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

Published online by Cambridge University Press:  15 January 2020

Luca Gori Open the ORCID record for Luca Gori [Opens in a new window] ,
Enrico Lupi ,
Piero Manfredi  and
Mauro Sodini
Luca Gori*
Affiliation:
Department of Law, University of Pisa, Via Collegio Ricci, 10, I-56126Pisa, PI, Italy
Enrico Lupi
Affiliation:
Management and Health Laboratory (MeS Lab), Institute of Management and Department EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33 I-56127Pisa, PI, Italy
Piero Manfredi
Affiliation:
Department of Economics and Management, University of Pisa, Via Cosimo Ridolfi, 10, I-56124Pisa, PI, Italy
Mauro Sodini
Affiliation:
Department of Economics and Management, University of Pisa, Via Cosimo Ridolfi, 10, I-56124Pisa, PI, Italy
*
*Corresponding author. E-mail: luca.gori@unipi.it and dr.luca.gori@gmail.com
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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.

Keywords

Fertility reversalfertility transitionHIV/AIDS epidemichuman capital accumulationquantity–quality switchSub-Saharan Africa

JEL classification

O1: Economic Development J11: Demographic Trends, Macroeconomic Effects, and Forecasts J13: Fertility • Family Planning • Child Care • Children • Youth O41: One, Two, and Multisector Growth Models
Type
Research Papers
Information
Journal of Demographic Economics , Volume 86 , Issue 2 , June 2020 , pp. 125 - 155
Copyright
Copyright © Université catholique de Louvain 2020

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Footnotes

A working paper version of this work, titled “Can HIV alter the quantity–quality switch and delay the fertility transition in Sub-Saharan Africa?” is available at https://ideas.repec.org/p/zbw/glodps/75.html (GLO Discussion Paper No. 75).

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