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More Health Workers, Yes. But Only Within Better Systems

*This post is co-authored by Ruth Levine
In the Washington Post today, three doctors with sterling reputations in the AIDS world (Lola Daré, executive secretary of the African Council for Sustainable Health Development International and a member of CGD's working group on IMF programs and health spending; Paul Farmer, pioneer of new AIDS treatment programs in Haiti and Rwanda; and chief of Harvard Medical School's Department of Social Medicine Jim Kim, a member of CGD's working group on the Global Fund), call on the Bush Administration to spend $8 billion on training of community workers, nurses and doctors in Africa to deal with AIDS treatment.
Their proposition that many more community-level health workers be deployed to provide essential services, breaking the implicit and costly monopoly of health "professionals" on health delivery, makes eminent sense. But more money for training, without complementary institutional changes that fundamentally alter the incentives for workers at all levels, won't get the outcomes sought by those who are working on AIDS, or any other health challenges.

Notes from Nairobi on World AIDS Day

We were fortunate to attend a World AIDS Day event in Nairobi this morning sponsored by the National AIDS Control Council, the Kenyan government's HIV/AIDS coordinating body. It was a celebration of sorts - dancing and singing, balloons and banners. Speakers, including the Minister of Health and Vice President, noted that Kenya has seen a recent drop in its prevalence rate, albeit a small one. They attributed part of this achievement to a strong partnership with civil society. And indeed, there was a strong civil society presence at the event. Community-based organizations from all over Kenya had booths displaying their work and the representatives of these groups spoke knowledgeably about programs in prevention, treatment and care.

Another bold step by Thailand in combatting HIV/AIDS

Even though the TRIPS agreement and the subsequent Doha declaration contain public health safeguards that allow developing countries to produce or import generic medicines, the reality is that few countries have had the political will and technical support to use those safeguards. That's why it's especially encouraging that earlier this week, Thailand's government announced it would issue a compulsory license for the antiretroviral drug Efavirenz, currently patented there by Merck.