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medpundit |
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Sunday, February 18, 2007The first link's author makes a more persuasive argument: One factor surely has been the success of HIV lobbies and activists in promoting HIV as exceptional. In rich countries, HIV has become the crusade of the famous, fashionable, and influential. In high prevalence countries, HIV affects the middle classes more than the poor and is of more concern to them: middle class children do not die from pneumonia or malaria and middle class women do not die in childbirth. The exceptional status accorded HIV, and its excessive relative funding, has produced the biggest vertical programme in history, with its own staff, systems, and structure. This is having deleterious effects apart from underfunding of other diseases. These include separating HIV from sexual and reproductive health and creating parallel structures that constrain the development of health services. National AIDS commissions, country coordinating mechanisms, UN agencies, etc are tripping over each other for funds and influence. HIV is also affecting adversely the organisation of health services. Funding for prevention of mother to child transmission, for example, is producing separate structures rather than strengthening everyday antenatal care and maternal child health by making testing and prevention part of the routine work of nurses and midwives. Also, well funded HIV programmes attract staff from other health services, aggravating chronic shortages. .....What is all this money being spent on? Much of it goes on "multisectoral" activities and "mainstreaming" HIV into just about every social activity. These have become the emperor's new clothes of public health. .....Much money is wasted in areas that reflect the interests of those on the AIDS industry payroll more than evidence. posted by Sydney on 2/18/2007 05:35:00 PM 0 comments 0 Comments: |
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