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BMJ. British Medical Journal. 2004 Nov 27; 329:1281-1283.WHO’s “3 by 5” initiative to increase access to antiretroviral drugs to people with AIDS in developing countries is highly ambitious. Some of the biggest obstacles relate to delivering care. Access to good quality antiretroviral treatment has transformed the prognosis for people with AIDS in the developed world. Although it is feasible and desirable to deliver antiretroviral drugs in resource poor settings, few of the 95% of people with HIV and AIDS who live in developing countries receive them. The World Health Organization has launched a programme to deliver antiretroviral drugs to three million people with AIDS in the developing world by 2005, the “3 by 5” initiative. We identify some of the challenges faced by the initiative, focusing on delivery of care. (excerpt)
In: Health care of women and children in developing countries, [edited by] Helen M. Wallace, Kanti Giri. Oakland, California, Third Party Publishing, 1990. 85-95.Primary health care (PHC) taken alone is not enough to significantly reduce the death and suffering currently experienced by 3rd world nations. There are a variety of other factors such as severe poverty, lack of education, contaminated environments, social fragmentation, and political instability that prevent people from leading healthy and productive lives. The purpose of this chapter is to make some brief observations about the nature of health problems of mother and children in developing countries and use some of these problems as models for discussing broader issues, followed by an examination of some approaches to the design, management, and evaluation of PHC systems. The discussion includes social, economic, and political factors that determine health outcomes. It is clear from the available data that recurrent health problems exist for mothers and children in the 3rd world. The primary causes of ill health and death for children are malnutrition, immunizable diseases, diarrheal diseases, and acute respiratory infection. The primary cause of ill health and death for mothers are associated with pregnancy and child birth. In order to achieve health care for everyone, the World Health Organization follows 5 essential rules; universal coverage with care based on need or risk; effective, affordable, accessible, culturally acceptable care; promotive, preventive, curative, rehabilitative; community participation that promote self-reliance; and interaction with other sectors of development.