Leon DA, Walt G, eds. New York, NY: Oxford University Press, 2001.
The editors identify four themes: health consequences of social and economic change; conceptual issues associated with health and wealth, including the role of health services; emerging and neglected priorities, e.g., the significance of mental illness and injuries; and evidence for policy and interventions. The role of the health care system is considered to be a central issue. The editors argue that access to health care is typically viewed as being more likely to affect health differences in developing than in developed nations, where, relatively speaking, access is more readily available. In contrast, in the developed world, health disparities, they argue, are more likely to be viewed as being due to differences in lifestyle and environmental exposures. Later, they acknowledge that health disparities, in fact, are due to the independent and joint effects of access to health care, as well as to other factors, including lifestyle and the effects of the physical environment.
Resource allocation and health financing
David M. Dror, International Labour Organization (ILO) Bulletin of the World Health Organization, July 2001, 79: 672–678.
Deficient financing of health services in low-income countries and the absence of universal insurance coverage leaves most of the informal sector in medical indigence, because people cannot assume the financial consequences of illness. The role of communities in solving this problem has been recognized, and many initiatives are under way. However, community financing is rarely structured as health insurance. Communities that pool risks (or offer insurance) have been described as micro-insurance units. The sources of their financial instability and the options for stabilization are explained. Field data from Uganda and the Philippines, as well as simulated situations, are used to examine the arguments. The article focuses on risk transfer from micro-insurance units to reinsurance. The main insight of the study is that when the financial results of micro-insurance units can be estimated, they can enter reinsurance treaties and be stabilized from the first year. The second insight is that the reinsurance pool may require several years of operation before reaching cost neutrality.
Harvey Whiteford, M. Teeson, R. Scheurer, Dean Jamison. CMH Working Paper No. WG1 : 12, July 2001 Commission on Macroeconomics and Health, WHO
Mental Disorders are found in all cultures, are prevalent, cause considerable disability and rank high on the league table of world disease burden. By extension, they constitute a significant economic burden in all countries. Better understanding the extent of this economic burden and the development of frameworks to deliver cost effective interventions will provide a basis for programs which not only reduce the disability associated with these disorders but also promote human development and economic productivity. International agencies such as the World Health Organisation are intensifying their focus on mental illness with the World Health Report 2001 dedicated to mental health. The World Bank has identified neuropsychiatric disorders as an important emerging public health problem for developing market economies.
Public discussions on combating HIV in Africa seem to be focusing on antiretroviral drugs rather than condoms, which are the mainstay of prevention. In sub-Saharan Africa most condoms are bought with funds from donors, although a few countries (such as South Africa and Botswana) buy them from national funds. We assessed provision of condoms in these countries.
The Nigerian government has drafted a plan for a national health insurance program that would eventually provide coverage for "all Nigerians," but certain individuals with "[h]igh-cost illnesses" such as HIV/AIDS would not be eligible to join, the Lancet reports.
How can health services meet the needs of children with communication disorders in developing countries? What can health professionals and parents add to the debate? A study by the UK Institute of Child Health sought the opinions of specialist professionals and parents of children with communication disorders in Nigeria.
Do rural and urban mothers differ in their choice of health providers when their children are ill? How does proximity to different health facilities affect a mother's decision? These questions are important for health planners responding to rising urban poverty and ill health, as sub-Saharan Africa has the highest rates of urbanisation in the developing world.
Thousands of desperately ill migrant mine workers in the Eastern Cape may be eligible for large sums of money in compensation. However, a concerted drive by health and community workers is needed to find the workers, and to assist them in claiming the money due to them. This is the recommendation of a team of scientists following a research project involving the migrant mine workers of Libode in the former Transkei.
The National Education, Health and Allied Workers Union (Nehawu) on Tuesday urged government to launch a wide-ranging and transparent probe into the South African National Tuberculosis Association (Santa). It was reacting to the government's decision on Monday to suspend Santa's R6,6-million subsidy and to undertake a forensic audit of the organisation. "We call on government to have a comprehensive and transparent investigation into how Santa uses money, quality of patient care, adherence to clinical protocols, quality of food given to clients, and all other related matters," the union said in a statement.
A sustained campaign on a vast scale, building on pockets of success, is needed to reverse the destructive tide of HIV/AIDS in Africa. Such a campaign would include a broad range of actions to prevent new infections, care for the infected, and mitigate the negative impacts of the pandemic – all underpinned by expressions of the highest political will and by the commitment of substantial sums of money. This short paper outlines the case for billions of dollars for AIDS in Africa, puts forward a bold but achievable financing plan for mobilizing resources on such a scale, and points to a number of the actions that need to be taken today to implement large-scale resource mobilization for the fight against AIDS.