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Towards a grand convergence for child survival and health: A strategic review of options for the future building on lessons learnt from IMNCI.
Geneva, Switzerland, World Health Organization [WHO], 2016 Nov. 78 p.This strategic review provides direction to the global child health community on how to better assist countries to deliver the best possible strategies to help each child survive and thrive. Over the past quarter century, child mortality has more than halved, dropping from 91 to 43 deaths per 1000 live births between 1990 and 2015. Yet in 2015 an estimated 5.9 million children still died before reaching their fifth birthday, most from conditions that are readily preventable or treatable with proven, cost-effective interventions. The review took as its departure point the implementation of Integrated Management of Childhood Illness (IMCI), developed by WHO and UNICEF in 1995 as a premier strategy to promote health and provide preventive and curative services for children under five in countries with greater than 40 deaths per 1000 live births. It includes contributions from over 90 countries and hundreds of experts in child health and related areas, with 32 specifically commissioned pieces of analysis. The final product represents a collaboration of child health experts worldwide, working together to examine past lessons and propose an agenda to stimulate momentum for improving care for children.
Supporting community responses to malaria: A training manual to strengthen capacities of community based organizations in application processes of the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria.
Cologne, Germany, STOP MALARIA NOW!, 2009 Nov. 53 p.This training manual is a product of the STOP MALARIA NOW! advocacy campaign and aims to support community responses to malaria. In particular, this manual aims to improve knowledge and skills of Community Based Organizations (CBOs) in application processes of the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria. The contents are based on results of the needs assessment 'Capacity Needs of CBOs in Kenya in Terms of Application Processes of the Global Fund to Fight HIV /AIDS, Tuberculosis and Malaria (GFATM)', conducted in June and July 2009.
Strengthening the Education Sector Response to HIV and AIDS in the Caribbean. UNESCO / WB partnership in support of CARICOM strategy in education and HIV and AIDS.
[Paris, France], UNESCO, 2007 Dec 14. 29 p.This report presents the findings and outcomes of the three joint UNESCO/WB missions to Guyana, Jamaica and St. Lucia, and elaborates on next steps identified for action at both national and regional levels. The report also sets these findings and next steps within the broader context of the Caribbean plan for action and presents in its appendices, sample resources to guide the development of a comprehensive response to HIV & AIDS by the education sector.
A trickle or a flood: Commitments and disbursement for HIV / AIDS from the Global Fund, PEPFAR, and the World Bank’s Multi-Country AIDS Program (MAP).
[Washington, D.C.], Center for Global Development, HIV / AIDS Monitor, 2007 Mar 5. 26 p.This paper provides an analytical framework for understanding funders' disbursement policies and practices while also offering an overview of the total volume of resources being committed and disbursed by each funder. The analysis is focused on the global-level, but does provide brief country case studies to help understand some of the implications of these large inflows of funding for HIV/AIDS at the country-level. (excerpt)
Following the funding for HIV / AIDS: a comparative analysis of the funding practices of PEPFAR, the Global Fund and World Bank MAP in Mozambique, Uganda and Zambia.
