This document, by the Zambian Ministry of Health and PHRplus, summarises how the National Health Accounts (NHA) system was used to assess both general health and HIV and AIDS-specific spending in Zambia in 2002. The document also reviews health care use and borrowing patterns for people living with HIV and AIDS (PLWHA). Findings show that the private sector, including households, finance 15.3 per cent of HIV and AIDS spending, whereas the public sector finances 7.2 per cent. Findings also reveal that PLWHA spend 12 times more on health care than those who are not infected. Traditional healers were also found to play a major role as providers of health care for people living with HIV and AIDS.
Resource allocation and health financing
HIV has severely affected the overall health of people in the southern Africa region by impacting directly on individuals and their families, and by placing additional burdens on economies, social structures and health services. Poorer people are disproportionately affected because they have fewer resources to deal with the impact of HIV on their daily lives. Now that international advocacy has led to reductions in process of antiretroviral drugs (ARVs), there is concern that poorer people will not have access to these drugs. To examine these issues, a study was commissioned by the Regional Network for Equity in Health in Southern Africa (EQUINET) and Oxfam GB to highlight equity issues in HIV and AIDS, health sector responses and treatment access in four countries in southern Africa.
A rise of more than 100 percent in the price of antiretroviral drugs is likely to put the life-prolonging medication beyond the reach of hundreds of thousands of Zimbabweans living with HIV. Pharmacists in Zimbabwe's second city of Bulawayo increased the price of a monthly course of ARVs from an average of Z$30,000 (US$120 at the official exchange rate) to between Z$80,000 (US$320) and Z$100,000 (US$400), telling IRIN the price hike was an inevitable response to the country's economic woes, which has seen inflation surge to 1,281 percent, and foreign currency become a scarce item.
This briefing proposes that while prospects for developing countries are often shaped by domestic and regional politics and aid, it is necessary to looks at beyond aid at issues like trade, migration, investment, environmental issues, security and technology. The authors explore the progress made towards policy coherence and conceptualise a three-phase cycle: phase 1 includes setting and prioritising objectives, which requires political commitment and policy statements; phase 2 looks at policy coordination and the implementation mechanisms by establishing formal mechanisms at inter-ministerial level for coordination and policy arbitration; and phase 3 is about effective systems of monitoring, analysis and reporting. The paper concludes by recommending that the Beyond Aid agenda could help drive faster progress towards partnerships for community development and policies that are more ‘development-friendly’, in practice as well as on paper.