Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

Stephen Gloyd, MD, MPH and Kenneth Gimbel-Sherr, MPH, PhC. Health Alliance International, University of Washington, 1107 NE 45th St, Suite 427, Seattle, WA 98105, 206-543-8382, gloyd@u.washington.edu

Issues: Public sector health services are essential to provide access to AIDS treatment for the poor. Neoliberal policies, including structural adjustment programs (SAPs) have been imposed over the past three decades on poor countries, resulting in profound weakening of public health services. PEPFAR and other donor policies have frequently supported NGO provision of clinical services, exacerbating weak public services by creating parallel systems and drawing scarce human resources from public clinics to NGO dominated “centers of excellence.” Description: Evidence from several African countries will demonstrate 1) the impact of SAPs on primary health care, private services for elites, and potential for expansion of government health services, 2) how aid policies and NGO involvement may foster rapid expansion of AIDS treatment, but often create inefficient systems of care, spotty coverage, internal brain drain, limited capacity for expansion, and questionable sustainability, and 3) how donor management and pooling resources by recipient government affects the short and long-term effectiveness of aid resources on local capacity and delivery of care. Estimates of the efficiency of aid dollars will be compared between the global fund, PEPFAR, and direct contribution to governments. Lessons Learned: AID policies and NGO involvement are critical to rapidly expand AIDS treatment. Management of donors can mitigate potential negative aspects of aid policies. Recommendations: Evaluate how donor policies strengthen and/or weaken government health services and use the findings to support the development of new paradigms of international assistance and models of care.

Learning Objectives:

• 1) Identify at least two donor policies and aid programs that affect access to and quality of AIDS treatment in African countries.
• 2) Discuss the advantages and disadvantages of current aid funding mechanisms for expanding AIDS treatment in Africa.
• 3) Explain how current donor policies are likely to affect sustainability of AIDS treatment in African countries.

Keywords: HIV/AIDS, Policy/Policy Development

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation