Estimating resource needs for HIV/AIDS health care services in low-income and middle-income countries.

As funding mechanisms like the Global Fund for HIV/AIDS, Tuberculosis and Malaria increasingly make funding decisions on the basis of burden of disease estimates and financial need calculations, the importance of reliable and comparable estimating methods is growing. This paper presents a model for estimating HIV/AIDS health care resource needs in low- and middle-income countries. The model presented was the basis for the United Nations' call for US dollars 9.2 billion to address HIV/AIDS in developing countries by 2005 with US dollars 4.4 billion to address HIV/AIDS health care and the rest to deal with HIV/AIDS prevention. The model has since been updated and extended to produce estimates for 2007. This paper details the methods and assumptions used to estimate HIV/AIDS health care financial needs and it discusses the limitations and data needs for this model

Resources and Tools:A Step-by-Step Methodological Guide for Costing HIV/AIDS Activities

Many developing countries have recognized the need for comprehensive national reforms and comprehensive prevention, treatment, and care and support initiatives to reduce future transmission of and to meet the growing demand for HIV/AIDS services. As a part of these national health reform initiatives, governments are exploring ways to allocate resources in the most efficient and effective way to mitigate the HIV/AIDS epidemic. However, many countries lack information on the level and nature of the costs of HIV/AIDS programs. This document provides an introduction to the procedure for calculating and analyzing the costs of HIV/AIDS programs and describes how to measure directly the actual costs of a program that is up and running. The step-by-step guide is intended to provide project managers in the field with a framework for how to do measure costs for a single, recent year in the life of an HIV/AIDS program. An illustrative activities list in the report annex will assist the user to develop an activities-based framework. The information gleaned from the costing framework will enable policymakers and program managers to make informed resource allocation decisions

Engaging Local Non-Governmental Organizations (NGOs) in the Response to HIV/AIDS.

During the past few years, a number of key donor programs have scaled up their global response to the crisis of HIV and AIDS. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the President’s Emergency Plan for AIDS Relief (PEPFAR), the United Nations’ Millennium Development Goals (MDGs), the World Bank’s Multi-country HIV/AIDS Program (MAP), and other bilateral donors and charitable foundations have raised significant resources to fight HIV/AIDS. Spending on HIV/AIDS in low- and middle-income countries increased from $1 billion in 2000 to$6.1 billion in 2004. By 2007, global resources for HIV/AIDS are expected to expand to $10 billion. Local non-governmental organizations (NGOs), faith-based organizations (FBOs), and community-based organizations (CBOs) have been at the center of the response to the HIV/AIDS pandemic. In many countries, they have been responsible for the majority of the resources reaching individuals and have played a leading role in developing and implementing sustainable strategies to mitigate and prevent HIV/AIDS. One of PEPFAR’s strategic principles is to encourage and strengthen faithbased and community-based non-governmental organizations. The identification of sustainable and efficient local NGOs and the capacity building of these partners is the cornerstone on which the effective engagement of local NGOs is built. The goal of this paper is to begin a discussion among donors, international and local NGOs, and multilateral and U.S. government representatives on how to effectively engage indigenous partners and transfer much-needed resources

Barriers to better care for people with AIDS in developing countries

Access to good quality antiretroviral treatment has transformed the prognosis for people with AIDS in the developed world. Although it is feasible and desirable to deliver antiretroviral drugs in resource poor settings,few of the 95% of people with HIV and AIDS who live in developing countries receive them. The World Health Organization has launched a programme to deliver antiretroviral drugs to three million people with AIDS in the developing world by 2005, the “3 by 5” initiative. We identify some of the challenges faced by the initiative, focusing on delivery of care

