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June 20, 2009

Anti-disease funds could be harming health systems

"On the minus side, the report finds that healthcare workers have been lured away from government hospitals by the higher salaries paid by international organisations involved in Aids and other disease programmes. In some countries, the rush to win grants from the Geneva-based Global Fund to fight Aids, TB and Malaria may have led to proposals being put forward that are inappropriate.

"The disease-specific programmes, says the report, "address issues of global importance, but whether they serve the specific needs of the countries in the best way possible is not known".

"The programmes have achieved much and must continue, it adds, but they need to include targets for strengthening the general health systems of the countries where they are working.

"On the plus side, millions of people are alive because of the roll-out of HIV drugs to more than 3 million people in developing countries. The number of children protected against malaria by insecticide-impregnated bed nets rose almost eightfold from 3% in 2001 to 23% in 2006. Disease elimination programmes, such as for polio and river blindness, are making good progress. Global immunisation has also made big strides, the report says.

"Some programmes have had a wider impact than their immediate focus. Following the big injection of funds for HIV/Aids to Botswana from mainly US donors and its own government, infant mortality dropped and life expectancy increased for the first time in decades."

Read more in The Guardian, UK, June 19, 2009.

Comment: We haven't analyzed this document, but one should keep a healthy skepticism, since there has been a big push recently to take money away from AIDS on the grounds that it could be spent more cost-effectively on other health projects.

The basic problem is that it still remains much harder to mobilize public support for health in general -- than for specific diseases, where it has been easier to show a face effectively in the newspapers. We need to work constantly to change this, so that government and other support can be better mobilized for health. But meanwhile, can we be confident that money taken from AIDS will go to other health programs? Or will it pay for more wars instead?

We do agree that a major goal and target of AIDS and other disease-specific programs should be improvement of health systems in general, to benefit people with any illness.