Your search found 9 Results
Ethical and programmatic challenges in antiretroviral scaling-up in Malawi: challenges in meeting the World Health Organization's "Treating 3 Million by 2005" Initiative goals.
Croatian Medical Journal. 2004; 45(4):415-421.The Fifty-seventh World Health Assembly's (WHA's) resolution on the "scaling up of treatment and care within a coordinated and comprehensive response to HIV/AIDS" is welcomed globally, and even more so in Sub-Saharan Africa, where the majority of the people currently in need of antiretroviral therapy do not have access to it. The WHA identified, among others, the following areas which should be pursued by member states and the World Health Organization (WHO): trained human resources, equity in access to treatment, development of health systems, and the integration of nutrition into the comprehensive response to HIV/AIDS. The WHO Director-General was requested to "provide a progress report on the implementation of this resolution to the Fifty-eighth World Health Assembly." Much of what happens between now and that time depends on the actions of the WHO and the member states and also on the contribution of the international community to the fight against HIV/AIDS. Much of what is to be done will be based on what is available now in terms of practice, human resources, and programs. This paper explores the WHA's resolution, especially regarding the scaling up of antiretroviral therapy, taking Malawi as the case study, to identify the challenges that a Southern African country may be facing which will eventually influence whether the initiative to "Treat 3 Million by 2005" ("3 by 5") will be achieved or not. The challenges southern countries may be facing are presented in this paper not in order to undermine the initiative but to create an awareness of these factors and initiate the appropriate action which would surmount the challenges and achieve the goals set. (author's)
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2004.  p.This document is one important step in a process for improving access to quality of care in family planning by reviewing the medical eligibility criteria for selecting methods of contraception. It updates the second edition of Improving access to quality care in family planning: medical eligibility criteria for contraceptive use, published in 2000, and summarizes the main recommendations of an expert Working Group meeting held at the World Health Organization, Geneva, 21-24 October 2003. (Please see Annex 2 for the list of participants.) The Working Group brought together 36 participants from 18 countries, including representatives of many agencies and organizations. The document provides recommendations for appropriate medical eligibility criteria based on the latest clinical and epidemiological data and is intended to be used by policy-makers, family planning programme managers and the scientific community. It aims to provide guidance to national family planning/reproductive health programmes in the preparation of guidelines for service delivery of contraceptives. It should not be seen or used as the actual guidelines but rather as a reference. The document covers the following family planning methods: low-dose combined oral contraceptives (COCs), combined injectable contraceptives (CICs), combined patch (P), combined vaginal ring (R), progestogen-only pills (POPs), depot medroxyprogesterone acetate (DMPA), norethisterone enantate (NET-EN), levonorgestrel (LNG) and etonogestrel (ETG) implants, emergency contraceptive pills (ECPs), copper intrauterine devices (Cu- IUDs), levonorgestrel-releasing IUDs (LNG-IUDs), copper-IUD for emergency contraception (E-IUD), barrier methods (BARR), fertility awareness-based methods (FAB), lactational amenorrhoea method (LAM), coitus interruptus (CI), and female and male sterilization (STER). (excerpt)
Manila, Philippines, WHO, Regional Office for the Western Pacific, Stop TB, 2004.  p.Globally, over 98% of the deaths caused by tuberculosis (TB) annually are in developing countries. Within the Western Pacific Region, the seven countries that account for 94% of the TB prevalence are low or lower middle-income economies. Within countries, as well, poor and marginalized communities suffer disproportionately from TB. Importantly, TB affects the most economically and socially productive age group, as 77% of TB deaths occur within the ages of 15 – 54. This evidence points to the important relationship between poverty and TB. The deprivation associated with poverty, such as overcrowding, poor ventilation and malnutrition, increases the rate of transmission and progression from infection to disease. In turn, the costs of TB can further impoverish poor households. This is because poor households must dedicate a larger proportion of their income to meet the direct and indirect costs of seeking TB care than the non-poor. The opportunity costs are likewise higher for the poor than non-poor. For the poor, a decrease in productivity or an increase in time away from work because of illness leads to a reduction in income. Moreover, coping mechanisms employed by poor households during periods of illness may reduce household productivity in the long-term. TB has important social costs as well, which are more likely to affect women with TB than men. For example, stigma and isolation resulting from TB can reduce an individual's social position. (excerpt)
London, England, Christian Aid, 2004 Jul. 17 p.The World Health Organisation (WHO) hopes to treat three million people with antiretroviral drugs by 2005. If ‘3 by 5’, as it is known, is achieved it would represent a ten-fold increase in the number of people in poor countries receiving antiretroviral treatment (ART). This would be a hugely important step – prolonging the lives of the most productive generation and allowing parents to survive long enough to put their children through school. Christian Aid applauds this commitment but warns that this is a highly complex situation. HIV/AIDS is the biggest threat to the developing world. Today’s productive generation is dying and the workforce of tomorrow is being left without parents; the economic future of the developing world is bleak. But, as Drugs alone are not enough shows, without the appropriate infrastructure the drugs themselves may actually become counter-productive. Community organisations and networks must provide recipients of drug treatment with backup. Home-based care and other community-support programmes, the backbone of much of Christian Aid’s HIV work, are ideally placed to provide these services. (excerpt)
