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In: State of the art: AIDS and economics, edited by Steven Forsythe. Washington, D.C., Futures Group International, POLICY Project, 2002 Jul. 58-63.The Declaration of Commitment of the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) calls for spending on HIV/AIDS programs to increase to US$7-10 billion annually by 2005. The Declaration specifies a number of goals at the global and national level and calls for specific actions to reach those goals, but it does not specify how the funding should be allocated. The Report of the Commission on Macroeconomics and Health estimates that spending on HIV/AIDS in low- and middle-income countries should increase by US$14 billion by 2007 and suggests that US$6 billion is needed for prevention, US$3 billion for care, and US$5 billion for antiretroviral (ARV) treatment. A detailed estimate of spending requirements prepared for UNGASS calls for minimum spending of US$9.2 billion annually by 2005 in low- and middle-income countries to provide coverage of essential prevention, care, and mitigation services in an effort to reach the UNGASS goals. Details of spending needs by category of intervention are shown in Figure 1. A recent analysis shows that these coverage levels are sufficient to achieve the UNGASS goals. However no analysis has been done to show whether this is the most cost-effective approach to achieving these goals or whether the same goals could be reached with less funding and a more strategic allocation of resources. (excerpt)
HIV / AIDS and globalization -- What is the epidemic telling us about economics, morality, and pragmatism?
In: State of the art: AIDS and economics, edited by Steven Forsythe. Washington, D.C., Futures Group International, POLICY Project, 2002 Jul. 9-15.Disease epidemics have been related as both cause and effect to increasing integration of human economies, societies, and cultures throughout history. It is well known that infectious diseases are not equally distributed between different societies and different sections of the same society. This is clear on a global scale where disparities in exposure to infection and access to public health provision and health care are acute. There is a debate as to the meaning and effects of “globalization” as well as about whether it is “new” and, if so, in what ways. This paper briefly examines (a) the history of disease in relation to globalization; (b) the meanings and importance of “globalization”; (c) where and how the HIV/AIDS epidemic fits into the picture; (d) some of the theoretical and ideological implications. (author's)
In: State of the art: AIDS and economics, edited by Steven Forsythe. Washington, D.C., Futures Group International, POLICY Project, 2002 Jul. 2-8.Policymakers need a reasonably complete picture of resource flows from sources to uses that finance HIV/AIDS prevention, care, support, and treatment. Without that picture, they risk misallocation, waste, and faulty strategic planning. For now, in most parts of the developing world, the picture remains largely unpainted. Filling in the details on financing is among the key challenges to HIV/AIDS policymakers today. Limited data for Latin American and Caribbean (LAC) region countries offer virtually the only cases of adequate resource flow data outside the United States. Those countries spent a thousand dollars per person living with HIV/AIDS (PLWHA) in 2000. The U.S. federal government’s Medicaid program for indigents spent 35 times as much for each AIDS patient under its care in that same year. Low-income countries, largely dependent on donor assistance, spent far less per person and per PLWHA—as little as 31 cents per person, and eight dollars per PLWHA in sub-Saharan Africa. These enormous disparities underline a dual challenge: First, use what little money is available in poor countries very effectively; and second, demonstrate to all concerned that more resources must be forthcoming to confront the HIV/AIDS pandemic in poor countries, lest the negative effects swamp any effort to develop. (author's)
In: AIDS in Africa: Help the victims or ignore them?, edited by V. Lovell. New York, New York, Novinka Books, 2002. 1-21.Sub-Saharan Africa has been far more severely affected by AIDS than any other part of the world. According to a December 1, 2001 report issued by the Joint United Nations Program on HIV/AIDS (UNAIDS), some 28.1 million adults and children are infected with the HIV virus in the region, which has about 10% of the world's population but 70% of the worldwide total of infected people. The overall rate of infection among adults is about 8.4%, compared with 1.2% worldwide. UNAIDS projects that half or more of all 15 year-olds will eventually die of AIDS in some of the worst-affected countries, such as Zambia, South Africa, and Botswana, unless the risk of contracting the disease is sharply reduced. An estimated 19.3 million Africans have lost their lives to AIDS, including an estimated 2.3 million who died in 2001. UNAIDS estimates that 3.4 million new HIV infections occurred in 2001, down from the estimated 3.8 million new infections in 2000. Experts are cautious in suggesting that this decline might represent some success in prevention efforts, particularly since the adult infection rates continue to increase in a number of countries, including Nigeria, Africa's most populous nation. Moreover, they point out that 3.4 million new infections still represents a very fast and highly destructive rate of spread. AIDS has surpassed malaria as the leading cause of death in sub-Saharan Africa, and it kills many times more people than Africa's armed conflicts. (excerpt)
Bangkok, Thailand, UNESCO, Asia and Pacific Regional Bureau for Education, 2002. 101 p.The inventory has been grouped by types of materials which include the following: Guideline materials; Curriculum; Teaching materials; Learning materials; Resource/reading materials; Training materials; Support audio-visual materials. Under each of these types of materials are sub-groups by themes or topics such as those dealing with care and counselling; information, education and communication, programme development, AIDS curriculum, life skills, adolescent reproductive health, prevention and care, training, peer education, and the like. However, in addition to accessing the various teaching/learning materials by types, the documents can also be retrieved by target audience, educational level, introduction methods, methodologies, objectives or specific uses, and geographical coverage through the help of the indexes found at the end of the inventory. (excerpt)
Journal of Acquired Immune Deficiency Syndromes. 2002 Feb 1; 29(2):184-90.The objective of this study was to estimate the global distribution and regional spread of different HIV-1 genetic subtypes and circulating recombinant forms (CRFs) in the year 2000. These estimates were made based on data derived from global HIV/AIDS surveillance and molecular virology studies. HIV-1 incidence during the year 2000 was estimated in defined geographic regions, using a country-specific model developed by WHO-Joint UN Programmes on HIV/AIDS (UNAIDS). The proportion of new infections caused by different HIV-1 subtypes in the same geographic regions was estimated by experts from the WHO-UNAIDS Network for HIV Isolation and Characterization, based on results generated by HIV molecular epidemiology studies in 1998-2000. The absolute numbers and relative proportions of new infections due to different genetic subtypes of HIV- 1 by different geographic regions were calculated using these two sets of estimated data. The results of the study demonstrated that the epidemiology of HIV-1 subtypes and CRFs is characterized by their differential distribution and varying significance as a driving cause of the pandemic on regional and global basis. The largest proportion of HIV-1 infections in the year 2000 was due to subtype C strains (47.2%). Subtype A/+CRF02_AG was estimated to be the second leading cause of the pandemic (27%), followed by subtype B strains (12.3%). The same analysis confirmed an increasing role of HIV-1 CRFs in the pandemic. The authors conclude that combined analysis of data based on the global HIV/AIDS surveillance and molecular virology studies provides for a useful model to monitor the dynamics of the global spread of HIV-1 subtypes and CRFs on regional and country levels--the information of potential importance for diagnosis and treatment of HIV/AIDS, as well as for the development globally effective HIV vaccines. (author's)