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Washington, D.C., World Bank, Global HIV / AIDS Program, 2006 Aug. 11 p.AIDS has wide consequences for development, and presents enormous challenges to businesses in the worst hit countries. The epidemic affects workers, managers and markets by increasing costs and reducing productivity. The International Finance Corporation (IFC), the private sector arm of the World Bank Group, works with client companies to mitigate the effects of the epidemic on their operations through its IFC Against AIDS program. The program works with companies in Africa and India, and efforts are underway to raise awareness among clients in China and assess program conditions in Russia. (author's)
Bethesda, Maryland, Abt Associates. Private Sector Partnerships-One [PSP-One], 2006 Dec. 48 p. (Technical Report No. 6; USAID Contract No. GPO-I-00-04-00007-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-754)Government health sectors in many countries face an uphill battle to reach the Millennium Development Goals (MDGs) set for 2015. In the last six years, Ministries of Health (MOHs) in many less developed countries (LDCs) have been unable to invest sufficiently in their health systems. To achieve the MDGs despite inadequate resources, new approaches for delivering critical clinical services must be considered. This paper explores the potential for private-sector midwives to provide services beyond their traditional scope of care during pregnancies and births to address shortcomings in LDCs' ability to reach MDGs. This paper examines factors that support or constrain private practice midwives' (PPMWs') ability to offer expanded services in order to inform the policy and donor communities about PPMWs' potential. Data was collected through literature reviews, stakeholder interviews, and field-based, semi-structured interviews in Ghana, Indonesia, Peru, Uganda, and Zambia. Ghana, Indonesia, and Uganda were chosen because they are countries where PPMWs provide expanded services. Peru and Zambia were selected as examples where midwives have struggled to develop private practices or they provide expanded services despite issues about midwives' roles and legal sanctions for private practices. (excerpt)
Guide to the implementation of the World Programme of Action for Youth. Recommendations and ideas for concrete action for policies and programmes that address the everyday realities and challenges of youth.
New York, New York, United Nations, Department of Economic and Social Affairs, 2006.  p. (ST/ESA/309)The following key policy messages form the foundation of the recommendations contained in this Guide: Recognize, address and respond to youth as a distinct but heterogeneous population group, with particular needs and capacities which stem from their formative age; Build the capabilities and expand the choices of young people by enhancing their access to and participation in all dimensions of society; Catalyze investment in youth so that they consistently have the proper resources, information and opportunities to realize their full potential; Change the public support available to youth from ad-hoc or last-minute to consistent and mainstreamed; Promote partnerships, cooperation and the strengthening of institutional capacity that contribute to more solid investments in youth; Support the goal of promoting youth themselves as valuable assets and effective partners; Include young people and their representative associations at all stages of the policy development and implementation process; and Transform the public perception of young people from neglect to priority, from a problem to a resource, and from suspicion to trust. (excerpt)
Engaging all health care providers in TB control. Guidance on implementing public-private mix approaches.
Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2006. 52 p. (WHO/HTM/TB/2006.360)A great deal of progress has been made in global tuberculosis control in recent years through the large-scale implementation of DOTS. It has been acknowledged though that TB control efforts worldwide, although impressive, are not sufficient. The global TB targets -- detecting 70% of TB cases and successfully treating 85% of them, and halving the prevalence and mortality of the disease by 2015 as part of the Millennium Development Goals (MDGs) -- are likely to be met only if current efforts are intensified. Among the important interventions required to reach these goals would be a systematic involvement of all relevant health care providers in delivering effective TB services to all segments of the population. Therefore, engaging all health care providers in TB control is an essential component of WHO's new Stop TB strategy¹ and the Stop TB Partnership's Global Plan to Stop TB 2006-2015. (excerpt)
Bulletin of the World Health Organization. 2006 Jun; 84(6):428.Tuberculosis care, a clinical function consisting of diagnosis and treatment of persons with the disease, is the core of tuberculosis control, which is a public health function comprising preventive interventions, monitoring and surveillance, as well as incorporating diagnosis and treatment. Thus, for tuberculosis control to be successful in protecting the health of the public, tuberculosis care must be effective in preserving the health of individuals. There are three broad mechanisms through which tuberculosis care is delivered: public sector tuberculosis control programmes, private sector practitioners having formal links to public sector programmes (the public--private mix), and private providers having no connection with formal activities. In most countries, programmes in both the public sector and the public--private mix are guided by international and national recommendations based on the DOTS tuberculosis control strategy -- a systematic approach to diagnosis, standardized treatment regimens, regular review of outcomes, assessment of effectiveness and modification of approaches when problems are identified. (excerpt)
Building effective public-private partnerships: experiences and lessons from the African Comprehensive HIV / AIDS Partnerships (ACHAP).
