The first section explores the role of economics in addressing the HIV/AIDS epidemic. Essays address use of resources, globalisation and HIV and economic evaluations of social interventions. Papers in section two consider the impacts of the disease, especially economic impacts, and consider methods of measuring those impacts. The final part of the document considers how economics can be used to respond to the pandemic, through assessment of resource allocations, economic evaluation and cost effectiveness as well as analysis of trials looking at prevention and treatment options.
Resource allocation and health financing
Not just "women" - better gender analysis for health sector programme support
New approaches to healthcare funding often rely on outdated attitudes to gender. How can donors ensure that gender analysis is effective? Should they move beyond a narrow focus on women as a separate group? Researchers from the UK University of Manchester argue for a new approach to gender in healthcare funding. In many countries, donors are changing the way they finance health programmes. They are moving away from funding individual health projects and now encourage aid for government-managed health sector programmes. This new form of funding requires innovative forms of gender analysis and gender-sensitive interventions in the health sector.
Same difference? Effects of health sector reforms on women’s access to reproductive healthcare
What are the implications for reproductive health of health reforms in low and middle-income countries? The last decade has seen a change in approach from supply-side health sector reforms to an emphasis on demand-driven and anti-poverty interventions. But has this increased access to reproductive healthcare and have services improved as a result? A report from the UK Institute of Development Studies argues that the impacts of health reform depend heavily on the local context in different countries. This includes economic, political, demographic and epidemiological factors. Different strategies are therefore needed to ensure further improvements in reproductive healthcare.
TRACKING EQUITY IN HEALTH IN SOUTHERN AFRICA
The case of the Global Fund
Dr Godfrey Swai, Tanzania Public Health Association.
HIV/AIDS, Tuberculosis and Malaria are diseases of poverty or deprivation. Effective rolling back of the three diseases must also roll back poverty. The intimate link between equity in health and poverty reduction cannot be ignored by the international community and poses the challenge for effectiveness of the Global Fund. The share of the global burden of the three diseases for Sub Sahara Africa is unacceptably high, and increasing, deepening poverty and threatening human survival. This region deserves special consideration under the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).
Further details: /newsletter/id/29249
Activists Criticize Global Fund Director's Statements Regarding Fund's Financial Health
Some activists have already called for the resignation of Richard Feachem, even though he has not yet signed a contract to become the first director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Boston Globe reports. Feachem, the founding director of the Institute for Global Health at the University of California-San Francisco, was named as the fund's first director in April by the fund's board but has come "under fire" from some activists because of comments regarding the amount of money in the fund. According to comments that first appeared in the Memphis Commercial Appeal, Feachem said that the fund had "plenty" of money to get started. Northeastern University law professor Brook Baker and Gorik Ooms, head of Medicins Sans Frontieres in Tanzania, last week in an e-mail demanded that Feachem step down from his prospective position unless he "distanced himself" from his comments. Baker said that Feachem, as the head of the "grotesquely underfunded" fund, should be "a drum major who is marching at the head of the pack and demanding the money" and should not be "making 'nice nice' with politicians in the hope that they will become more forthcoming in the future." Feachem, who could "as early as today" sign a $200,000 annual tax-free contract to become the fund's first director, responded to both Baker and Ooms by e-mail, saying that he "understood ... the activists' frustration" and acknowledging that the fund "needed much more money."
Contraceptive Funding Faces Crisis in Developing Countries
Hopkins Report
The number of contraceptive users in developing countries is expected to surge by more than a third within the next 13 years, reaching 764 million by 2015. Without more funding for contraceptives, many couples will be unable to plan how many children to have and when, or to protect themselves against HIV/AIDS or other sexually transmitted infections, according to a new report from the John Hopkins Bloomberg School of Public Health.
