The impact of HIV/AIDS on livelihoods, poverty and the economy of Malawi

Malawi is one of the poorest countries in the world. With an HIV prevalence of around 14 per cent of adult population, it is also one of the hardest hit by HIV/AIDS. The HIV/AIDS disaster came as an additional burden on households, communities, public institutions and private enterprises at a time when margins were already small or non-existent. Most of those who are HIV-positive are still healthy and do not know that they are infected. Thus, what can be registered today as consequences of the epidemic merely represent the tip of an iceberg. The purpose of the present study, commissioned by the Swedish International Development Cooperation Agence (Sida), is to analyze the impact of HIV/AIDS on eople's livelihoods and on the overall socio-economic development of the country. A number of different factors are believed to be responsible for the high level incidence of HIV/AIDS in Malawi. As in many other countries, gender inequality and the subordination of women in sexual relationship are two of the main driving forces of the epidemic. Harmful traditional practices, such as "dry sex" and various initiation ceremonies are frequently mentioned as contributing factors; Untreated sexually transmitted infection greatly increase the risk of becoming infected. Poverty and vulnerability are other factors that may also accelerate the spread of the diseases, as many girls and women engage in commercial sex as a survival strategy. HIV/AIDS is not a gender-neutral disease. More Malawian women than men are currently infected, and the ratio of female to male HIV-prevalence among adolescents is around five to one. Girls and women are also responsible for the lion's share of care and support when a family member falls ill. At the household level, the costs of HIV/AIDS are dramatic. In addition to direct costs in the form of medical expenses, transport for patients seeking treatment, funerals and other out-of-pocket expenditure, indirect cost in the form of loss of labour within the household represent an extremely heavy burden on the family, in particular when a head of a household falls ill and passes away. The nature of the disease also makes it common for children to lose both their parents in households affected by HIV/AIDS. The traditional safety net in the form of the extended family is placed under severe strain as the number of AIDS orphans increases.