Those seeking a bit of inspiration in the struggle to improve weak health systems should check out the Time Magazine story of the radical transformation of the U.S. Veteran's Administration hospitals over the past 10 years. The VA has long had a reputation for sub-standard quality, crumbling infrastructure and unhappy workers and patients -- conditions attributed by some to its status as a large, government-run hospital system.
CGD Policy Blogs
When health and development experts study the causes of poor health in poor countries, weak health systems are often the scapegoat. With so many fingers pointed at the many inefficient, corrupt, and poorly-resourced systems, you would think that coherent, large-scale efforts would seek to address this constraint on better health. This has not been true -- until now.
The John D. and Catherine T. MacArthur Foundation gives unrestricted individual "genius" grants to activists, academics, musicians, authors and others. (Michael Kremer, a non-resident fellow of CGD and the thinker behind the Making Markets for Vaccines, is a previous recipient.)
Stephen Lewis's closing remarks at the International AIDS Conference have sparked controversy in the AIDS community because Mr. Lewis, speaking in his capacity as the UN Special Envoy for HIV/AIDS in Africa, lambasted the South African government for its AIDS policies. Mr. Lewis's choice of language was indeed quite inflammatory, but the substance of his comments was quite accurate. Namely, South Africa continues to promote policies that are antithetical to stopping the spread of AIDS.
I left the Toronto AIDS Conference last week unsettled. One of the purposes of these conferences is to bring together most of the people working in the field to share lessons and re-energize us to fight harder and do more to help people infected and affected by the disease. But Toronto felt like a professional trade show. Why?
At a satellite session on Sunday, a striking statistic was reported by the humanitarian organization Medecins Sans Frontieres: in one of its ARV treatment programs, 60 percent of project costs are going toward the treatment of 10 percent of patients. Why? After several years on standard ARV treatment regminens, many patients will inevitably develop resistance to the drugs and require newer ones.
The World Health Organization has launched a new report, Taking Stock: Health worker shortages and the response to AIDS (.pdf), which states that the "reasons for the health workforce shortage include poor pay and conditions, lack of training and migration." Among other things the report praises "ethical recruitment" -- a euphemism for "rich countries should not tell African women about the lucrative nursi
After four days of official speak, diplomatic handshakes and business card swaps at the International AIDS Conference in Toronto, I decided to take a stroll through the Global Village, the open-to-public forum for exchange of information about AIDS as it really affects people.
International AIDS Conferences are known for their dramatic protests. Tommy Thompson was booed off the stage in Barcelona. Randall Tobias, then head of PEPFAR, silently fumed at the podium for 45 minutes in Barcelona before protesters quieted enough for him to speak. The Prime Minister of Thailand was embarrassed at the Bangkok opening ceremony. AIDS activists, following the tradition of ACT UP! are known for their vocal presence -- and for pushing for real dialogue and action.