Warren Buffett’s donation in early July of $31 billion to the Bill and Melinda Gates Foundation has fed many hopes and expectations. How are we to regard the creation by these extremely rich families of the world’s largest foundation, with resources of over $62 billion at their disposal? On one level, their philanthropy must of course be warmly welcomed. [Yet] this display of unprecedented generosity raises some serious questions about the way we think nowadays about issues such as altruism versus public action, and charity versus human rights. First, private altruism by the rich does not get governments off the hook. Second, in any case, for the poorest countries and the poorest people in any country, escaping poverty is not a matter for charity and altruism. It is an issue of social justice.
Resource allocation and health financing
Health campaigners and activists led by 2004 Nobel Laureate Prof Wangari Mathai have petitioned the African Union member states for failing to honour their 15 per cent pledge of their annual budgets on health care. This fact became public knowledge as the World Social Forum (WSF) entered the third day. The petition comes ahead of the forthcoming AU Heads of State and Government summit in Addis Ababa. The petition by South African Nobel Laureate Arch Bishop Desmond Tutu, but signed on his behalf by Prof Mathai calls for Africa leaders to act fast and implement their pledges in a bid to reverse the ugly trends of treatable diseases in 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.
The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 11th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. Objectives We reviewed the literature on incorporating considerations of cost-effectiveness, affordability and resource implications in guidelines and recommendations.
Given the size of the HIV epidemic in South Africa and other developing countries, scaling up antiretroviral treatment (ART) represents one of the key public health challenges of the next decade. Appropriate priority setting and budgeting can be assisted by economic data on the costs and cost-effectiveness of ART. The objectives of this research were therefore to estimate HIV healthcare utilisation, the unit costs of HIV services and the cost per life year (LY) and quality adjusted life year (QALY) gained of HIV treatment interventions from a provider's perspective. This article presents baseline cost-effectiveness data from one of the longest running public healthcare antiretroviral treatment programmes in Africa that could assist in enhancing efficient resource allocation and equitable access to HIV treatment.
This study exploits the opportunities created by a pilot study of micro health insurance with capitation in Rwanda to address this issue. Using cross-sectional data collected in 52 health centres, the paper employs an econometric cost function with payer-specific outputs to assess the cost impact of two provider payment mechanisms: (1) user fees for care paid by the uninsured, and (2) capitation payment paid by informal insurance schemes for the insured. Findings point to significant differences in cost between the two payment forms. For both payment types there are important short-run economies of scale, which could be exploited through more intensive use of idle resources in health centres.
This article argues that the suspension of funding to Uganda from the Global Fund could have been avoided. The article outlines how the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) suspended five grants to Uganda following an audit report that exposed gross mismanagement in the Project Management Unit. The authors argue that this could have been avoided if a legitimate and fair decision-making process was used and that this lesson should be applied to other countries.
South Africa’s apartheid health system was grossly ineffective. Private and public health spending combined was among the highest in the world at 8.4% of GDP, yet inequalities in provision, poor efficiency of spending and other factors impacting on health status meant that the country was not among the top 60 in terms of health status indicators (Goudge, 1999). In an attempt to remove obstacles to access to health services, the government introduced free primary health care in 1996. The paper attempts to gauge the impact of these changes. The focus falls on changes in the incidence of South African public health spending.
South Africa's Department of Health confirmed on Thursday that a new social grant system was on the cards for chronically ill people, including those living with HIV/AIDS. At present, government policy stipulates that HIV positive grant recipients be deregistered once antiretroviral (ARV) treatment restores them to good health and they are able to start seeking work. However, local AIDS activists charged that with national unemployment estimated at around 35 percent, most beneficiaries were usually jobless and too ill to work before they started receiving the monthly stipend. The article describes these issues raised.
Recently, there has been an increasing focus on social health protection through health insurance as a potentially promising way to better deal with health risks in developing countries. However, the empirical basis for a profound analysis of the effects of health insurance is still very weak. This paper summarises the results of three individual research projects measuring the impact of membership in a health insurance scheme in three African countries: Kenya, Senegal and South Africa.