The economic benefits of better access to clean water outweigh the extra investment necessary eight-fold by creating a healthier workforce, the World Health Organisation said in a report. An additional investment of around 11.3 billion dollars (9.5 billion euros) per year on top of the money already being spent on improving basic sanitation facilities could generate a total economic benefit of 84 billion dollars annually, the report said. Such an investment would reduce the global occurrence of diarrhoea by an average of 10 percent, according to the study by the Swiss Tropical Institute, which was commissioned by the WHO.
Resource allocation and health financing
Extra spending on clean water promises eight-fold economic benefits, says WHO
Global funding for HIV/AIDS in resource poor settings
This fact sheet analyses current trends in the global funding of HIV/AIDS. It argues that funding to address the epidemic (provided by major donor governments, multilateral organisations, affected countries, and the private sector) has only recently increased to significant levels, but it is still less than estimated need. Actual spending is typically less than budgeted funding, and in 2003 both were well below the estimated need of $6.3 billion. Some key findings included the fact that budgeted funding for HIV/AIDS in 2003 totalled $4.2 billion while actual spending in 2003 totalled about $3.6 billion. In addition, donor governments provide 61% of budgeted funding to address HIV/AIDS in resource poor settings utilising bilateral and multilateral channels.
Tuberculosis control needs strong national health services
The lack of health care resources is the most obvious barrier for developing countries to reach TB control targets. However, there is a strong association between poverty and TB, say researchers from Belgium's Institute of Tropical Medicine. The number of tuberculosis cases continues to rise worldwide and only a minority of people has access to high quality tuberculosis services. Tuberculosis control cannot reach its targets without investing in an adequate network of accessible, effective and comprehensive health services, say the researchers. However, only a small proportion of all TB patients in the world are detected and many are diagnosed and treated late. The researchers identify many problems in the way in which care and support are delivered. These include insufficient and rundown health facilities, lack of trained and motivated staff, shortages of drugs and medical supplies, poor supervision of health personnel and difficult communication and transport. In many regions, the private health sector is growing rapidly while the regulatory system remains poor.
Meeting the backlog in providing basic services in South Africa
This paper by the Southern African Regional Poverty Network examines the backlog in the delivery of water and electricity services for the rural population in South Africa. It argues that considerable additional resources to those currently assigned by the government are needed to make these services available to the rural poor. The paper identifies the backlogs in the water and electricity sectors, their location, and the additional investment needed to meet backlogs. It says that the backlog in electricity has proved stubborn: although it was predicted that at the end of the year 2000 about 2,75 million households would be without electricity, the total in that year was 3,65m. In 1994 the backlog in water delivery was some 12m people - now it has been calculated at 10,554,306.
Predicting the Impact of Antiretrovirals in Resource-Poor Settings
The authors use mathematical models to predict the potential impact that low to moderate usage rates of antiretroviral (ARV) therapy might have in developing countries. They also review the current state of HIV/AIDS treatment programs in resource-poor settings and identify the essential elements of a successful treatment project, noting that one key element is integration with a strong prevention program. They apply program experience from Haiti and Brazil and the insights gleaned from their modelling to address the emerging debate regarding the increased availability of ARVs in developing countries.
Producing national health accounts: A guide for low income countries
National health accounts are designed to answer precise questions about a country's health system. They provide a systematic compilation and display of health expenditure. They can trace how much is being spent, where it is being spent, what it is being spent on and for whom, how that has changed over time, and how that compares to spending in countries facing similar conditions. They are an essential part of assessing the success of a health system and of identifying opportunities for improvement. This Guide to producing national health accounts from the World Health Organisation, with special applications for low-income and middle- income countries, provides practical help in developing this socio-economic information.
Financing HIV/AIDS in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe
The gravity of the HIV/AIDS situation in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe calls for prioritisation, protection and targeting of HIV/AIDS spending, says a comparative study by the Human Sciences Research Council (HSRC), South Africa that assesses the readiness and ability of six African countries to respond to the HIV/AIDS epidemic. The study says revenue neutral efforts have not been very successful and that it will be important for all these countries to share lessons and experiences before and after they embark on the Global Fund process. Furthermore, the ability to absorb the vastly increased resources will be a critical determinant of whether these resources are translated into increased outputs and ultimately increased outcomes.
Generalized cost-effectiveness analysis for national-level priority-setting
Cost Effectiveness and Resource Allocation 2003, 1:8 (19 Dec 2003)
Cost-effectiveness analysis (CEA) is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. However, health policy-makers and programme managers can use results as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.
PUBLIC HEALTH APPROACHES TO EXPAND ANTIRETROVIRAL TREATMENT
The objective of this paper is to review experiences of ARV programmes already under way in countries with very big HIV epidemics but severely constrained resources, as in most of Africa and part of the Caribbean. Its aim is to show how some of the key policy issues for scaling up HIV/AIDS treatment have been dealt with and to identify common elements that should be considered by all who seek to provide HIV/AIDS care on a significant scale. The paper demonstrates that ARV programmes now under way in developing countries have successfully capitalised on existing resources and infrastructure through the use of standardised treatment regimens, simplified monitoring procedures and making use of available human resources, including communities and family members.
Decentralization in Zambia: Resource Allocation and District Performance
This article examines quality of services following decentralization to districts in Zambia, and an analysis of data assessing allocation choices, as well as some indicators of the performance of the health systems under decentralization. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. Findings suggest that decentralization may not have had either a positive or negative impact on services.