Aid is ineffective and donors should raise the effectiveness of their aid by reducing the amount of ‘aid’ that is actually spent in donor countries themselves and by reducing the number of sectors and countries each donor tries to support. Thanks to today’s financial crisis, global trade might contract for the first time in decades and demand for poor countries’ exports will decline, while credit dries up, devastating poor producers’ livelihoods. Rich countries should start by eliminating wasteful agricultural policies that only help their own farmers at the expense of poor people elsewhere. Limitations to market access for the poorest and most vulnerable economies must be lifted. Rich countries may promise to provide 100% free market access, but maintain restrictions that make a mockery of their commitments.
Resource allocation and health financing
The United Nations Population Fund (UNFPA) has expressed concern that the world has dropped further behind commitments made at a 1994 global conference to invest $17 billion a year on population and reproductive health by 2000. “Given rising demands and HIV/AIDS infections, the mobilization of resources is more critical to the success of the Cairo Programme of Action and the Millennium Development Goals,” UNFPA Executive Director Thoraya Obaid said.
Held in Istanbul, Turkey on 9-13 May 2011, a United Nations summit to assist least-developed countries (LDCs) ended with new pledges, but the results were disappointing, according to this article. The Istanbul Programme of Action, adopted by the Conference, merely states that those countries already providing more than 0.20% of their gross national product (GNP) as aid to LDCs will continue to do so; those which have met the 0.15% target will undertake to reach 0.20%; and others which have committed themselves to the 0.15% target will either achieve the target by 2015 or try their best to do so. This weak statement with its loopholes was rebuked by the civil society groups attending the Conference. The author of this article notes that the Programme of Action seems to contain more commitments by LDCs to take their own actions than commitments by rich countries to assist them, which is a reversal from previous LDC conferences.
The United Nations has teamed up with world leaders to launch a new initiative to strengthen health systems in an effort to reduce the number of women who die in pregnancy and childbirth, one of the eight Millennium Development Goals (MDGs), with a 2015 deadline. The task force on maternal mortality, which will be co-chaired by British Prime Minister Gordon Brown and World Bank President Robert Zoellick, will focus on innovative financing to strengthen health care systems and pay for health care workers. The recommendations that will flow from the group, which will include UN World Health Organization (WHO) Director-General Margaret Chan and several global leaders, will potentially save the lives of 10 million women and children by 2015. They will be presented to next year's meeting of the leaders of the Group of Eight (G-8) industrialised nations, to be held in Italy.
The United Nations Children's Fund has publicly listed for the first time the price it pays for vaccines. The decision - which immediately revealed wide disparities in what vaccine makers charge - could lead to drastic cuts in prices for vaccines that save millions of children's lives. UNICEF paid US$747 million for vaccines in 2010, buying over two billion doses for 58% of the world's children. Shanelle Hall, director of UNICEF's supply division and the driving force behind the new transparency policy, said she hoped to extend it to other goods that the organisation buys, including mosquito nets, diagnostic kits, essential medicines and ready-to-eat foods for starving children. Newer procurement agencies like the Global Fund to Fight AIDS, Tuberculosis and Malaria routinely reveal what they pay for drugs. But vaccines have been largely exempt because UNICEF has avoided confrontation with its suppliers, posting only the average prices it pays; and external funders had not demanded more details. Doctors Without Borders have commented that when external funders see the differentials they will insist on procurement at better prices.
The National Education, Health and Allied Workers Union (Nehawu) on Tuesday urged government to launch a wide-ranging and transparent probe into the South African National Tuberculosis Association (Santa). It was reacting to the government's decision on Monday to suspend Santa's R6,6-million subsidy and to undertake a forensic audit of the organisation. "We call on government to have a comprehensive and transparent investigation into how Santa uses money, quality of patient care, adherence to clinical protocols, quality of food given to clients, and all other related matters," the union said in a statement.
The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) has boosted its assistance to Uganda's AIDS programme with an emergency supply of antiretroviral (ARV) drugs worth more than US$5.5 million - enough to put an estimated 72,000 HIV-infected people on the treatment over the next two years. But it has also served notice that Uganda must find new sources of funding if its HIV programmes are to be sustainable. The drugs are expected to help bridge the gap in the availability of ARV drugs in Uganda and prevent stock-outs and are included as part of an increase in funding recently announced by PEPFAR, following appeals from Ugandan AIDS activists and health providers struggling to put patients on ARVs. Uganda is the biggest recipient of PEPFAR funds.
In 2005, the member states of WHO adopted a resolution to develop health financing systems to deliver universal coverage of health services by moving away from out-of-pocket payments and developing prepayment methods instead. This paper proposes a comprehensive framework, focusing on health financing rules and organisations, that countries can use to achieve universal coverage. For many countries, it will obviously take some years to achieve the goal and their responses will be determined partly by their own histories and the way their health financing systems have developed to date, as well as by social preferences relating to concepts of solidarity. The proposed framework considers fund collection, pooling and purchasing/provision separately, as well as the links between the three functions to indicate what rules need to be modified or developed and where organisational capacity should be strengthened.
Africa’s population is estimated to reach 2.5 billion by 2050, raising a challenge for progress toward Universal Health Coverage (UHC), the principle that everyone receives needed health services without financial hardship. The primary reason for investing in UHC is argued to be a moral one: it is not acceptable that some members of society should face death, disability, ill health or impoverishment for reasons that could be addressed at limited cost. However, UHC is also argued to be a good investment. Prevention of malnutrition and ill health is likely to have enormous benefits in terms of longer and more productive lives, higher earnings, and averted care costs. Effectively meeting demand for family planning will accelerate the fertility transition, which in turn will result in higher rates of economic growth and more rapid poverty reduction. And strong health and disease surveillance systems halt epidemics that take lives and disrupt economies. The authors report for example that In 2015, the forgone economic growth due to Ebola amounted to more than a billion US dollars in the three countries hit by the epidemic.
This is the eighth edition of ‘Untangling the web of price reductions: a pricing guide for the purchase of ARVs for developing countries’. The report was first published by Médecins Sans Frontières (MSF) in October 2001 in response to the lack of transparent and reliable information about prices of pharmaceutical products on the international market, a factor which significantly hampers access to essential medicines in developing countries. The situation is particularly complex in the case of antiretrovirals (ARVs). The purpose of this document is to provide information on prices and suppliers that will help purchasers make informed decisions when buying ARVs. Since the first edition of ‘Untangling’, prices of some first-line ARVs have fallen significantly due to competition between multiple producers. However, not all countries are able to benefit from these lower prices because of patent barriers to accessing generic versions.