"The introduction of antiretroviral drugs will bring with it new challenges because this treatment is different from that for opportunistic infections, palliative care, home based care and cotrimoxasol prophylaxis which we have been providing and will continue to provide. It is different in the sense that these drugs are delicate, have a variety of side effects and have to be taken regularly and correctly for life. However, I am confident that Uganda will succeed to roll out this treatment to our people."
Equity and HIV/AIDS
Free ARV's for Uganda
Statement by Ugandan health minister at the launch of free ARV programme
Further details: /newsletter/id/30491
HIV/AIDS, democracy and governance in Africa
The GAIN Issues Brief is being launched in response to a perceived gap in current news analysis on the issues of HIV/AIDS, its implications for democracy and governance in Africa, and the challenges of ensuring that the response to HIV/AIDS is consonant with democratic principles. This Issues Brief is a product of the African Civil Society Governance and AIDS Initiative (GAIN), launched in October 2003. The aim of this Issues Brief is to provide civil society activists, journalists and policymakers with a concise analytical digest of developments in the field of HIV/AIDS, governance and democracy.
Reframing the HIV/AIDS debate in developing countries: an effective, equitable response
In Southern Africa, only 100 000 out of 4.1 million people who need HIV/AIDS anti-retroviral therapy (ART) are able to access it. The drop in the price of ART has led to opportunities to increase the numbers receiving treatment, but problems remain. Increasing health service focus on HIV might poach staff and resource from other important programs like TB, malaria or child health. Developing countries need to balance resources for treatment and prevention.
The HIV/AIDS Pandemic: Implications for Agricultural Policy
This paper considers how the design of agricultural policies and programmes might be modified to better achieve policy objectives in the context of severe HIV epidemics and underscores the central role of agricultural policy in mitigating the spread and impacts of the epidemic. It is argued that - even though the absolute number of working age adults in the hardest-hit countries is projected to remain roughly the same over the next two decades - the cost of labour in agriculture may rise in some areas as increasing scarcity of capital (notably, animal draft power for land preparation and weeding) will increase the demand for labour in agricultural production or shift agricultural systems to less labour- and capital-intensive crops.
** Ensuring universal treatment access through sustainable public health systems
Abstract of paper presented at the Equinet conference, Durban, 8-9 June 2004, by David McCoy and Rene Loewenson, Equinet
There is no question that an effective and urgent response is needed to extend access to antiretroviral therapy (ART) in southern Africa. The efforts of treatment activists, national governments, the World Health Organisation and the Global Fund to highlight this unmet health need are commendable. However, after decades of under-investment, harmful structural adjustment programmes and de-skilling, many health systems face significant obstacles in rising to the challenge of meeting the treatment needs. Treatment activism now needs to join with broader public health activism to ensure that treatment can be extended in ways that are sustainable, effective and equitable. This paper draws on work carried out by EQUINET and others to discuss the threats and opportunities entailed with the expansion of ART access in Southern Africa- threats that must be managed and opportunities tapped to realise aspirations of treatment access for more than a minority.
Further details: /newsletter/id/30454
ARV's and the prevention of MTCT in resource-constrained settings
Interventions focusing on HIV-infected pregnant women need to be complemented by interventions that address primary prevention of HIV infection, particularly in women of child-bearing age and their partners, and prevention of unintended pregnancies among HIV-infected women. This is one of the findings of a paper that analyses the different alternatives that are available for the prevention of mother-to-child transmission (MTCT) of HIV in resource-constrained settings, and makes recommendations about the best course of action in a number of situations.
Health systems approaches to treatment access in Tanzania
Equinet meeting report
The meeting was focused on ensuring universal treatment access through sustainable public health systems. The goal of the meeting was to develop resolutions on the principles for strengthening health systems for treatment access, and to develop potential areas for work for EQUINET related to EQUINET’s programme of work areas. In the introductory remarks, it was indicated that while there were various prevention activities, focused on for example, workplace education, condom promotion, sexually transmitted infection treatment and control, youth, women, commercial sex workers, men who have sex with men, etc, there was 2.2 million Tanzanians living with HIV out of which 800 000 have full-blown AIDS.
South Africa Civil society network ready to help ARV rollout
About 90 non-governmental organisations (NGOs) in South Africa's KwaZulu-Natal province have teamed up to work with the government in rolling out antiretroviral (ARV) drugs, in the first structured civil society response of its kind in South Africa, and possibly even on the continent. When the government announced a national rollout plan for free ARVs in September 2003, Cati Vawda, director of the Durban-based Children's Rights Centre, and a number of her NGO colleagues, quickly realised that "government alone cannot do it".
Strengthening health systems for treatment access
This summary document presents: The principles for ensuring universal treatment access through sustainable public health systems; The major findings and issues from the work carried out in southern Africa on equity in health sector responses to HIV and AIDS, particularly in terms of access to antiretroviral treatment; The key challenges for follow up work identified at the southern African regional meeting on 'Strengthening Health systems for treatment access and equitable responses to HIV/AIDS' in Harare, Zimbabwe, February 2004.
Antiretroviral therapy in Africa
The experience of tuberculosis treatment in Africa shows that the potential short term gains from reducing individual morbidity and mortality may be far outweighed by the potential for the long term spread of drug resistance, says an article in the British Medical Journal. Given the high levels of HIV prevalence and the lack of resources and infrastructures, HIV/AIDS antiretroviral therapy is likely to be introduced to Africa in a random and haphazard way, with inconsistent prescribing practices and poor monitoring of therapy and adherence: this risks the rapid development and transmission of drug resistance.