Evolving norms of north-south assistance will they be applied to HIV/AIDS?

The world is in the early stages of what will be the greatest health crisis in modern times. Millions of people—most of them in the world’s poor countries—are infected with HIV. The vast majority of these people will suffer and die from AIDS. The extent of this problem presents profound moral and ethical questions for the world’s wealthy people and countries, for it is they who are most able to assist the poor in addressing this tragedy. What is more, the spread of HIV and AIDS poses major threats to the interests of the developed countries. In short, HIV/AIDS presents the world with some of the most profound moral and practical challenges it has ever faced during peacetime. Nevertheless, developed countries have been very slow in responding to the international dimensions of this problem. They have instead focused on the relatively few people within their own borders at risk for HIV or suffering from AIDS, seemingly unwilling to recognize the greater challenges posed by the global spread of HIV. The rhetoric has started to change, but the developed countries have not backed this rhetoric with the substantial new and additional funds to assist the poor countries in coping with and reversing the HIV/AIDS epidemic. This essay examines this moral and practical problem in the context of North-South relations. It serves to highlight the need for much more international assistance to combat HIV/AIDS in the developing world

PROTECTION FOR WHOM?

For several decades almost all the states have addressed the goal of ensuring an adequate supply of blood and blood products through the provision of "blood shield laws." These laws shield the blood industry from strict liability in the case of viral or other contamination of blood or its components. These laws were passed with little regard for other considerations, such as safety incentives. This article traces the development of the blood industry, its influence on state and national blood policy, and the consequences of such policy for people infected with hepatitis and HIV through blood and blood products. The authors conclude that the closed nature of the policy process has had negative consequences for the creation of blood policy that should balance concerns of both supply and safety. Copyright 2001 by The Policy Studies Organization.

An assessment of interactions between global health initiatives and country health systems

Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity value for money, and outcomes in global public health, then these opportunities should not be missed