In an earlier article, the authors outline some reasons for the disappointingly small effects of primary health care programs and identified two weak links standing between spending and increased health care. The first was the inability to translate public expenditure on health care into real services due to inherent difficulties of monitoring and controlling the behavior of public employees. The second was the "crowding out" of private markets for health care, markets that exist predominantly at the primary health care level. This article presents an approach to public policy in health that comes directly from the literature on public economics. It identifies two characteristic market failures in health. The first is the existence of large externalities in the control of many infectious diseases that are mostly addressed by standard public health interventions. The second is the widespread breakdown of insurance markets that leave people exposed to catastrophic financial losses. Other essential considerations in setting priorities in health are the degree to which policies address poverty and inequality and the practicality of implementing policies given limited administrative capacities. Priorities based on these criteria tend to differ substantially from those commonly prescribed by the international community.
Human Resources
Latest review reveals that voluntary community care can help and prevent SA losing R6bn a year to AIDS. IF SA began a massive home-based care programme for people infected with HIV/AIDS, it could slash hospital costs and relieve a fiscus already losing R6bn a year to AIDS. The losses are recorded in the latest intergovernmental review, while the cost benefits of using Home-Based Care are being proved by a two-year programme, Enhancing Care Initiative (ECI), run by the University of Natal, with the US's Harvard University and the KwaZulu-Natal government.
The emerging crisis of health manpower in Africa could defeat the efforts of governments, private health care providers, NGOs, and donors in controlling the HIV/AIDS epidemic. This was one of the principal findings of a consultative meeting on improving collaboration amongst health professionals, government and other stakeholders on health workers issues, recently held by WHO and the World Bank in Addis Ababa, Ethiopia.
Neil Pakenham-Walsh, Moderator, HIF-net at WHO
Many thanks to all contributors on this subject so far. 22 messages have been posted from 30/1/02 to 15/2/02. Further messages are encouraged through to Friday 8 March, in time for the 'eContent for eDevelopment' workshop in Dar es salaam (11-13 March). After that time, I shall post further summaries and a report of the workshop. Here is a list of contributors and a summary of the discussion so far. All contributors to this discussion (through to Friday 8 March) will be offered a complimentary printed copy of INASP Health Links, a gateway to information for health professionals in developing countries (INASP Health Links will be published in early March 2002).
G. Goldstein, R. Helmer, M. Fingerhut
WHO, African Newsletter on Occupational Health and Safety, Volume 11, December 2001.
Conditions at work, and especially occupational health and safety have improved substantially during the past few decades in many parts of the world. But the overall global situation remains poor. Working conditions for the majority of workers do not meet the minimum standards and guidelines set by the International Labour Organisation (ILO) and the World Health Organization for occupational health, safety and social protection. As an example the majority of the world’s workforce is still not served by competent occupational health services. As a result the global burden of occupational disease and injury remains unacceptably high, on a par with the burden from malaria. Yet occupational health programmes receive only a tiny fraction of the resources devoted to combating malaria.
Zimbabwe's unemployment rate is set to reach an unprecedented 70% in 2002 due to company closures, labour economists said this week. The economic analysts said that it was imminent that failure by the economic stakeholders labour, business and government in creating opportunities to stimulate industrial expansion would lead to increases in unemployment.
What do we know about the impact of AIDS on mortality rates in developing countries? Do existing methods of data collection provide enough information? Researchers from the London School of Hygiene and Tropical Medicine and the UK Medical Research Council look into these questions.
South African companies are missing out on lucrative returns by failing to see that money spent on HIV/Aids is an investment, rather than a cost, according to a new study into major Southern African companies.
According to a report in the UN's IRIN (Integrated Regional Information Network) humanitarian information unit, Capital Alliance, an insurance company, has produced South Africa's first insurance product that allows employers to take out insurance against the risk of their employees contracting HIV/AIDS.
African truck drivers have long been implicated in the spread of HIV. They stop at towns along major routes to eat, sleep, sell goods and have sex. Intermediaries are often involved in negotiations between drivers and commercial sex workers (CSWs). Could these middlemen contribute to HIV prevention efforts?