Resource allocation and health financing


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.

Mobilizing billions to fight AIDS in Africa: the way forward
Presentation to Conference of African Ministers of Finance Algiers, Algeria, 8 to 10 May 2001

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.

Further details: /newsletter/id/28643
Sanctions and Civil Conflict

Gershenson, Dmitriy, International Monetary Fund, IMF Institute Working Paper WP/01/66, May 2001
Using a general equilibrium framework, this paper analyses how sanctions imposed on the contestants in civil conflict affect the welfare of these contestants and the allocation of resources to conflict. It is shown that weak sanctions can hurt the contestants they are supposed to help, while strong sanctions augment the expected welfare of their intended beneficiaries. Moreover, sanctions are more likely to be sucessful if the contestant who is subject to sanctions can expect to derive a positive income in case of compliance. The likehood of success rises as this income increases.

Antenatal care reborn? Healthcare for pregnant women in developing countries

Antenatal care is important for identifying and responding to risk factors in pregnancy. But do mothers in the developing world receive adequate and appropriate antenatal care? Researchers from the Population Council and the UK University of Southampton investigated antenatal services in Kenya.

Social, Cultural and Environmental Contexts and the Measurement of the Burden of Disease

Daniel D. Reidpath, Pascale Allotey, Aka Kouame, Robert A. Cummins March 2001. Funding Agencies: Global Forum for Health Research, The University of Melbourne (MRCEG Scheme).
Internationally, there is growing commitment to health policies and programs that are "evidence-based": that is, that they derive from a body of research that has been proven true, effective or successful. In establishing an evidence-base, there is a continued concern with replicability of research, with the robustness of findings across time and place, and in the absence of replication, with an explanation for the lack of fit. In this endeavour, considerable attention has been paid to common tools, common protocols and consistent, shared measures – validated questionnaires, common tools to assess physical and mental health and summary indices for quality of life, health inputs and health outcomes. This concern for comparability in public health matches a concern by economists and health planners, locally, nationally and internationally, to rationalise, to set priorities and goals, to allocate funds on the objective basis of need and impact, and to direct resources where the outcome will be most effective.

Further details: /newsletter/id/28616
Beyond Our Means? The Cost of Treating HIV/AIDS in the Developing World

Millions of people in the developing world are in urgent need of the antiretroviral drugs that suppress HIV and indefinitely postpone symptoms of AIDS. But the majority live in the world's poorest countries and cannot afford the cost of these drugs, medical tests, and consultations. The price of these antiretrovirals is not the only factor preventing treatment for AIDS reaching those who need them. In many countries, health care systems are weak, with far too few doctors, nurses, and medical facilities. This report provides an overview of the issues surrounding HIV in the developing world.

Why rank countries by health performance?

In 1978, from a little-known region of what was then the USSR, emerged a WHO/UNICEF statement of intent with the slogan "Health for all by the year 2000". That year has passed, leaving the Alma-Ata declaration largely unfulfilled. Indeed in some parts of the world the situation has worsened, and not just because of AIDS and civil unrest. Yet the failure of Alma-Ata is often viewed positively: the declaration was never meant to be taken literally as a target that everyone would be healthy by last year, and it is argued, reasonably, that the slogan has kept the issue of primary care to the forefront of the debate in WHO and other United Nations agencies. But this is a card--labelling a failure a success because the matter was worth raising--that must be played sparingly. As this week's Lancet shows (pp 1671,1685), The world health report 2000, published a year ago, continues to attract critical attention. Does it matter that the criticisms are serious provided the underlying objective, which is the use of national performance indices to improve health in all countries, is worthy, as it clearly is? If WHO is to become a science-led global policy body, the answer has to be Yes.