This report is from a study carried out by the Uganda Coalition for Access to Essential Medicines (UCAEM), to assess the implementation of the Global Fund to fight HIV/AIDS, Malaria and TB in Uganda. The study was specifically designed to offer an analysis of the implementation process and activities of the UGFATMP with the aim of establishing the involvement of key stakeholders particularly CSOs, identify the challenges, document beneficiary perspectives and make recommendations on key CSOs concerns about the process. Despite successes around the world this report reveals that there are still concerns at the country level in Uganda.
Resource allocation and health financing
The Global Fund to Fight AIDS, Tuberculosis and Malaria has welcomed the latest "endorsement by the G8 leaders of US$6 billion to US$8 billion per year for the Global Fund, a three-fold increase from the current level," as "a strong agreement that makes it possible to defeat" the pandemics.
Whether Governments should charge patients fees to use public health services has become one of the most contentious social policy issues worldwide. Sadly for policy makers, in recent years, the quality of debate in this area has often been poor, with opposing camps usually resorting to unproven theory and emotive rhetoric. Perhaps a new perspective should be brought to this debate. How would the world of business deal with this problem; which in effect, is an issue of what (if any) price one should charge for health services?
Hilary Benn of DFId calls for the global community to deliver better health for poorer people around the world.
A minimum yearly average increase in resources of US$ 3.9 billion is needed to scale up maternal and newborn health services within the context of the Millennium Development Goals, although annual costs increase over the time period of the model. When more rapid rates of scale-up are assumed, this minimum figure may be as high as US$ 5.6 billion per year. The 10-year estimated incremental costs range from US$ 39.3 billion for a moderate scale-up scenario to US$ 55.7 billion for the rapid scale-up scenario. These projections of future financial costs may be used as a starting point for mobilizing global resources. Countries will have to further refine these estimates, but these figures may serve as goals towards which donors can direct their plans. Further research is needed to measure the costs of health system reforms, such as recruiting, training and retaining a sufficient number of personnel.
More than 300 delegates gathered at the first-ever assembly of The Partnership for Maternal, Newborn and Child Health. Hosted by the Government of Tanzania, the Partner's Forum (17-20 April 2007) declared that action is urgently required, if high rates of unjust deaths of mothers, babies and children in poor countries are to be reversed.
Social health insurance is critical for improving equity in our health system, which is characterised by tremendous disparities between public and private care. As much as there have been increases in real terms in the budgets for public health services, more funding is still required, especially in light of additional demands posed by HIV and Aids.
In a statement ahead of the WHA meetings, APHRA coordinator Rotimi Sankore stated: “The World Health Assembly has in the past three years passed several resolutions on health financing and health worker shortages - yet there has been an overall increase in annual African deaths resulting from lack of sustainable health finance and health worker shortages. The worlds Health Ministers must now move from passing resolutions to effecting resolutions and emergency action to end the deaths of over 8 million Africans a year to preventable, treatable and manageable diseases, caused mainly by maternal mortality, child mortality, HIV/AIDS, TB and malaria.”
In 2001, the Tanzanian government changed their malaria treatment policy from chloroquine (CQ) to sulfadoxine-pyrimethamine (SP) as the first-line drug. How much did this policy change cost? Researchers from the London School of Hygiene and Tropical Medicine, UK, assess the costs and make recommendations for other countries undertaking treatment policy change.
The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism.