Antoinette Ntuli, Health systems Trust South Africa, Co-ordinator EQUINET HRH theme network
After decades of neglect, Human Resources for Health (HRH) has in the past few years moved to centre stage of both international and regional debates. Within southern Africa health personnel continue to be scarce in services where they are most needed, are a critical bottleneck to the uptake of new resources from global funds and the region is suffering from escalating out migration of health workers.
Dealing with this impact of the migration of health personnel raises debates about effective and just strategies. Those that restrict health worker rights of movement often don’t work and punish individuals. ‘Ethical human resource’ policies and codes appear to have made little difference to practice on the ground, especially when movement is driven by pull and push factors in both sending and receiving countries. So what comprehensive measures will secure the human resources that southern Africa needs for its health services?
EQUINET is addressing this through a network of institutions from government and non government sectors in southern Africa and working with institutional hubs in Canada, Australia and the UK (given their role as countries absorbing significant numbers of the regions health workers). The network aims to collaborate on research and use the evidence to harmonise policy engagement and advocacy.
At a meeting in April this year the network of researchers developed the analytical framework to guide this work. This framework takes the policy interest of the country planners and authorities in the region as the starting point, and includes four major components:
1. Equitable human resource policies- what will encourage health workers to work in areas of greatest need? This work is looking at what positively and negatively affects the internal distribution of health personnel, including both traditional and allopathic practitioners. In Zimbabwe, Oliver Mudyarabikwa at the UZ Medical School is identifying the factors that cause a maldistribution of public sector health workers. Yoswa Dambisya of the University of the North in South Africa is following up on the distribution of pharmacists who trained at the University of the North, to understand what drives their choices of both sector and location of work. Steve Reid of the University of KwaZulu-Natal in South Africa is exploring what educational factors influence the choice of rural or urban sites of practice of health professionals.
2. Ethical Human Resource Policies- how to respond to international migration of health workers?. Given the work already taking place on codes of practice, and reasons for health workers leaving EQUINET is focusing its work on identifying “what makes health personnel stay”. If the retention factors are known then ethical policies in other countries should reinforce and not undermine these factors and should contribute resources towards their achievement. Scholastika Lipinge of the University of Namibia is exploring how health professionals perceive their conditions of service, and the extent to which this acts as a factor keeping them in the country and the public sector. In Malawi, Adamson Muula from the College of Medicine in the University of Malawi is exploring the coping mechanisms of health workers who stay in the Malawi health sector to identify possible strategies to support these mechanisms and reinforce health worker retention.
3. How are the HIV and AIDS epidemic and the resources for AIDS affecting the distribution of health personnel? The network has built links through its work on HIV and AIDS and its networks with Municipal Services Unions to understand the impact of HIV and AIDS on health workers, and to explore how new resources for treatment are being used in relation to improving (or undermining) the availability, conditions and retention factors of health workers, especially within district health systems.
4. What can we learn as a region and where do we need to act regionally? Country level evidence will be shared regionally, recognising the gain for exchange of experience, policies and interventions across countries in the region. This is also a regional issue, both in terms of the flow of health personnel across national boundaries and the need for a regional policy response to international factors. Common evidence from all countries in the region, and more detailed evidence from Swaziland, Botswana, Namibia, South Africa, Zimbabwe and Malawi will be used to build a more detailed regional picture of the distribution and flows of personnel and the factors affecting this. We will also carry out in early 2005 an analysis of the policy environment, in terms of the priorities, actors and forces in this area and the options this raises for national and regional authorities.
EQUINET and HST are aware of the significant volume of work taking place in different institutions and countries on this issue. We have a database on human resources for health on our website at www.equinetafrica.org through which we hope to share materials and information that we access and encourage people to use and contribute to it.
When the African Ministers of Health raised issues of health personnel migration at the 2004 World Health Assembly they were profiling a situation that calls for policy recognition, such as through protocols and codes, but also for wider strategies and interventions. Those strategies should as first call reinforce the health workers who stay in the system, particularly those who work at primary care and district level, and strengthen the environments that encourage health workers to do this.
* EQUINET briefings are edited by R Loewenson, EQUINET secretariat, Training and Research Support Centre. Please send feedback or queries on the issues raised in this briefing to the secretariat email admin@equinetafrica.org . Reports cited are available as a downloadable pdf file from our website at www.equinetafrica.org
1. Editorial
The World Health Organization (WHO) recently released the first set of comprehensive data comparing the prevalence of HIV/AIDS in poor countries with the rates of antiretroviral (anti-HIV) drug access in those nations. The data are striking and disheartening, yet have received little press coverage. Indeed, at the time of their release, some American newspapers ran editorials indicating that antiretroviral access has received "too much attention".
Two problems are implicit in such a contention. The first is political. AIDS is very much a symptom - albeit the most extreme symptom - of the large diseases of inequality and poverty that result not only in HIV, but also in hunger, hemorrhagic fever and housing problems. The same credit and political obstacles that have led to gender discrimination in housing and employment have led women into prostitution and relationships based on sexual dominance [1, 2]. The same structural adjustment programs and neoliberal economic policies that have crashed farming sectors and forced thousands into migration are the same policies that have led migrants to the barracks of minefields to live with depression, alcoholism and the subsequent solicitation of prostitutes [3-5]. And so to address AIDS appropriately would be to appreciate that it does not simply receive "too much attention", but that the attention it receives should be drawn towards its base - and this includes the inequalities in healthcare access that are symbolized by antiretroviral access disputes.
The second problem with the new popular line of thought on antiretrovirals is a statistical problem. The recently-released WHO data are striking but perhaps not surprising. If "too much attention" has been focused on drug access, then why are only six-tenths of a percent of the 1.6 million infected people in Tanzania able to access antiretroviral medications? Why are only 1.5% of the 2.4 million in Mozambique and the Congo able to gain such access? In a country like Zimbabwe, where one of every four adults is infected, only one of every fifth can access an antiretroviral medication. As one scrolls through the WHO's data, the numbers of infected persons continue to be expressed in seven digits, while the percent of those gaining access to antiretrovirals continues into smaller and smaller decimal ranges.
* Please click on the link to read the full article.
EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN SOUTHERN AFRICA (EQUINET) http://www.equinetafrica.org/ EQUINET NEWS is a newsletter designed to keep you informed about materials on the Internet on equity and health in southern Africa, focusing primarily on EQUINET's principal themes. The newsletter also includes news about Equinet activities, policy debates or theme work to keep you updated on work taking place. Further information on the materials in these briefings is available from TARSC (email: admin@equinetafrica.org).
2. Latest Equinet Updates
This call invites applicants to participate in and present work at the EQUINET regional meeting on participation and Governance in Health being held in co-operation with Centre for Health and Social Science Research (CHESSORE) Zambia and Training and Research Support Centre (TARSC) Zimbabwe in Lusaka, Zambia, January 26-28 2004.
The call:
EQUINET invites researchers and practitioners working on community participation and governance in health to participate in a regional meeting to
- Discuss and exchange evidence and experience on the impacts of community participation and joint community- health service structures on the performance of health systems
- Identify areas for follow up research, training and policy review to strengthen mechanisms for effective community involvement in health systems and for increased responsiveness of health services to community priorities and needs.
We invite interested organisations and individuals to submit an application to participate with information on their work and role in this area (see below). Applicants can also apply for EQUINET sponsorship to the meeting (see below). Applications need to be sent to the EQUINET secretariat by December 5 2004.
The programme:
The Regional Network on Equity and Health in Southern Africa (EQUINET) (www.equinetafrica.org) has noted that equity related work needs to define and build a more active role for important stakeholders in health, and to incorporate the power and ability people (and social groups) have to make choices over health inputs and their capacity to use these choices towards health. To do this requires a clearer analysis of the social dimensions of health and their role in health equity, i.e. the role of social networking and exclusion, of the forms and levels of participation and of how governance systems distribute power and authority over the resources needed for health. To understand these factors, EQUINET has been carrying out research work to evaluate the current and desired forms of participation within health systems in Zambia, Zimbabwe and Tanzania amongst other Southern African countries. This work has been co-ordinated by CHESSORE Zambia and TARSC Zimbabwe.
The multicountry programme explored the functioning of district and clinic level structures (neighbourhood and health centre committees and district health boards) for community participation in terms of whether they
i. represent the interests of communities
ii. have any role in health system performance and resource allocation
iii. include community preferences in health planning and resource allocation
iv. improve equity in resource allocation
v. improve health system performance, especially in relation to equity
The field studies and literature review in this programme explored outcomes in these areas, and how these outcomes were influenced by the functioning of these joint community- health service structures and deeper underlying determinants, including their legal status, authority and mandate.
The regional meeting:
The EQUINET/ CHESSORE/ TARSC regional meeting will be held in Lusaka, Zambia 26-28 January 2005 and will review the results of the multicountry programme and of other experiences in the region of joint health service and community structures for community participation in health, particularly in terms of their effectiveness representing community interests, and in improving the equity, relevance and quality of health systems. The meeting aims to share experience over a 3 day period from individuals and organisations working in east and southern Africa, and to use this to identify a follow-up programme of training, research and policy review in the region. EQUINET also propose to produce a book on participation, governance, equity and health in 2005 and will invite submissions from presentations to the regional meeting.
Call for participation and applications:
Interested applicants should submit a 1-2 page ‘expression of interest’ that outlines
- a title that summarises their work in this area
- an abstract of the research question, methods and key findings in this area OR a summary of the work they are doing in this area, that they would want to present at the meeting
- a personal CV,
- brief information on the institution that they work in, and
- a sample document written by the applicant on any relevant theme.
- An indication of whether they are self sponsored or whether they need sponsorship for travel, or accommodation,. or both
Applicants should submit this information by 5th December 2004 to the EQUINET secretariat admin@equinetafrica.org / Fax 263-4-737 220 and copy it to rene@tarsc.org and chessore@zamnet.zm
Applicants will be informed by 17th December 2004 on the outcome of their submission, including sponsorship and of the logistic details for the meeting. Participants of existing EQUINET programmes are welcome to apply.
Focal points for queries on this programme are Dr TJ Ngulube at the Centre for Health and Social Science Research Zambia and Dr R Loewenson (TARSC). Please send queries through admin@equinetafrica.org)
This call invites applicants for the second round of student research grants.
The Regional Network for Equity in Health in Southern Africa (EQUINET) promotes policies for equity in health across a range of priority theme areas (See www.equinetafrica.org) EQUINET has over the years, organized its work in various theme areas, including: economic and trade policy and health; human rights, governance and participation, equity in health sector responses to HIV/AIDS, human resources for health; monitoring and surveillance and others. Within these areas of work EQUINET aims to identify, recruit and build capacity and analysis. EQUINET is now implementing a programme of student research support that provides small research grants for students at college or university in various programmes in east and southern Africa. The programme will support student research applicants who propose projects in areas of research relevant to EQUINETs priority areas of theme work, and who provide evidence of supervision from expertise in these areas.
This second round of the EQUINET student research grant programme (SRGP) is being implemented in November 2004. EQUINET will award a number of small grants to post graduate students and undergraduate students in East and Southern Africa for research proposals in the areas of
- Equity in Human Resources for Health
- Equity issues in food security and nutrition
- Equity in health sector responses to HIV/AIDS and treatment access
- Using health rights as a tool for equity in health
- Health equity in economic and trade policies
- Fair financing in health
- Governance and community participation in health
- Understanding and analyzing policy processes
The grants are for students to carry out supervised, small research projects in the course of their studies and are set at a maximum of $750. Applicants are requested to provide brief information in 2-3 pages on
- The name, institution, course and year of study of the student
- The name, department and institution and contact email/fax for the proposed supervisor for the study
- The theme area of the proposal
- The hypothesis, research question or research objective(s)
- The methods to be used, and indicators / (quantitative, qualitative information) to be collected and the intended analyses to be carried out
- The time frames and budget
The application should be supported by a letter of commitment from a supervisor who is a professional working in the relevant area of the study in an institution in east and southern Africa. Preference will be given to supervisors who have worked in EQUINET programmes and activities so this should be made note of in the letter. The grants will be open to all EQUINET members, undergraduate and postgraduate students, students from all disciplines. Applications should be submitted to admin@equinetafrica.org with STUDENT GRANTS in the subject line or by fax to 263-4-737220 by November 31 2004.
The selection of grants will be made on the basis of relevance of subject area and quality of proposal but with some attention to ensuring equity in the distribution of grants across countries in the region. Applications in French or Portuguese will be considered.
EQUINET web based resources, newsletter and expertise in the theme areas will be available to the students. The reports of the research projects will be made available on the EQUINET website. Publication from the research is encouraged, with acknowledgement of the support from EQUINET. EQUINET will also have the right to use the research in its theme work and will encourage the students participation in future EQUINET activities and information exchange.
Focal points for queries on this programme are Dr R Loewenson and G Musuka at the EQUINET Secretariat (TARSC) and Dr A Muula at the Malawi College of Medicine/ Malawi Health Equity Network. Please send queries through admin@equinetafrica.org)
The EQUINET June conference resolutions Reclaiming the State:Advancing Peoples Health, challenging Injustice are now available in Swahili, French, Portuguese and English.
In October 2004, EQUINET and the Equi-TB programme Malawi hosted a regional meeting in Lilongwe Malawi to review options for monitoring equity and health systems issues in the current programmes to expand treatment access in the region. The meeting gathered government, academic, civil society, international and UN agencies and regional organisations from the SADC region. It aimed to propose a framework and follow up work to strengthen the monitoring of equity and health system issues in ART rollout at national and regional level. The meeting proposed that existing monitoring integrate key policy issues, three core indicators and thirteen shortlist indicators at local, national, regional and global level to track priority health systems and equity concerns.
3. Equity in Health
The third meeting of the African Reproductive Health Task Force was opened in Harare, Zimbabwe, with a call on African countries and the international community at large to allocate more resources to reproductive health programmes with a view to stemming the tide of maternal and child deaths. "African health policies, including global health policies, have for a long time overlooked the need to allocate adequate resources to reproductive health programmes…and this has contributed to the massive numbers of maternal and newborn deaths", Zimbabwe's Minister of Health and Child Welfare, Dr David Parirenyatwa, told the meeting.
Health systems are consistently inequitable, providing more and higher quality services to the well-off who need them less than the poor who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet these inequities need not be accepted as inevitable, for there are many promising measures that can be pursued, says this Lancet article.
Mozambique plans to have 8,000 people living with AIDS on free triple-therapy antiretroviral (ARV) treatment through its public health system by the end of the year. Although this is only a small proportion of the estimated 200,000 people in need of treatment, it is seen as a breakthrough for one of the world's poorest countries, where in the past ARVs were regarded as a luxury for Western countries only.
Eighty-five countries last month signed a statement reaffirming commitment to reproductive health- and HIV/AIDS-related population and health goals agreed to 10 years ago at the 1994 International Conference on Population and Development in Cairo, Egypt, the AP/Philadelphia Inquirer reports. More than 250 world leaders - including presidents, prime ministers and Nobel Prize winners - endorsed the goals of ensuring a woman's right to education, health care and reproductive choices. Despite endorsement by the entire European Union, China, Japan, Indonesia, Pakistan and more than 12 African nations, the Bush administration refused to support the statement because it mentioned upholding "sexual rights" - a term that the administration says has no "agreed definition" in the international community.
The U.S. Agency for International Development plans to give Zambia $24 million to combat AIDS and malaria and improve the quality of drinking water, the U.S. embassy in Lusaka, Zambia, said last Tuesday in a statement, the Associated Press reports. The money will be used to fund health education programs - coordinated by the government and the Society for Family Health - over the next six years. Zambia on Tuesday banned free condom distribution in schools just as USAID announced its funding for HIV/AIDS programs, with condom distribution a "key part of the strategy," Reuters reports.
4. Values, Policies and Rights
This paper argues that the human rights framework does provide us with an appropriate understanding of what values should guide a nation's health policy, and a potentially powerful means of moving the health agenda forward. It also, however, argues that appeals to human rights may not necessarily be effective at mobilizing resources for specific health problems one might want to do something about. Specifically, it is not possible to argue that a particular allocation of scarce health care resources should be changed to a different allocation, benefiting other groups. Lack of access to health care services by some people only shows that something has to be done, but not what should be done.
5. Health equity in economic and trade policies
Botswana was warned last month by a UN Committee that trade agreements should not undermine Botswana’s ability to ensure access to affordable treatment for children or other people with HIV/AIDS. The UN Committee on the Rights of the Child, in a document made public, strongly recommended that Botswana ensure that “regional and other free trade agreements do not have a negative impact on the implementation of children’s rights.” Most importantly, it warned Botswana that trade agreements should not “affect the possibility of providing children and other victims of HIV/AIDS with effective medicines for free or at the lowest price possible.”
6. Poverty and health
An estimated 200 million people on the continent are undernourished, and their numbers have increased by almost 20 percent since the early 1990s. The result is that more than a third of African children are stunted in their growth and must face a range of physical and cognitive challenges not faced by their better-fed peers. Undernutrition is the major risk factor underlying over 28 percent of all deaths in Africa (some 2.9 million deaths annually). The continuing human costs of inadequate food and nutrition are enormous, and the aggregate costs of food and nutrition insecurity at the national level impose a heavy burden on efforts to foster sustained economic growth and improved general welfare.