[Washington, D.C.], Center for Global Development, HIV / AIDS Monitor, 2007 Oct 10.  p.Donor funding for HIV/AIDS has reached levels unprecedented in the history of global health: annual funding for AIDS in low- and middle-income countries increased 30-fold from 1996 to 2006, from US$ 300 million to US$ 8.9 billion. While funding remains far short of the estimated need, international donor commitments for HIV/AIDS are significant, and likely to be so, well into the future. The resources for AIDS are a topic of considerable interest and debate internationally, yet little is understood about how these resources are actually being spent, and whether they are being made available as efficiently and effectively as possible for the fight against AIDS. Through the lens of what is happening in several countries in sub-Saharan Africa, this paper examines the flow of resources from three of the world's largest AIDS donors: the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and the World Bank's Multi-Country HIV/AIDS Program for Africa (MAP). Drawing on country-level research undertaken by collaborating local research organizations, we describe the levels and types of funding from these donors, and highlight the procedures through which funds are committed, released and accounted for in three countries in which all of the programs are active: Mozambique, Uganda, and Zambia. Through this close look at how money moves from donor to specific purposes, we describe bottlenecks and other difficulties in the disbursement of funds, document the way their disbursement systems attempt to build national capacity to fight AIDS, and identify specific ways in which the donor agencies could make the resources move more efficiently. (excerpt)
Geneva, Switzerland, UNAIDS, .  p.Funding for AIDS has grown significantly over the past decade. In 2007, US$10 billion is expected to be available for the AIDS response - about one third coming from developing countries - compared to less than US$300 million in 1995. The substantial increase in financial resources has allowed countries to scale up their AIDS response with the ultimate goal of achieving universal access to HIV prevention, treatment, care and support. However, many countries face difficulties in effectively implementing large-scale grants made available by funding bodies such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, and bilateral actors. They require rapid and adequate technical support to effectively implement AIDS programmes. To address this implementation challenge, UNAIDS has taken a leading role in "making the money work" in countries. It has invested significant resources over the past two years in strengthening countries' national AIDS programmes, particularly through the establishment of Technical Support Facilities in five regions. (excerpt)
Lancet. 2007 Jul 28; 370(9584):311.In 1983, Michel Kazatchkine was a clinical immunologist at the Hôpital Broussais in Paris, France, when he was called to see a French couple with unexplained fever and severe immune deficiency who had been airlifted home from Africa. This man and woman were the first of many AIDS patients that Kazatchkine would take care of in the coming decades. There were no effective antiretroviral treatments available, and the couple lived only a few months on the ward before dying. "Those were difficult years with patients dying every day on the wards", Kazatchkine recalls. Much of his time, he says, was spent providing end-of-life care, consoling patients, "and holding their hands when they were dying". This year, after more than two decades of working in AIDS clinical care, research, and international programmes, Kazatchkine takes over the helm of the second largest funder of AIDS care: the Global Fund to Fight AIDS, Tuberculosis & Malaria. Anthony Fauci, Director of the US National Institute of Allergy andInfectious Disease, who says he has worked "up close and personal" with Kazatchkine since the early days of the epidemic, calls him "the perfect kind of person for the position". He's a scientist who understands the science; a clinician who understands clinical care; and an expert in AIDS who understands the epidemic, Fauci says. "He's also a fine 'people person': the kind of person who can build consensus, but also the kind of person who can take the lead." (excerpt)
JAMA. 2007 Feb 21; 29(7):744-746.HIV disease is essentially the black death of the 21st century, killing on a massive scale and threatening to cripple economies and topple governments. However, the continued spread of the HIV epidemic and the new availability of lifesaving antiretroviral drugs have triggered an extraordinary response by governments, international organizations, philanthropies, pharmaceutical companies, religious organizations, and individuals. Campaigning against HIV/AIDS has no precedent in the history of medicine. Smallpox was eliminated by a globally coordinated strategy that required a single patient encounter to deliver the vaccine. In contrast, the directly observed therapy strategy at the core of modern tuberculosis treatment necessitates daily patient contact over much of the treatment course and, therefore, a much larger health workforce. Treating AIDS requires the daily delivery of medications as well as the clinical management of patients-- for the rest of their lives. Antiretroviral medications can help control disease, but do not cure it. More problematic yet, stopping treatment once started promotes the emergence of resistant strains of the virus, making halfway programs hazardous to public health. The sheer volume of health workers needed to tackle HIV disease--and the health systems to support their work--is off the scale of any previous public health campaign. (excerpt)
