2018-HIV和艾滋病对工作世界的影响_全球估计（英文版）-2mb

Summary of The Impact of HIV and AIDS on the World of Work: Global Estimates

Core Content

This report, published by the International Labour Organization (ILO) in 2018, provides global estimates of the impact of HIV and AIDS on the world of work. It focuses on five key areas of impact: prevalence of HIV among the working population, mortality, work impairment, lost earnings, and the indirect effects on households and children's education.

Main Findings

(a) Prevalence

• The number of people living with HIV in the global labour force increased between 2005 and 2015 and is projected to continue rising, even with the expansion of antiretroviral therapy (ART).
• HIV prevalence rates are slightly higher for women than for men, but men account for the majority of cases due to their higher labour force participation.
• The geographical distribution of HIV prevalence is shifting, with an increase expected in Latin America and the Caribbean, Eastern Europe and Central Asia, Western and Central Europe and North America, and the Middle East and North Africa, while it is expected to decrease in Asia and the Pacific and sub-Saharan Africa.

(b) Mortality

• AIDS-related mortality in the global labour force has declined significantly for both men and women, but the trend for men accelerates in the final five years of the study period.
• Over 500,000 labour-force deaths are projected for 2020, which are largely avoidable with better access to ART.
• AIDS most commonly affects workers in their late 30s, when they are at peak productivity for themselves, their families, and society.

(c) Work Impairment

• The number of workers fully or partially unable to work due to HIV and AIDS has decreased dramatically since 2005, with projections showing a continued decline.
• Fully unable to work: estimated to drop from about 350,000 in 2005 to around 40,000 in 2020 (85% and 93% decline for men and women respectively).
• Partially unable to work: estimated to decline from 655,000 in 2005 to 95,000 in 2020 (81% and 91% decline for men and women respectively).

(d) Impact 1: Lost Earnings Due to Death or Full Inability to Work

• Lost earnings due to death or full inability to work have declined significantly, but are still expected to reach $7.2 billion in 2020.
• The decline reflects the expansion of ART, which has reduced the number of people entering the early stages of severe health and productivity impacts.

(e) Impact 2: Lost Earnings Due to Partial Inability to Work

• Lost earnings due to partial inability to work have also declined over the study period, reaching about 20% of the 2005 level by 2020.
• This decline is attributed to the reduction in the number of workers with low CD4 counts due to ART uptake.
• Three productivity loss scenarios were used to estimate the impact, with the medium scenario as the baseline.

(f) Impact 3: Additional Care Work in AIDS-Affected Households

• Care work burden in AIDS-affected households has decreased significantly, from over half a million people in 2005 to just over 50,000 in 2020.
• This decline is linked to the expansion of ART, which reduces the number of people with severe AIDS symptoms.
• The care burden is measured in work-year equivalents, with the medium scenario showing the most substantial reduction.

(g) Impact 4: Additional Chores Performed by Children in AIDS-Affected Households

• The number of children performing additional chores in AIDS-affected households has declined rapidly over the study period.
• The ILO recommends a threshold of 21 hours per week of chores to classify a child as a child labourer.
• Estimates are based on three scenarios reflecting the range of chore burdens identified in the literature.

(h) Impact 5: Impaired Education of Children in AIDS-Affected Households

• Education impairment among children in AIDS-affected households is relatively low, with 5% and 10% of children at risk under medium and high scenarios respectively.
• Even in the high scenario, the number of educationally impaired children is modest compared to the total number of children at risk from other factors.
• However, 84,000 children are still projected to face diminished educational opportunities by 2020.

Key Methodology

• The report uses health data from UNAIDS, combined with economic and demographic information, to estimate the impact on the global workforce.
• Surveys and epidemiological tools such as the Estimates and Projections Package (EPP) and Case Surveillance and Vital Registration (CSAVR) are used to extrapolate data into population-level estimates.
• The labour force participation rates for men and women are used to convert population-level estimates into workforce-specific data.

Conclusion

• Despite progress in HIV treatment, significant gaps remain in access to ART, leading to avoidable deaths and work impairments.
• The economic and social impacts of HIV and AIDS on the workforce and households are substantial, though they are expected to decline with increased treatment coverage.
• The report emphasizes the need for continued investment in ART, prevention, and the integration of health data with social and economic data to better understand and address the impacts of HIV and AIDS on the world of work.

Key Data and Projections

• Projected HIV prevalence in 2020: 29.9 million people in the global labour force.
• Projected AIDS-related deaths in 2020: ~500,000.
• Projected lost earnings due to death or full inability to work in 2020: $7.2 billion.
• Projected care work burden in 2020: ~50,000 people.
• Projected child labour equivalents in 2020: ~20,000.
• Projected educationally impaired children in 2020: ~84,000.

Importance of the Report

• The report aims to inform national and global HIV and AIDS responses, particularly in the world of work.
• It provides quantitative data to support policy and program development, ensuring that interventions reach the right people at the right time.
• The findings highlight the ongoing challenges and the importance of addressing the secondary impacts of HIV and AIDS on households and children's education.