14 research outputs found
Financing HIV Programming: How Much Should Low- And Middle-Income Countries and their Donors Pay?
Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in terms of actual versus expected national domestic funding, considering resource needs and donor financing. With UNAIDS and World Bank data, we examine domestic and donor HIV program funding in relation to need in 84 low- and middle-income countries. We estimate expected domestic contributions per person living with HIV (PLWH) as a function of per capita income, relative size of the health sector, and per capita foreign debt service. Countries are categorized according to levels of actual versus expected domestic contributions, and resource gap. Compared to national resource needs (UNAIDS Investment Framework), we identify imbalances among countries in actual versus expected domestic and donor contributions: 17 countries, with relatively high HIV prevalence and GNI per capita, have domestic funding below expected (median per PLWH 376, respectively), yet total available funding including from donors would exceed the need (305, respectively) if domestic contribution equaled expected. Conversely, 27 countries have actual domestic funding above the expected (medians 149) but total (domestic+donor) funding does not meet estimated need (1,173). Across the 84 countries, in 2009, estimated resource need totaled 5.1 billion and actual donor contributions 7.4 billion, turning a funding gap of 0.8 billion. Even with imperfect funding and resource-need data, the proposed country classification could help improve coherence and efficiency in domestic and international allocations
More and more patients, fewer and fewer health workers: the human resources for health crisis in Africa
SEGURANÇA OU INSEGURANÇA DA SAÚDE MUNDIAL NA ÁFRICA? MAIS SAÚDE PARCIAL DO QUE SAÚDE GLOBAL
World Health Organization and the search for accountability: a critical analysis of the new framework of engagement with non-state actors
Mother-to-child transmission of human T-cell lymphotropic virus types I and II (HTLV-I/II) in Gabon: a prospective follow-up of 4 years
For 4 years, we determined the mode and risk of mother-to-child transmission of HTLV-I in a prospective cohort of 34 children born to seropositive mothers in Franceville, Gabon. We also determined the prevalence of antibodies to HTLV-I/II in siblings born to seropositive mothers. Antibodies to HTLV-I/II were detected by Western blot, and the proviral DNA was detected by the polymerase chain reaction (PCR). The risk of seroconversion to anti-HTLV-I for the 4 years of follow-yp was 17.5 %. Anti-HTLV-I/II and proviral DNA were only detected after age 18 months. We observed a seroprevalence rate of 15 % among the siblings born to HTLV-I/II seropositive mothers. Furthermore, we report a case of mother-to-child transmission of HTLV-II infection in a population of HTLV-II-infected pregnant women that is emerging in Gabon. The lack of detection of HTLV-I/II proviral DNA in cord blood and amniotic fluid and, furthermore, the late seroconversion observed in the children indirectly indicate that mother-to-child transmission occured postnatally, probably through breast milk. (Résumé d'auteur