Professor Larry Sawers is examining the link between health and poverty in developing countries. "People in poor countries are much sicker than people in wealthy countries," the economics professor says. "People in poor countries are more likely to be burdened with infectious and parasitic diseases—many of which are spread by poor sanitation or poor housing—and lack access to safe and effective medical care."
He and economist Eileen Stillwaggon, of Gettysburg College, are examining the HIV epidemic in developing countries—particularly southern Africa, where the percentage of adults infected with the virus reaches as high as 25%.
Thus far, their evidence suggests that having certain diseases such as malaria or a parasitic infection called schistosomiasis—both extremely common diseases within the region—makes a person both more likely to contract HIV and, if already infected, to spread it. These findings imply that the high prevalence of cofactor infections explains why 10 or 20 percent of adults in some African countries have HIV while only a tenth of a percent are infected in many other countries with a healthier disease environment. That finding suggests that the spread of HIV in Africa could be slowed by treating or preventing these common diseases.
Since schistosomiasis and malaria prevention are exponentially less expensive than HIV treatment, slowing the spread of HIV by dealing with cofactor infections is more cost effective than treating those already infected with the disease. Thus, Sawers' research could point the way to a more cost-effective method of controlling HIV infection in developing countries. "Researchers and policy makers around the world are increasingly aware that focusing exclusively on HIV in the developing world while ignoring the broader disease environment simply does not work."