Social Science and Medicine. 2006 Jul; 63(2):397-408.This paper examines the processes for building highly collaborative public--private partnerships for public health, with a focus on the efforts to manage the complex relationships that underlie these partnerships. These processes are analyzed for the African Comprehensive HIV/AIDS Partnerships (ACHAP), a 5-year partnership (2001--2005) between the government of Botswana, Merck & Co., Inc. (and its company foundation), and the Bill & Melinda Gates Foundation. ACHAP is a highly collaborative initiative. The ACHAP office in Botswana engages intensively (on a daily basis) with the government of Botswana (an ACHAP partner and ACHAP's main grantee) to support HIV/AIDS control in that country, which had an adult prevalence of 38.5% HIV infection in 2000 when ACHAP was being established. The paper discusses the development of ACHAP in four stages: the creation of ACHAP, the first year, the second and third years, and the fourth year. Based on ACHAP's experiences over these four years, the paper identifies five lessons for managing relationships in highly collaborative public--private partnerships for public health. (author's)
Bulletin of the World Health Organization. 2006 May; 84(5):405-411.Since the first WHO Model List of Essential Medicines was adopted in 1977, it has become a popular tool among health professionals and Member States. WHO's joint effort with the United Nations Committee on Economic, Social and Cultural Rights has resulted in the inclusion of access to essential medicines in the core content of the right to health. The Committee states that the right to health contains a series of elements, such as availability, accessibility, acceptability and quality of health goods, services and programmes, which are in line with the WHO statement that essential medicines are intended to be available within the context of health systems in adequate amounts at all times, in the appropriate dosage forms, with assured quality and information, and at a price that the individual and the community can afford. The author considers another perspective by looking at the obligations to respect, protect and fulfil the right to health undertaken by the states adhering to the International Covenant of Economic, Social and Cultural Rights (ICESCR) and explores the relationship between access to medicines, the protection of intellectual property, and human rights. (author's)
Bulletin of the World Health Organization. 2006 May; 84(5):338.The context for this theme collection is the publication of the report of the Commission on Intellectual Property Rights, Innovation and Public Health. The report of the Commission -- instigated by WHO's World Health Assembly in 2003 -- was an attempt to gather all the stakeholders involved to analyse the relationship between intellectual property rights, innovation and public health, with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines, vaccines and diagnostic tests, to tackle diseases disproportionately affecting developing countries. In reality, generating a common analysis in the face of the divergent perspectives of stakeholders, and indeed of the Commission, presented a challenge. As in many fields -- not least in public health -- the evidence base is insufficient and contested. Even when the evidence is reasonably clear, its significance, or the appropriate conclusions to be drawn from it, may be interpreted very differently according to the viewpoint of the observer. (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):337-424.Developing countries are failing to make full use of flexibilities built into the World Trade Organization's (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to overcome patent barriers and, in turn, allow them to acquire the medicines they need for high priority diseases, in particular, HIV/AIDS. First-line antiretroviral (ARV) drugs for HIV/AIDS have become more affordable and available in recent years, but for patients facing drug resistance and side-effects, second-line ARV drugs and other newer formulations are likely to remain prohibitively expensive and inaccessible in many countries. The problem is that many of these countries are not using all the tools at their disposal to overcome these barriers. Medicines protected by patents tend to be expensive, as pharmaceutical companies try to recoup their research and development (R&D) costs. When there is generic competition prices can be driven down dramatically. The TRIPS Agreement came into effect on 1 January 1995 setting out minimum standards for the protection of intellectual property, including patents on pharmaceuticals. Under that agreement, since 2005 new drugs may be subject to at least 20 years of patent protection in all, apart from in the least-developed countries and a few non-WTO Members, such as Somalia. Successful AIDS programmes, such as those in Brazil and Thailand, have only been possible because key pharmaceuticals were not patent protected and could be produced locally at much lower cost. For example, when the Brazilian Government began producing generic AIDS drugs in 2000, prices dropped. AIDS triple-combination therapy, which costs US$ 10 000 per patient per year in industrialized countries, can now be obtained from Indian generic drugs company, Cipla, for less than US$ 200 per year. This puts ARV treatment within reach of many more people. (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):371-375.Most countries have acceded to at least one global or regional covenant or treaty confirming the right to health. After years of international discussions on human rights, many governments are now moving towards practical implementation of their commitments. A practical example may be of help to those governments who aim to translate their international treaty obligations into practice. WHO's Essential Medicines Programme is an example of how this transition from legal principles to practical implementation may be achieved. This programme has been consistent with human rights principles since its inception in the early 1980s, through its focus on equitable access to essential medicines. This paper provides a brief overview of what the international human rights instruments mention about access to essential medicines, and proposes five assessment questions and practical recommendations for governments. These recommendations cover the selection of essential medicines, participation in programme development, mechanisms for transparency and accountability, equitable access by vulnerable groups, and redress mechanisms. (author's)
Tropical Medicine and International Health. 2006 Mar; 11(3):255-257.A lavishly sponsored Global Health Summit conference in New York organized in early November by Time magazine included a panel discussion on the pertinent issue of whether global health can be good for business,1 and in the process highlighted many of the contradictions confronting health care providers, policy makers and planners the world over. Attempts to graft compassion onto the root stock of global capitalism have been only partially successful, if at all. Certainly none of the big players in the $3 trillion plus health care industry - whether they be pharmaceutical corporations, equipment manufacturers, hospital chains or health insurers - has been able to demonstrate any long term or sustained commitment to the delivery of health care services to the billions of people in low income countries who currently lack access to them. Many of the 'Global Public Private Partnerships' favoured by the WHO appear to serve largely as public relations campaigns for the private sector 'partners' and also as a means to help them to secure and potentially expand their longer-term market for drugs and vaccines. Meanwhile some of the largest donors supporting such partnerships come from outside of the health care industry altogether - most notably Bill and Melinda Gates, whose benevolent billions also help make Microsoft's cosmic profits seem more socially acceptable. (excerpt)