Geneva, Switzerland, WHO, 2004. 6 p.WHO and UNAIDS are actively promoting the scale-up of programmes to deliver antiretroviral therapy (ART), with the aim of reaching three million people by the end of 2005 ('3 by 5 Initiative'). Equity in access to HIV treatment is a critical element of the '3 by 5' and will contribute to the broader 'right to health' for all. Attention must therefore be given to ensuring access to ART and other treatment, care and prevention, for people who risk exclusion including on the basis of their sex. Currently there is limited information available on the sex and age distribution of those receiving ART, however, we know that gender-based inequalities often affect women's ability to access services. Attention is therefore required to ensure that women and girls have equitable access to ART as it becomes available. Gender-based inequalities put women and girls at increased risk of acquiring HIV. Women's limited ability to negotiate safer sex practices with their partners, including condom use, can place even women who are faithful to one partner at risk of HIV infection. Married adolescent girls may be particularly vulnerable. Sexual violence, including rape, likewise increases the risk of HIV for women and girls. In addition, they typically have less access to education, income-generating opportunities, property ownership and legal protection than men. This means many women are not able to leave relationships even when they know that they may be at risk of HIV. (excerpt)
Central European Journal of Public Health. 2004 Mar; 12(1):52.Health workers' experience shows that HAART can be delivered and is effective in poor settings. The World Health Organization (WHO) welcomes the research published in the issue of The Lancet highlighting the substantial increased survival for people with HIV/AIDS who have access to highly active antiretroviral therapy (HAART). The new report focuses on findings in rich countries, but the experience of WHO and public health workers in clinics around the world shows that antiretroviral therapy (ART) can be delivered effectively and with equally dramatic results in poor countries. This research and the new evidence that antiretroviral therapy is extremely effective gives added backing to WHO in its push to deliver antiretrovirals to three million people in developing countries by the end of 2005 (the "3 by 5" target). WHO expects survival gains to be as good or even better in resource-poor settings over a similar period of time. "Treatment with antiretrovirals works for everyone - rich and poor. Now the poor urgently need access to these drug," said Dr Charlie Gilks, head of WHO's "3 by 5" team. "We are determined too simplify treatments and to ensure that affordable, quality drugs reach those in need as quickly as possible." (excerpt)
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)
Forced Migration Review. 2004 Jan; (19):16-18.Every year more than half a million women die from complications of pregnancy and childbirth. Many more suffer severe disabilities. WHO estimates that 15% of all pregnant women will develop direct obstetric complications such as haemorrhage, obstructed or prolonged labour, pre-eclampsia or eclampsia, sepsis, ruptured uterus, ectopic pregnancy and complications of abortion. If left untreated, they will lead to death or severe disability. Maternal mortality and morbidity can only be reduced by ensuring women with obstetric complications receive good-quality medical treatment without delay. The desperate circumstances of refugee and IDP women fleeing conflict place them at exceptional risk of pregnancy-related death, illness and disability. The target of reducing maternal mortality by 75% by 2015 is a key UN Millennium Development Goal. Because obstetric complications cannot be predicted or prevented, all pregnant women need access to good quality EmOC. (excerpt)
The role of civil society in protecting public health over commercial interests: lessons from Thailand.
Lancet. 2004 Feb 14; 363(9408):560-563.In October, 2002, two Thai people with HIV-1 won an important legal case to increase access to medicines. In its judgment in the didanosine patent case against Bristol-Myers Squibb, the Thai Central Intellectual Property and International Trade Court ruled that, because pharmaceutical patents can lead to high prices and limit access to medicines, patients are injured by them and can challenge their legality. This ruling had great international implications for health and human rights, confirming that patients—whose health and lives can depend on being able to afford a medicine—can be considered as damaged parties and therefore have legal standing to sue. The complexities of pharmaceutical intellectual property law are most poorly understood by those most affected by their consequences—the patients who need the drugs. The Thai court case was the outcome of a learning process and years of networking between different civil society actors who joined forces to protect and promote the right of access to treatment. Our Viewpoint, based on key interviews and published reviews, summarises the efforts of civil society in Thailand to achieve a fair balance between international trade and public health. These efforts have focused on didanosine, an essential antiretroviral drug that in Thailand has become symbolic of how multinational companies and governments of industrialised countries protect their own interests at the expense of access to essential medicines for the poor. (author's)