ot+ t+e go.ern,ent% infected Nigerians and t+eir supporti.e
relations5friends.
6+at t+is countr1 ,a1 sooner or later -e e9periencing a declining population wit+ its attendant negati.e
econo,ic conse7uences.
6+at t+is countr1 needs concerted efforts of -ot+ go.ern,ent% N=#?s and possi-le foreign support to -e
a-le to co,-at t+e disease. 6+is could -est -e ac+ie.ed t+roug+ sustained su-sid1 of drugs international
agencies.
6+at 4I$5)I(S education in Nigerian sc+ools as currentl1 o-tains is not ade7uate and effecti.e for
controlling t+e disease. In-ser.ice orientation courses% se,inars and wor2s+ops s+ould -e organi*ed for
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teac+ers and students to furt+er strengt+en 4I$5)I(S education in sc+ools.
6+e National #rientation )genc1 (N#) s+ould in addition to N)/) -e e,powered5,o-ili*ed to e,-ar2
on ,edia ca,paigns and pu-lic awareness progra,,es a-out t+e disease. Jnowledge t+e1 sa1 is power and
in t+is case one re7uired for proper decision ,a2ing and corresponding attitudinal c+ange and .alue re-
orientation for ste,,ing t+e pre.alent rate of 4I$5)I(S in our societ1.

<$ Concl"sion
6+e de.astating i,pact of 4I$5)I(S is capa-le of rolling -ac2 t+e decades of gains in t+e de.elop,ent progress
in Nigeria if urgent ,easures are not ta2en to address t+e trend. 6+is i,pact is +ea.il1 felt -1 t+e +ealt+ sector
t+roug+ direct costs suc+ as e9penditure on ,edical treat,ents% su-sidi*ed drugs and so on% as well as t+roug+
indirect costs suc+ as reduction in t+e nu,-er of ,edical pro.iders and increasing stress on +ealt+ s1ste,. 6+e
4I$5)I(S epide,ic is a serious c+allenge in Nigeria-a countr1 t+at is alread1 faced wit+ difficulties in ,eeting
-asic +ealt+ care needs of t+e population.
6+e .er1 low national +ealt+ -udget in t+e total -udget allocation is una-le to ,eet t+e growing -urdens e.en if
4I$5)I(S usurp all t+e -udgetar1 allocation of t+e sector. 6+is paper found out t+at t+e low go.ern,ent
co,,it,ent to t+e +ealt+ sector is una-le to ade7uatel1 address t+e rising spate of t+e disease. It was e7uall1
o-ser.ed t+at t+e per capita real =(P can -e reduced wit+ t+e increasing incidence of 4I$5)I(S in t+e countr1.
6+us% t+e fluctuating +ealt+ sector allocation puts undue pressure on t+e +ealt+ sector acti.ities leading to t+e
worsening scenario witnessed in t+at sector. 6+e o-ser.ations ,ade in t+e paper calls for dra,atic inter.ention
,easures to curtail t+e upsurge of t+e epide,ic. In addition to increase in +ealt+ sector -udget ensuring
econo,ic independence -1 a wa1 of e,plo1,ent% less discri,ination against PCA4)% de.elop,ent of acti.ities
suc+ as ps1c+o-educational progra,,e to ,oti.ate and foster pre.enti.e -e+a.iours a,ong t+e entire
population especiall1 t+e wor2ing class are needed.

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pro-le,s in Nigeria. Inaugural lecture% 0ni.ersit1 of Nigeria% Nsu22a. P.15.
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(ece,-er% p.3&@.
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,et+ods and indicated.

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