Some interesting notes from The Economist, July 15th edition: http://www.economist.com/PrinterFriendly.cfm?Story_ID=2921425 (requires paid subsciption)
The biggest bone of contention is PEPFAR. PEPFAR stands for the President's Emergency Plan for AIDS Relief, and the president in question is George Bush, who proposed the fund in 2003 and persuaded Congress to stump up the money. PEPFAR is offering a total of $15 billion, of which $10 billion is new cash, over the next five years. One-fifth of the fund is to be spent on campaigns to prevent the virus from spreading, the rest on treating those already infected and looking after the bereaved�especially children. Most of the new money will be spent in 15 countries, mainly in sub-Saharan Africa, which is by far the worst affected part of the world. The plan's aims over that period are to treat 2m people infected with human immunodeficiency virus (HIV), which causes the disease, to prevent 7m new infections, and to care for 10m HIV-infected individuals and AIDS orphans. The money is now starting to reach the field. Not everyone, however, is happy. One reason many activists are unhappy is that Congress requires at least one-third of the prevention money to be spent on programmes that focus on sexual abstinence..... Condoms are included in the "ABC" (Abstain, Be faithful, use a Condom) acronym that describes this part of PEPFAR. But activists fear that the importance of condom use is being played down, for religious reasons, rather than played up, as it will need to be if PEPFAR is to achieve its objectives. ..... There is also the question of whether local health systems can handle the largesse being showered on them. Here is one small, but significant, example. ACHAP (the African Comprehensive HIV/AIDS Partnerships) is Botswana's anti-AIDS programme. It began four years ago with promises from the Bill and Melinda Gates Foundation, and the Merck Foundation, of $50m each. So far, only half of this money has been allocated, and only 70% of that has actually been spent. The system simply cannot take any more and deploy it wisely or usefully. This is one of the facts that dare not speak its name. Botswana is an honest, well-governed and, by African standards, wealthy country. If its health system cannot absorb treatment funds effectively, serious questions need to be asked of larger efforts, such as the WHO's �3 by 5� programme to put 3m infected people on antiviral drugs by 2005. Indeed, a report that came out at the conference showed that this (admittedly ambitious) campaign is significantly behind schedule. Perhaps more needs to be spent on the unglamorous task of building new health delivery systems, and less on the actual drugs themselves. _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
