Health systems’ responses to the roll-out of antiretroviral therapy (ART) in India: a comparison of two HIV high-prevalence settings

The government of India launched the free anti-retroviral therapy (ART) initiative in 2004 and the programme has since scaled up expansion in a phased manner. Programme authorities acknowledge problems in scale-up, yet discussions have been restricted to operational constraints, with little consideration for how local health system responses to HIV/AIDS influence the delivery of ART. This paper draws on the perspectives of key informants and people living with HIV (PLHIV) to compare delivery of ART in two ART centres in the States of Maharashtra and Andhra Pradesh at two distinct points of time. In 2005, data were collected through key informant interviews (KIIs) using interview guides and a survey of PLHIV using a semi-structured interview schedule. Differences were observed in the functioning and resources of the two centres, indicating different levels of preparedness which in turn influenced PLHIV's pathways in accessing ART. We examine these differences in the light of programme leadership, ownership and the roles of public, private and non-governmental organisation actors in HIV care. KIIs conducted during a follow-up visit in 2009 focused on changes in ART delivery. Many operational problems had been resolved; however, new challenges were emerging as a result of the increased patient load. An understanding of how ART programmes evolve within local health systems has bearing on future developments of the ART programme and must include a consideration of the wider socio-political environment within which HIV programmes are embedded

Ebola research funding: a systematic analysis, 1997–2015

Background: The latest outbreak of Ebola in West Africa overwhelmed the affected countries, with the impact on health extending far beyond Ebola–related deaths that have exceeded 11?000. The need to promptly mobilise resources to control emerging infections is widely recognized. Yet, data on research funding for emerging infections remains inadequately documented.Methods: We defined research investment as all funding flows for Ebola and/or Marburg virus from 1997 to April 2015 whose primary purpose was to advance knowledge and new technologies to prevent or cure disease. We sourced data directly from funding organizations and estimated the investment in 2015 US dollars (US$).Results: Funding for Ebola and Marburg virus research in 1997 to 2015 amounted to US$ 1.035 billion, including US$435.4 million (42.0$ 758.8 million (73.1%), philanthropic sources US$65.1 million (6.3$ 213.8 million (20.6%). Prior to the Ebola outbreak in 2014, pre–clinical research dominated research with US$443.6 million (73.9$ 399.1 million, with 61.3% awarded for vaccine research, 29.2% for novel therapeutics research such as antivirals and convalescent blood products, and 9.5% for diagnostics research. Research funding and bibliometric output were moderately associated (Spearman's ??=?0.5232, P?=?0.0259), however number of Ebola cases in previous outbreaks and research funding (??=?0.1706, P?=?0.4985) and Ebola cases in previous outbreaks and research output (??=?0.3020, P?=?0.0616) were poorly correlated.Conclusion: Significant public and philanthropic funds have been invested in Ebola and Marburg virus research in 2014 and 2015, following the outbreak in West Africa. Long term, strategic vision and leadership are needed to invest in infections with pandemic potential early, including innovative financing measures and open access investment data to promote the development of new therapies and technologies

Opportunities in the UK healthcare market A strategic analysis

Available from British Library Document Supply Centre-DSC:V98/50053 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Impact of an effective multidrug resistant tuberculosis control programmes in the setting of an immature HIV epidemic : system dynamics simulation model

This study sought to determine the impact of an effective programme of multidrug resistant tuberculosis control (MDRTB) on a population that is witnessing an explosive HIV epidemic among injecting drug users (IDUs), where the prevalence of MDRTB is already high. A transmission model was constructed that represents the dynamics of the drug-susceptible tuberculosis (DSTB), MDRTB and HIV spread among the adult population of Samara Oblast, Russia: from official notifications of tuberculosis and of HIV infection, estimates of MDRTB derived from surveillance studies, population data from official regional statistics, data on transmission probabilities from peer-reviewed publications and informed estimates, and policy-makers' estimates of IDU populationsPeer reviewe

Transparency and availability of data for cancer research

Open research data allows for verification, replication, scrutiny, and subsequent analyses of published studies, while reducing likelihood of research duplication. By contrast, failing to publish data, which is a key impediment in the fight against cancer and non-communicable disease epidemics, hinders timely and effective response to these challenges. Hence, data should be liberated and made widely available to researchers

Contractual design and PPPs for hospitals: lessons for the Portuguese model

Public–private partnerships, Contract design, I11, I18,