Africa has a right to demand support from the international community in its fight against AIDS, tuberculosis, malaria and other diseases, Professor Jeffrey Sachs, executive director of the Earth Institute at Columbia University, told a meeting of African heads of state in Maputo, Mozambique in July. Professor Sachs said that only a very small fraction of the more than $10bn (£6.2bn; €8.8bn) needed each year to effectively combat these illnesses had yet been allocated to African countries.
Resource allocation and health financing
Africa has a right to support from international community in its fight against HIV/AIDS, malaria, and tuberculosis
Economists tell scientists AIDS drug projects can be scaled up
Economists said at the international AIDS conference on HIV pathogenesis and treatment in Paris on July 14 that nations with a high HIV/AIDS burden should spend more of their resources on antiretrovirals, a move which directly contradicts current medical opinion. The medical community has said that handing out antiretrovirals would be a waste of resources; could worsen drug resistance; and instead it urged preventative measures. Three pilot studies presented at the meeting from the Ivory Coast, Senegal, and Uganda--funded by UNAIDS--found that with a little help to set up medical infrastructure, drugs can be delivered, even to remote areas, without increasing drug resistance. (Access requires registration.)
Programme costs in the economic evaluation of health interventions
Estimating the costs of health interventions is important to policy-makers for a number of reasons including the fact that the results can be used as a component in the assessment and improvement of their health system performance. Costs can, for example, be used to assess if scarce resources are being used efficiently or whether there is scope to reallocate them in a way that would lead to improvements in population health. As part of its WHO-CHOICE project, WHO has been developing a database on the overall costs of health interventions in different parts of the world as an input to discussions about priority setting.
A Disease-based Comparison of Health Systems: What is best and at what cost?
Health system performance is a function of how effective the health system's approach to treating diseases is in improving health outcomes and reducing resource costs, according to a document from the Organisation for Economic Cooperation and Development (OECD). In an era when health systems account for increasing sums of money aiming to provide their citizens with the best healthcare possible, surprisingly little is known about how effective much of this spending is. Health policy makers have extensive information available to them on how much is spent on healthcare at an aggregate level. But their knowledge of what, in terms of health outcomes, they receive in return for this spending remains very limited, the document says.
Access to antiretroviral therapy in resource-poor settings
Of the 40 million people that are infected with HIV globally, approximately 95% live in severely resource-constrained settings. From a humanitarian perspective alone, not bringing antiretroviral therapy to those in need implies accepting a number of casualties that is difficult to imagine and impossible to accept. But there is another important argument to take up the challenge: HIV/AIDS mainly affects adults in their productive prime, leaving the very young and old to cope alone. This severely hampers economic growth and development of countries concerned. There is little doubt that poverty facilitates the spread of HIV/AIDS, but conversely HIV/AIDS perpetuates poverty. Generalizing HIV/AIDS into a problem of poverty will paralyze an effective and specific response to it, and conflicts with the "art of the soluble" principle that we should adhere to.
ACCESS TO HIV PREVENTION: CLOSING THE GAP
This report authored by the Global HIV Prevention Working Group assesses the shortfall in access to HIV prevention services worldwide, detailing the specific shortfall in the regions of Sub-Saharan Africa, Asia and the Pacific, Eastern Europe and Central Asia, and North Africa and the Middle East. It discusses regional prevention priorities for each and identifies funding gaps. The document calls for the scale up of treatment and care programs, in coordination with prevention work. The authors finally call on political leaders, both nationally and in donor countries, to increase their commitment to effective prevention programmes.
Resource Management and Cost Containment
Health care for all does not always mean increased health expenditure. This article looks at various strategies that may be employed to save costs and maximise resources. Health policy reforms alone have not been successful in containing health care cost. While lack of money is often a governing constraint, it does not mean that progress is not possible without the injection of money into the system. It is necessary to identify areas of wastage, inappropriate spending and strategies to contain health care cost while improving quality of health care provision. It makes sense to start by spending money on cost-effective interventions that save a lot of lives. A recent experiment in Tanzania illustrates the impact of rational spending. Researchers were sent to the rural districts of Morogoro and Rufiji. They carried out a door-to-door survey asking whether anyone had died or been laid low recently, and if so, with what symptoms. They found that the amount of money local authorities spent on each disease had no relation whatsoever to the harm it inflicted on local people.
Trace amounts? Assessing hospital costs in Zimbabwe
Hospital costs are difficult to measure when there is limited or poor quality data. Current accounting methods may miss key aspects of inefficiency. Researchers from the London School of Hygiene and Tropical Medicine find that using ‘tracer’ illnesses is a more effective way to assess costs in Zimbabwe’s hospitals. Crude methods of hospital costing do not consider case mix or severity – both vital to understanding cost structures and differences between hospitals. They may miss unnecessary costs that stem from wasted staff time, over-prescription of drugs, needless diagnostic tests, inappropriate length of stay and other redundant activities. Using the tracer approach may resolve some of these problems.
Global plagues and the Global Fund: Challenges in the fight against HIV, TB and malaria
Although a grossly disproportionate burden of disease from HIV/AIDS, TB and malaria remains in the Global South, these infectious diseases have finally risen to the top of the international agenda in recent years. Ideal strategies for combating these diseases must balance the advantages and disadvantages of 'vertical' disease control programs and 'horizontal' capacity-building approaches. Nevertheless, it is clear that significant structural changes are required in such domains as global spending priorities, debt relief, trade policy, and corporate responsibility. HIV/AIDS, tuberculosis and malaria are global problems borne of gross socio-economic inequality, and their solutions require correspondingly geopolitical solutions.
LARGE GAP BETWEEN HIV PREVENTION NEEDS AND CURRENT EFFORTS, SAYS NEW REPORT
Fewer than one in five people at risk of HIV infection today have access to prevention programs, and annual global spending on prevention falls $3.8 billion short of what will be needed by 2005, according to a new report released by the Global HIV Prevention Working Group. The report, Access to HIV Prevention: Closing the Gap, is the first-ever analysis of the gap between HIV prevention needs and current efforts, and provides recommendations for expanding access to information and services that could help save lives and reverse the global epidemic.