[Brighton, England], University of Sussex, Institute of Development Studies, 2000 Nov. 30 p. (IDS Working Paper 121)This study examines the reasons for the rise in Zambian under-five mortality during the 1990s, paying particular attention to the relevance and effectiveness of health sector reform strategies and their impact on ordinary Zambians. In the 1980s, economic crisis and structural adjustment led to reduced public health spending in real terms so that by the early 1990s, Zambia's health care delivery system was characterised by a low-supply, low utilisation paradigm, typical of most of SSA. Health reform was designed to improve these trends by the integration and decentralisation of services, district capacity building and addressing issues of sustainability and financing. While large investments were made by the donors in the development of financial and health information systems, they did not actually improve the delivery of basic services. On the contrary, reform measures taken by government and donors appear to have further reduced access especially among the vulnerable populations through the implementation of user charges, and failed attempts to decentralise and integrate services. Although a variety of shocks are contributing to the rise in under-five mortality, particularly the HIV epidemic, there is strong evidence that a key factor explaining the rise over the last 20 years is that vulnerable populations have not received adequate protection from restructuring operations. Government and donors had little or no motivation to see that the poor had access to effective health care, were protected from the worst drought in 50 years, food subsidy withdrawal, falling living standards and rising prices. Poverty interest groups have never participated in the policy process and agencies which ought to have represented the poor have been a disappointment. As a consequence, health restructuring as social policy has been far removed from the reality of ordinary Zambians. An alternative set of reform strategies might have provided better protection for the poor by incorporating a livelihoods perspective, by being more flexible, attentive and responsive to changing needs in a turbulent environment. (author's)
UNFPA fifth country programme of assistance to the government of Kenya, 1997 to 2001. Framework for the reproductive health sub-programme.
[Unpublished] 1997 Dec. xiii, 32 p.This project between the UN Population Fund and Kenya's Ministry of Health proposes to strengthen technical and institutional capacity at all levels in the effective provision of reproductive health (RH) services during 1997-2001. The aims are to increase quality and accessibility of RH by a specific percentage, to reduce maternal mortality by 20%, to reduce perinatal morbidity and mortality by 30%, and to increase contraceptive prevalence by 20% in selected districts and Nairobi slums. The aims are also to provide youth-appropriate RH services, to reduce the spread of sexually transmitted infections (STIs) including HIV/AIDS, and to intensify IEC activities in support of RH services and other activities. This proposal describes the background, justification, and health reforms in Kenya; the RH achievements and lessons learned; selected issues to be addressed in the national RH program; goals; strategies and activities; monitoring and evaluation; the institutional framework; related activities and funding sources; and the summary budget. The budget will be shared between the Government (60%) and implementing nongovernmental organizations (40%). About 10% will be directed to IEC. The total summary budget is US$13 million. The main strategy for preventing STIs and HIV/AIDS is to integrate the education within day-to-day activities of health staff and to train service providers (SPs) at all levels. Surgical gloves and male-friendly services will be provided to all SP points. Technical support will be provided by advisers in Addis Ababa, selected national consultants, and field office program staff.
UNFPA fifth country programme of assistance to Kenya, 1997 to 2001. Strengthening reproductive health planning and management capacity of Ministry of Health.
[Unpublished] 1998 Feb. , 43,  p.This proposal describes a reproductive health (RH) program during 1997-2001 in Kenya that is supported by the UN Population Fund (UNFPA). The program builds upon prior achievements and lessons learned and supports the Ministry of Health (MOH) in efforts to strengthen the MOH's RH planning and management capacity. The project aims to strengthen institutional capacity; increase access and quality of integrated RH services; and address issues of safe motherhood, sexual and RH of adolescents and youth, sexually transmitted infections (STIs) including HIV/AIDS, and IEC. It is expected that by 2001, 38% of service delivery points will have been strengthened with integrated RH services. 6% of other services will be upgraded for closing the distance within 5 km to services among 25% of women who lack such access. The maternal mortality ratio will be reduced by 20%. Perinatal morbidity and mortality rates will be reduced by 30%. Contraceptive prevalence will be increased by 20% in selected districts and Nairobi slums. Adolescents should have more accurate and appropriate information, counseling, and services. The program should have increased community awareness of STIs and HIV/AIDS, counseling, and health facilities for reducing transmission of STIs. IEC should have been intensified by 2001. This proposal includes a description of the logical framework, the background-justification, project goals, strategies, institutional framework, advance preparations, government follow-up, UNFPA assistance and input, projected budget, justification of government input, and other related activities and funding.