This paper finds that there is a clear association between the risk of maternal death and a variety of poverty-related characteristics. Moreover there is an indication that maternal mortality is a sensitive marker of disadvantage, since non-maternal deaths did not exhibit such extreme clustering in the poorest groups. The authors demonstrate the magnitude of the poor-rich gap in maternal mortality, and should be a stimulus to setting and monitoring poverty-relevant development goals.
This report from UNFPA focuses on world population, reproductive health and poverty ten years after the International Conference on Population and Development (ICPD) Programme of Action was agreed in Cairo. The report finds that many developing countries have made substantial progress in implementing the ICPD's recommendations. However, resources remain inadequate and the needs of the poorest populations are still not being met. Key challenges include the continued spread of HIV/AIDS, especially among the young, unmet need for family planning, and high rates of maternal mortality in the least-developed countries.
7. Human Resources
Human resources are the crucial core of a health system, but they have been a neglected component of health-system development. The demands on health systems have escalated in low income countries, in the form of the Millennium Development Goals and new targets for more access to HIV/AIDS treatment. Human resources are in very short supply in health systems in low and middle income countries compared with high income countries or with the skill requirements of a minimum package of health interventions. Equally serious concerns exist about the quality and productivity of the health workforce in low income countries.
As South Africa rolls out its national treatment programme, the country continues to lose skilled healthcare professionals to wealthier nations abroad, leaving severe shortages in an already over-stretched public health system. On a Tuesday morning earlier this month at Johannesburg General Hospital's medical wards, an exhausted-looking Dr Candace Latilla was about to go off duty. But, as the only doctor on call that night, she would be back in a couple of hours. Latilla has been working at the hospital as an intern doctor for the past nine months. With a staff component of 470 doctors and 1,300 nurses, Johannesburg General handles more than 1.5 million patient visits a year.
8. Public-Private Mix
If access to health services were distributed according to need, the poor would come first. But they do not. Within developing countries disparities are less pronounced, and they vary greatly from place to place and from sector to sector within the health system. However, these disparities are almost always regressive, or pro-rich. This fact can be seen from the information available about the public and private components of health systems, and about specific services that health systems deliver. (requires registration)
9. Resource allocation and health financing
How can developing countries implement health systems that are both equitable and sustainable? Is social health insurance (SHI) a valid healthcare finance mechanism for these countries? This article examines the lessons that can be drawn from the South African experience of adapting and implementing SHI.
Despite a broad commitment to combating the spread of HIV/AIDS on the continent, African governments spend far too little of their own funds on intervention programmes, a new study has found. A review of national budgets included in 'Funding the Fight: Budgeting for HIV/AIDS in Developing Countries' showed that while many had developed strategic plans to tackle the virus, these were "poorly costed and budgeted". Sub-Saharan Africa remains by far the region worst affected by the AIDS epidemic - it has just over 10 percent of the world's population, but is home to two-thirds of all people living with HIV, according to UNAIDS.
"In this article we outline research since 1995 on the impact of various financing strategies on access to health services or health outcomes in low income countries. The limited evidence available suggests, in general, that user fees deterred utilisation. Prepayment or insurance schemes offered potential for improving access, but are very limited in scope. Conditional cash payments showed promise for improving uptake of interventions, but could also create a perverse incentive. The largely African origin of the reports of user fees, and the evidence from Latin America on conditional cash transfers, demonstrate the importance of the context in which studies are done."
10. Equity and HIV/AIDS
By the end of 2001, the number of HIV/AIDS infected adults stood at 180,000, while children orphaned by the death of their AIDS-infected parents numbered around 73,000. With a total population of just under two million, the situation in Lesotho is clearly severe. Added to this pandemic is a poorly performing economy, unable to generate the necessary finances to implement a comprehensive strategy to tackle this disease. This paper looks at Lesotho's policy response to the HIV/AIDS pandemic, and looks at the capacity the country has for meeting the challenges posed by the disease.
Health experts have attributed fewer AIDS-related deaths in Botswana to the government's steadily progressing rollout of anti-AIDS drugs. In a new report Botswana's health ministry and the World Health Organisation said the overall mortality of patients on treatment was less than 10 percent.
South African AIDS NGO, Treatment Action Campaign (TAC), has dismissed claims that its dropped legal action against the health department. The department said that TAC had decided to withdraw its action for the provision of certain annexes to the government's Comprehensive Plan for Management, Care and Treatment of HIV/AIDS. TAC spokesman Mark Heywood said on Monday the group's action remained as the health department was legally bound to have an AIDS implementation plan and to make it public.
