The World Bank has warned India about its lackluster response to the AIDS epidemic ahead of a high-level summit on the disease in Bangkok, notes the Bank in its press review Thursday.
The Bank said it would emphasize that inaction on the disease could set back significantly the pace of development. It also announced a 60 million US dollar program to improve treatment of the disease in Ghana, Burkina Faso and Mozambique.
Infection rates remain relatively low in India as a proportion of the population – around 0,8 percent of the population or 4,6 million people. But the bank said it expected India to take over from South Africa as the country with the largest number of people carrying the disease.
– Even if the rate of prevalence seems low, the absolute number of people is high, said Praful Patel, the banks vice-president for south Asia. – If left unaddressed the proportion can rise very rapidly, added he.
Bank officials have praised African leaders for decisive action to tackle AIDS over the past few years – holding up Uganda as an example of what can be achieved. There the rates of infection have been coming down for 12 years.
The World Bank also praised Thailand, which is hosting the conference between July 11 and 16, for its swift response to the disease in the 1990s. They warned, however, that there remained a reluctance to tackle the issue in other important countries.
– While the disease is confined to marginal groups, some policymakers are reluctant to act, said Keith Hansen, manager of the banks AIDS projects in Africa. The World Bank has committed close to 1,7 billion US dollar to AIDS programs over the past few years, but problems in some recipient countries mean that not all the money has been spent.
Patel said that “leaders of South Asia are in a state of denial and there is a very high level of discomfort to even talk about HIV/AIDS.”
He noted that the leaders thought “HIV-AIDS is an African problem and it cannot happen in South Asia,” calling for a perception change in leadership “from the states at the ground level all the way to Prime Minister and head of state. Patel said he experienced the same attitude among leaders in Africa about seven years ago when HIV/AIDS was emerging as problem there.
In related news, health care professionals from around the world are meeting in Kenya this week to work out a plan for expanding private sector participation into care for AIDS and tuberculosis patients in Africa. The conference is looking into what organizers call a franchise model of AIDS and tuberculosis care in several sub-Saharan African countries.
The proposal circulated at the conference calls for setting up the franchise system first in Kenya, Uganda, and Tanzania, and then in Nigeria, Cameroon, Malawi, and Zambia. The franchise, which would be set up by an international, private organization, would be responsible for recruiting franchisees, enforcing clinical standards, providing training, purchasing and distributing drugs and products, and marketing.
A health care consultant with the World Bank, Khama Rogo, says this approach would also make more efficient use of private sector resources. For instance, he says, an average of 30 percent of beds in private facilities across Africa are vacant, while in some public hospitals, there may be up to three patients sharing one bed.
TMeanwhile the UN health agency said Wednesday that it believes it will achieve its ambitious plan to get 3 million people infected with HIV onto anti-retroviral drugs by 2005. The target is likely to be reached, thanks to global campaigns and work by individual countries, said Alex Ross, chief of staff of the World Health Organization group that deals with HIV/AIDS.
The UN-led Global Fund to Fight AIDS, Tuberculosis and Malaria announced Wednesday that it has approved grants worth 2,9 billion US dollar over five years. The grants will put another 932.000 people onto anti-retroviral treatments, bringing the total for the fund to 1,6 million people.
The Global Funds new grants also will finance 123 million anti-malaria treatments and provide 44 million bed nets treated with insecticide, which experts say reduce malaria among children by a quarter.
The Wall Street Journal Europe meanwhile notes that evidence to date suggests that even very poor countries can use the Global Funds money effectively to deliver drugs to AIDS patients. For example, Honduras topped its target for putting patients on AIDS drugs by 40 percent after getting a Global Fund grant in 2003. Haiti has exceeded its goal of treating 1.200 patients by 67 percent even though it was in the midst of a civil war, according to a fund-raising official for the fund.
Audits of the funds first 25 recipients showed that only five were failing so badly that they were at risk of losing their grants. One reason the Global Fund needs so much money is that it is expensive to improve health systems that are short of trained medical personnel.
For example, thousands of South African nurses desperately needed at home to deal with a rising tide of AIDS patients have been wooed away by the higher pay in England. Mozambique is considering importing doctors from Brazil, India and Cuba.
Kilde: www.worldbank.org
