According to the conventional theory of the demographic transition, mortality decline has represented the major trigger of fertility decline and sustained economic development. In Sub-Saharan Africa (SSA), the HIV/AIDS epidemic has had a devastating impact on mortality, dramatically reversing the long-term positive trend in life expectancies in high HIV-prevalence countries. Moreover, SSA is experiencing a delayed and slower fertility transition compared to other world regions and there is growing empirical evidence highlighting the potential for a paralysis, or even a reversal, of the fertility transition in countries with severe HIV epidemics. This work builds on a unified growth theory-like general equilibrium model combined with HIV spread, where mortality endogenously feeds back into fertility and education decisions. The model supports the evidence of an HIV-triggered fertility reversal in SSA via the fall in education and human capital investments due to increased adult mortality, which eventually breaks the switch from quantity to quality of children. Fertility reversal is predicted to be more likely to occur in countries experiencing severe HIV epidemics, and its effects may persist even under successful scenarios of HIV control. These results suggest that the alarming possibility of a paralysis in the fertility transition, which so far has aroused little concern among international organizations, e.g., in the last round of UN population projections, should be seriously considered with a view to prioritizing policy interventions.

A contribution to the theory of economic development and the demographic transition: fertility reversal under the HIV epidemic

Luca Gori
;
Pietro Angelo Manfredo Francesco Manfredi;Mauro Sodini
2019

Abstract

According to the conventional theory of the demographic transition, mortality decline has represented the major trigger of fertility decline and sustained economic development. In Sub-Saharan Africa (SSA), the HIV/AIDS epidemic has had a devastating impact on mortality, dramatically reversing the long-term positive trend in life expectancies in high HIV-prevalence countries. Moreover, SSA is experiencing a delayed and slower fertility transition compared to other world regions and there is growing empirical evidence highlighting the potential for a paralysis, or even a reversal, of the fertility transition in countries with severe HIV epidemics. This work builds on a unified growth theory-like general equilibrium model combined with HIV spread, where mortality endogenously feeds back into fertility and education decisions. The model supports the evidence of an HIV-triggered fertility reversal in SSA via the fall in education and human capital investments due to increased adult mortality, which eventually breaks the switch from quantity to quality of children. Fertility reversal is predicted to be more likely to occur in countries experiencing severe HIV epidemics, and its effects may persist even under successful scenarios of HIV control. These results suggest that the alarming possibility of a paralysis in the fertility transition, which so far has aroused little concern among international organizations, e.g., in the last round of UN population projections, should be seriously considered with a view to prioritizing policy interventions.
Gori, Luca; Lupi, Enrico; Manfredi, PIETRO ANGELO MANFREDO FRANCESCO; Sodini, Mauro
File in questo prodotto:
File Dimensione Formato  
Gori_Lupi_Manfredi_Sodini_2019_Post_print.pdf

accesso aperto

Tipologia: Documento in Post-print
Licenza: Creative commons
Dimensione 866.14 kB
Formato Adobe PDF
866.14 kB Adobe PDF Visualizza/Apri
Gori_Lupi_Manfredi_Sodini_2019_JODE.pdf

solo utenti autorizzati

Tipologia: Versione finale editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 693.11 kB
Formato Adobe PDF
693.11 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11568/1013862
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 8
social impact