This briefing explores the logic of International Monetary Fund (IMF) loan conditions to developing countries and why the IMF insists that keeping inflation low is more important than increasing public spending to fight HIV/AIDS in Africa, Asia, Latin America, and Eastern Europe. In 2003, funding levels for HIV/AIDS prevention and treatment are estimated to have reached almost $5 billion; meanwhile financing needs will rise to $12 billion in 2005 and $20 billion by 2007. But if these large increases in foreign aid become available, will lowincome countries be able to accept them? Despite the fact that the global community stands ready to significantly scale-up levels of foreign aid to help poorer countries finance greater public spending to fight HIV/AIDS, many countries may be deterred from doing so due to either direct or indirect pressure from the IMF.
11. Governance and participation in health
This study sought to analyse and better understand the relationship between health centre committees in Zimbabwe as a mechanism of participation and specific health system outcomes, including: Improved representation of community interests in health planning and management at health centre level; Improved allocation of resources to health centre level, to community health activities and to preventive health services o improved community access to and coverage by selected priority promotive and preventive health interventions; Enhanced community capabilities for health (through improved health knowledge and health seeking behaviour; Appropriate early use of services); Improved quality of health care as perceived both by providers and users of services.
Published by the Center for Communication Programs (CCP), this report is the first in a new series entitled “Health and Communication Insights”. The author suggests that the use of information and communication technologies (ICTs) and e-health (electronic health) applications, such as interactive websites, can be effective in helping people manage diseases, access health services and obtain assistance with behaviour change. Acknowledging the rich-poor digital divide, he notes that access to new technologies is increasing rapidly in developing countries.
12. Monitoring equity and research policy
Complex global public health challenges such as the rapidly widening health inequalities, and unprecedented emergencies such as the pandemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) demand a reappraisal of existing priorities in health policies, expenditure and research. Research can assist in mounting an effective response, but will require increased emphasis on health determinants at both the national and global levels, as well as health systems research and broad-based and effective public health initiatives. Civil society organizations (CSOs) are already at the forefront of such research.
This article from the Bulletin of the World Health Organization highlights health inequities both between and within countries, and how this is reflected in research, focusing on poverty and gender. The authors argue that there has been little research into the social causes of ill-health among groups, or factors affecting health inequity that are beyond the control of the individual. They highlight the publication bias in medical journals, where research into diseases that most affect the poorest people is often less likely to be published.
13. Useful Resources
The Council on Health Research for Development (COHRED) is an international non-governmental organisation that works towards enabling countries to set up and use health research to foster health, equity in health, and development. A special edition of the COHRED newsletter looks at COHRED's impact on health research for development since it was established in 1993.
The first issue of the Healthlink Worldwide newsletter, 'The Link', looks at the efficacy and appropriateness of HIV/AIDS communication - which become ever more critical as the epidemic's complexity and spread continue to grow.
14. Jobs and Announcements
This course is for senior and mid-level programme/projects managers, medical and health personnel and government officers. The purpose of this course is to empower the participants with advocacy and lobbying skills in order to advocate for health and health related issues.
Two decades after HIV/AIDS was discovered, it continues to spread across continents, infecting and killing millions and destroying entire communities. Sub-Saharan Africa, which accounts for 11 percent of the total world population, has 70 percent of all HIV/AIDS infections in the world, making it the worst-affected continent. Although one may dispute the alarming figures, the fact remains that HIV/AIDS has had devastating consequences for countries, societies, families and individuals. It is a global crisis and the outlook is worsening, with India, China and Russia projected to be the next centres of the pandemic.
A call has been made for individuals and organisations – activists, communities, health workers and academics – from around the world to submit case studies and testimonies to be part of the process of the second Peoples’ Health Assembly and the Global Health Watch report 2005. Click on the link for more information.
Published for the Network for Equity in Health in Southern Africa by Fahamu - learning for change http://www.fahamu.org/ Contact EQUINET at TARSC c/o admin@equinetafrica.org EQUINET-Newsletter is hosted on Kabissa - Space for change in Africa To post, write to: equinet-newsletter@equinetafrica.org Website: http://www.equinetafrica.org/newsletter Please forward this to others. To subscribe, visit http://www.equinetafrica.org/newsletter/subscribe.php or send an email to info@equinetafrica.org * Please send materials for inclusion in the EQUINET NEWS to editor@equinetafrica.org