G8 Approves Plan to Increase Development Aid, Offer Help to Battle AIDS
The leaders of the world's major industrial nations have said they would provide about $6 billion in foreign aid -- some of which would be used to fight the spread of HIV/AIDS -- to African countries that meet specific reform criteria, the Los Angeles Times reports. The plan, called the New Partnership for Africa's Development, was proposed at the G8 summit meeting near Calgary, Canada, by leaders from South Africa, Nigeria, Algeria and Senegal and was accepted by the G8 members, including the leaders of Britain, Canada, France, Germany, Italy, Japan, Russia and the United States. The plan requires African countries that wish to receive aid to "demonstrate they are pursuing free market reforms and democracy." Starting in the next four years, the G8 will offer countries that meet such criteria "help in the battle against the AIDS epidemic," in addition to assistance to end civil wars and improve market access for African goods.
Highly Active Antiretroviral Therapy and Tuberculosis Control in Africa: Synergies and Potential
Bulletin of the World Health Organization 2002, 80 (6): 464
WHO, 2002. Anthony D. Harries, Technical Adviser, National Tuberculosis Control Programme, Ministry of Health, Lilongwe, Malawi; Nicola J. Hargreaves, Coordinator, PROTEST Project, National Tuberculosis Control Programme, Lilongwe, Malawi and Lecturer in Tropical Medicine, Liverpool School of Tropical Medicine, Liverpool, England; Rehab Chimzizi, Coordinator, PROTEST Project, National Tuberculosis Control Programme, Lilongwe, Malawi; and Felix M. Salaniponi, Programme Manager, National Tuberculosis Control Programme, Ministry of Health, Lilongwe, Malawi.
A decline in TB is unlikely to occur unless strategies to combat HIV and TB simultaneously are implemented. HIV/AIDS and TB are two of the world?s major pandemics, the brunt of which falls on sub-Saharan Africa. Efforts aimed at controlling HIV/AIDS have largely focused on prevention, little attention having been paid to care. Work on TB control has concentrated on case detection and treatment. HIV infection has complicated the control of tuberculosis. There is unlikely to be a decline in the number of cases of TB unless additional strategies are developed to control both this disease and HIV simultaneously. Such strategies would include active case-finding in situations where TB transmission is high, the provision of a package of care for HIV-related illness, and the application of highly active antiretroviral therapy. The latter is likely to have the greatest impact, but for this therapy to become more accessible in Africa the drugs would have to be made available through international support and a programme structure would have to be developed for its administration. TB programmes could contribute towards the development and implementation of a comprehensive HIV/AIDS management strategy complementing the preventive work already being undertaken by AIDS control programmes. Correspondence should be addressed to Anthony D. Harries, c/o British High Commission, PO Box 30042, Lilongwe 3, Malawi.
Contact: adharries@malawi.net
Reversing development gains - the impact of AIDS in southern Africa
How has AIDS affected development in the world's poorest regions? How can we reduce the devastation caused by the epidemic? The Zimbabwe-based NGO, SAfAIDS, examined the impact of HIV in Southern Africa where the disease affects a quarter of the adult population. The AIDS epidemic is assuming crisis proportions in the region and is reversing advances made against poverty and under-development. As the cost of care for people with AIDS escalates, donors find it difficult to provide adequate funding for support and care efforts. Communities have a critical role to play in looking after the sick.
AFRICA: Africans demand more funds for AIDS research
An HIV/AIDS vaccine offers the best hope of controlling the pandemic in Africa, leading scientists have said at the opening of a two-day meeting of the African AIDS Vaccine Programme (AAVP) in Cape Town, South Africa. HIV/AIDS was a "nightmare" for Africa but the development of a vaccine for the continent was a "dream worth dreaming", Jose Esparaza, coordinator of the World Health Organisation (WHO)/UNAIDS HIV Vaccine Initiative, told about 200 delegates attending the meeting. Two-thirds of all people living with HIV are in Africa, yet African vaccine research received only 1.6 percent of the US $2.5 billion spent on HIV research annually, he said.