Health care and AIDS

The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values.     

AIDS costs in Trinidad and Tobago

This article examines the dramatic emergence of HIV/AIDS as a major public health problem in Trinidad and Tobago. While there were only eight registered cases of AIDS in 1983, by the beginning of 1992 Trinidad and Tobago had arrived at an incidence that put it in the 17th spot in the world, according to the World Health Organisation (WHO). The disease, which was first evinced among homosexuals, quickly spread to the heterosexual population. The cost of the disease, estimated in a human capital approach, has already made a dent on the GDP. Even the most conservative of projections suggests that the number of cases will rise by a factor of between four and five by the year 2000. Although there is little by way of comparative cost data on other diseases, AIDS/HIV, in all probability, could be very costly to the country. Ralph Henry received his B.A. at the University of the West Indies and his Ph.D. at the University of Alberta. He is currently senior lecturer and head of the Department of Economics at the University of the West Indies, Trinidad and specializes in human resource economics. Elizabeth Newton received her Bachelor and Master degrees at the Massachusetts Institute of Technology, Cambridge. She is currently a visiting scientist at the Caribbean Epidemiology Centre in Port of Spain, Trinidad. Her main research interests include biostatistics and infectious disease modelling.