Demographic and socioeconomic patterns of HIV/AIDS prevalence in Africa

Understanding the demographic and socioeconomic patterns of the prevalence and incidence of HIV/AIDS in Sub-Saharan Africa is crucial for developing programs and policies to combat HIV/AIDS. This paper looks critically at the methods and analytical challenges to study the links between socioeconomic and demographic status and HIV/AIDS. Some of the misconceptions about the HIV/AIDS epidemic are discussed and unusual empirical evidence from the existing body of work is presented. Several important messages emerge from the results. First, the study of the link between socioeconomic status and HIV faces a range of challenges related to definitions, samples, and empirical methods. Second, given the large gaps in evidence and the changing nature of the epidemic, there is a need to continue to improve the evidence base on the link between demographic and socioeconomic status and the prevalence and incidence of HIV/AIDS. Finally, it is difficult to generalize results across countries. As the results presented here and in other studies based on Demographic and Health Survey datasets show, few consistent and significant patterns of prevalence by socioeconomic and demographic status are evident.Population Policies,Disease Control&Prevention,HIV AIDS,Gender and Health,Health Monitoring&Evaluation

The use of theatre for development in the prevention of HIV/AIDS : a dissertation presented in partial fulfilment of the requirements for the degree Master of Philosophy in Development Studies at Massey University

Over the last three decades development practitioners have begun to search for new theoretical approaches to the problems of underdevelopment. This has given rise to approaches that focus on the participation of people and their culture in development programs. The teachings of Paulo Freire, latterly developed by Augusto Boal, gave voice to theatre that is participatory, provides two-way communication and aims to raise the critical awareness of spectators. This form of theatre is known as Theatre for Development. It aims to promote awareness of political, social and economic issues. Theatre for Development goes beyond the theatrical event giving people skills to confront problems and solve them. The AIDS pandemic is a human tragedy that is threatening development in the world's poorest countries. In fact, 95 per cent of people with HIV or AIDS live in developing countries. HIV accentuates inadequacies that exist in health care infrastructures and highlights social and economic inequalities. There is no known cure for this disease but through systematic national programs that focus on preventing HIV transmission it is possible to significantly lower infection rates. Theatre should be part of any national HIV/AIDS program. Theatre for Development is effective in communicating HIV/AIDS related information and promoting attitude changes. Theatre has many advantages as an educational technique; it engages participants, is appropriate to the local situation, adapts to indigenous cultures, assists with skill development and encourages discussion about sensitive issues. In Vanuatu, Wan Smolbag theatre uses Theatre for Development to provide people with the knowledge and skills required to prevent HIV/AIDS infection. The mainstay of this Non Governmental Organisations' (NGO) work is short interactive theatre pieces of 20 to 50 minutes. In addition, WSB has created videos, radio dramas and educational materials. WSB's HIV/AIDS theatre is based on the Freiran concepts of participation and dialogue. As a consequence, the group's theatre reflects the lives of its participants and is proving that theatre can be a powerful tool for improving people's knowledge of HIV/AIDS

Facing an Epidemic: An Analysis of HIV/AIDS, Antiretroviral Drug, and International Response to the AIDS Pandemic

More than 33 million people are living with HIV/AIDS around the globe with 68% of all cases occurring in sub-Saharan Africa. The global prevalence rate is shocking considering that the disease was relatively unknown just 30 years ago. After reviewing medical, health policy, and health statistical journals, I will argue in this paper that international aid to nations struggling with AIDS needs to be redirected and refocused on supplying antiretroviral therapy to afflicted nations because ARV has been proven to be effective in managing the disease in countries that can afford the costs of treatment. International aid to countries that are ravished by the epidemic, and the United States is one of the top contributors to such efforts with its “President’s Emergency Plan For AIDS Relief (PEPFAR). The U.S. has realized the potential economic benefits of helping out such as becoming primary trade partners with the nations who have plenty of valuable natural resources despite their AIDS issues. In the U.S.’s efforts to combat terrorism, the nation has an interest in “stabilizing” certain countries, which are typically in Africa, so that they can resist potential terrorist threats or military coups. PEPFAR’s goal in fighting AIDS is part of the stabilization effort on the continent of Africa. Fortunately, major pharmaceutical companies have discovered compounds that are effective in attacking the HIV virus, and this has led to the production of “antiretroviral” drugs. Anti-retroviral therapy has proven to be a useful tool used by those suffering from HIV/AIDS to manage their disease better and obtain a higher quality life. Such medications are widely available in wealthy nations, but poor countries that have the highest HIV/AIDS prevalence have a harder time affording such therapy or managing the drug supplies. Potential solutions to this problem include selling antiretroviral drugs at a lower cost to developing nations or using generic versions of such drugs

Collection Development of HIV/AIDS Information Resources in American Libraries

HIV/AIDS remains an incurable epidemic in the United States that disproportionately affects men who have sex with men (MSM) and African Americans. Library and information science (LIS) professionals can play a vital role in keeping these higher risk groups informed about preventing HIV/AIDS and living with the disease, through a variety of current information resources that addresses their specific questions. This paper reviews collection development policies proposed by LIS professionals and library agencies since the late 1980s, and evaluates how such policies took higher-risk user groups into consideration. The findings of this paper are that collection development policies have become more attentive to higher-risk user groups but that LIS research trends are now beginning to focus more on the HIV/AIDS epidemic in developing countries, which is to the detriment of Americans who still need up-to-date materials on the disease

Sources of error and bias in methods of fertility estimation contingent on the P/F ratio in a time of declining fertility and rising mortality

Almost all commonly used indirect fertility estimation methods rely on the P/F ratio. As originally conceived, the ratio compares cumulated cohort fertility with cumulated period fertility on the basis of three, fairly strong, assumptions. The intention of this paper is to interrogate what happens to the results produced by the P/F ratio method as each of these three assumptions is violated, first independently, and then concurrently. These investigations are important given the generally poor quality of census data collected in developing countries, particularly sub-Saharan Africa, and the radically altering demographic conditions associated with a generalised HIV/AIDS epidemic in the region.AIDS/HIV, developing countries, estimation, fertility, indirect techniques

The potential demand for an HIV/AIDS vaccine in Brazil

This study assesses the potential demand by the public sector for a preventive HIV/AIDS vaccine in Brazil and the costs of alternative strategies for a vaccination program. Brazil has a mature AIDS epidemic: the percent of the population living with HIV or AIDS (about 0.6 percent of adults) is not as high as in other severely affected developing countries, but infection rates in specific risk groups in the population are very high and HIV has spread beyond these groups into the general population of low-risk individuals. Preventive HIV/AIDS vaccines are still in the testing stage. The characteristics of the first vaccines developed, in terms of their efficacy, duration of effectiveness, ease of administration, and price, are still unknown. But the potential benefits of such a vaccine in Brazil would be high. The study reviews the cost and impact of HIV/AIDS in Brazil, in terms of disease and economic burden, as a proxy for the benefits of an HIV/AIDS vaccine. The epidemiology of AIDS and Brazil's experience with immunization coverage with other vaccines are used to assess the number of vaccines, delivery strategies, and possible costs of an HIV/AIDS immunization program in Brazil, assuming the availability of a 100 percent effective AIDS vaccine that lasts a lifetime under different pricing and dosing assumptions. A low-cost, highly effective vaccine would likely be affordable to an upper-middle-income country like Brazil and yield large benefits from a policy of universal, publicly subsidized immunization. But if prices are higher and the impact less favorable, the costs and effects would have to be compared with other AIDS prevention programs or other health interventions. Both political and economic considerations will likely figure into public policy on HIV/AIDS vaccination, when such a vaccine is developed.Disease Control&Prevention,Early Child and Children's Health,Health Economics&Finance,Public Health Promotion,Health Monitoring&Evaluation,HIV AIDS,Health Monitoring&Evaluation,Health Economics&Finance,Adolescent Health,Health Indicators