The fight against AIDS will need more resources from the US, with faster delivery, than what the President is proposing," says Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance. "We will need fast action by Republican and Democratic leaders in the US Congress to deliver on an appropriate package for 2003 and 2004. It's very disappointing the President (George W. Bush) is not calling for a more rapid increase in new funding. Plus, it's troubling that the President gives such short shrift to the Global Fund, which is fast running out of resources."
Resource allocation and health financing
NEW ANALYSIS DECRIES LACK OF US SUPPORT FOR GLOBAL AIDS FUND
New evidence: tax financing for UHC
Mohga Kamal-Yanni: Oxfam Global Health Check, May 2015
The Ebola crisis exposed the weaknesses of healthcare systems in low- and middle-income countries created mainly by insufficient funding. Given the global community’s commitment to universal health coverage (UHC), the Ebola outbreak has prompted serious reflection among health policy decision-makers. One of the central features of this debate is financing: how can relatively poor countries find the money to pay for universal health coverage? To date, low- and middle-income countries have been growing toward UHC through social health insurance systems funded through employment. Yet, progress has been slow and uneven leaving people in the informal sector, who are the majority of the population, out was insurance schemes. Rather than seeking innovative solutions to this old problem, this blog outlines how Aaron Reeves argues that what is needed is a renewed commitment to an old solution: tax-based financing. Using data from low- and middle-income countries my colleagues and I examined the association between tax revenues and health spending. We found that tax revenue was a major statistical determinant of progress towards UHC. Each $10 per-capita increase in tax revenue was associated with an additional $1 of public health spending per capita. Whereas each $10 increase in GDP per capita was associated with an increase of $0.10. Crucially, tax revenues sit on the pathway between economic growth and health spending. In short, tax financing is an efficient way of translating economic growth into health spending. Countries with more tax revenues have also made more progress on other indicators of UHC, even after adjusting for economic activity in the country. Among tax poor countries, greater tax revenues are associated with more women being attended by a skilled healthcare worker during pregnancy and greater access to healthcare for all people.
New Zambian SADC leadership must make 15% health pledge priority
Africa15percentcampaign, 21 August 2007
The Africa Public Health Rights Alliance “15% Now!” Campaign has called on the new Chair of SADC President Levy Patrick Mwanawasa to make it a priority of his term of office to ensure that alongside upholding Democracy and Good Governance, all SADC countries emulate the leadership of Botswana and meet the Abuja African Union pledge to allocate at least 15% of national budgets to health. President Mwanawasa assumed SADC leadership at the end of the last summit that ended on the 17th of August. In a statement issued in Lusaka, the Campaigns coordinator Rotimi Sankore stated:“SADC leaders must realise that they have no choice but to follow the lead of Botswana in meeting the Abuja 15% pledge. Its really a choice between meeting the 15% commitment now, or presiding over mass burials of citizens between now and 2015 when they should have met the health based Millennium Development Goals”.
NGO participation in the Global Fund
This paper summarises a review undertaken by the International HIV/AIDS Alliance (the Alliance) in August and September 2002, assessing the participation of HIV non-governmental organisations (NGOs) in 6 country-level processes of the Global Fund for AIDS, TB and Malaria. These
processes include the Country Coordinated Mechanism (CCM), the Country Coordinated Proposal (CCP) and all other Global Fund related activities and consultations. The review was undertaken on the basis of anonymity, so all quotes and experiences are not attributed to specific individuals or countries. Recommendations are made based on these NGO experiences and from broader Alliance experience in providing technical and financial support to NGOs and community-based organisations in over 40 developing countries.
NHI Conference calls for strong primary health care system
Skade T: Independent Online News, 8 December 2011
Speaking at the opening of the national consultative health forum’s National Health Insurance (NHI) conference on 7 December 2011, Organisation for Economic Co-operation and Development economist Ankit Kumar said South Africa should look to South Korea, which achieved universal health care for its entire population in just 12 years by investing in a strong primary healthcare system, eliminating fragmentation and containing hospital prices. South Koreans achieved universal coverage by starting the rollout of health insurance with the informal labour market before gradually expanding coverage to the formal labour market. In preparation for the roll out of South Africa’s NHI, the country’s Health Minister, Aaron Motsoaledi, reiterated his call for the establishment of a pricing commission to tackle uncontrolled commercialism and the exorbitant cost of private healthcare. Fragmentation in the form of private health care for the wealthy and public health care for the poor was also contributing to low levels of access to health care, he added.
NHI far from reality but progress made in improving public health
Health E-News, 1 June 2015
South Africa's proposed National Health Insurance (NHI) scheme, is many years away, but many of the country’s 10 pilot sites are reported to be making progress. Of the 10 NHI pilot districts Health e-news investigated all – with the exception of OR Tambo in the Eastern Cape – are making reasonable progress in improving public health. The pilot districts, covering 20 percent of the population, were set up almost five years previously after Health Minister Aaron Motsoaledi announced the NHI as government policy. Negative patient experiences in public health facilities led government to concentrate on cleaning its own house before attempting any engagement of the NHI with the private sector.
NHI: The need for a value-driven, inclusive process
Momberg M: Health-e, 3 August 2009
The author observes that there are problems with the way in which discussions concerning South Africa’s new national health insurance (NHI) are being conducted behind closed doors. A top-down management approach is seen to be not working, excluding consultation with stakeholders, especially civil society. The challenges government and civil society now face on the issue are related to leadership and accountability (visible leadership at the highest possible level and one single voice and proposal from government), positioning and values (to what extent should principles of solidarity be applied in the design of the new system), the process followed in developing the provisions (extensive and in-depth consultation and a clearly defined process with milestones and deadlines), as well as delivery (especially in administration and management to ensure sustainable benefits).
Nigerian Government to Exclude People With HIV/AIDS from National Health Insurance Plan
The Nigerian government has drafted a plan for a national health insurance program that would eventually provide coverage for "all Nigerians," but certain individuals with "[h]igh-cost illnesses" such as HIV/AIDS would not be eligible to join, the Lancet reports.
No excuse for missing the goal
Simonelli M: Action Aid International, 21 July 2011
Low-income countries bear over 60% of the HIV disease burden, but ActionAid argue that their total annual resources for HIV went down from 2009 to 2010. This raises a gap between resources available and needed. To close this gap by 2015, UNAIDS estimate that the international community needs to raise an additional US$6 billion annually, with a parallel increase in commitments for the period 2011-2020. Proposed potential sources of funding include innovative financing mechanisms, indirect taxation (airline tickets, mobile phone usage, exchange rate transactions), front-loading mechanisms (IFF-Im) and advance market commitments. The author urges pharmaceutical companies to enter into negotiations with the Patented Medicines Pool and to ensure that the geographic scope of these licensing agreements includes low- and middle-income countries.
No money, no services in Malawi
PlusNews 1 July 2009
An inability to access adequate funding is crippling efforts by community-based organisations (CBOs) to help some of Malawi's most vulnerable children. For example, Monkey Bay, 125km east of the capital, Lilongwe, has some of the highest poverty and HIV-prevalence rates in the country, according to the government's National Statistics Office. Yet a recent report by the Regional Network for Equity in Health in East and Southern Africa (EQUINET), ‘Promoting and protecting health of orphans and vulnerable children in Monkey Bay, Malawi’, said many community-based organisations (CBOs) in the area could not access government funding to support interventions targeted at orphaned and vulnerable children. Donald Makwakwa, programme officer for the Malawi Network of AIDS Service Organisations (MANASO), which provides technical support to CBOs, explained that many grassroots bodies could access technical assistance, but faced periodic funding shortages due to late allotments by the National Aids Council.