The Tale of Two Epidemics: HIV/AIDS in Ghana and Namibia

Background: In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) introduced the 90-90-90 goals to eliminate the AIDS epidemic. Namibia was the first African country to meet these goals. Objective: To construct a comparative historical narrative of international and government responses to the HIV/AIDS epidemic in the two countries, to identify enabling and non-enabling factors key to mitigate the HIV/AIDS pandemic. Methods: We conducted a desk review of public documents, peer-reviewed articles, and media reports to evaluate actions taken by Namibia and Ghana’s governments, donors, and the public and compared disease prevalence and expenditure from all sources. Results: Namibia’s progress is due to several factors: the initial shocking escalation of infection rates, seen by donors as a priority; the generalizability of the epidemic generated, which resulted in overwhelming public support for HIV/AIDS programs; and a strong health system with substantial donor investment, allowing for aggressive and early ramp up of ART. Modest donor support relative to the magnitude of the epidemic, a weak health care system, and widespread household cost-sharing are among the factors that diminished support for universal access to HIV treatment in Ghana. Conclusion: Four factors played a key role in Namibia’s success: the nature of the HIV/AIDS epidemic, the government and international community's response to the epidemic, health system characteristics, and financing of HIV/AIDS services. Strengthening the health systems to support HIV/AIDS testing and care services, ensuring sustainable ART funding, empowering women, and investing in an efficient surveillance system to generate local data on HIV prevalence would assist in developing targeted programs and allocate resources to where they are needed most.

Download Full-text

Challenges in HIV/AIDS prevention, care and treatment programme in India

SAARC Journal of Tuberculosis Lung Diseases and HIV/AIDS ◽

10.3126/saarctb.v7i1.3955 ◽

1970 ◽

Vol 7 (1) ◽

pp. 1-7

Author(s):

R Sogarwal ◽

D Bachani ◽

S Venkatesh

Keyword(s):

Millennium Development Goals ◽

Universal Access ◽

Aids Prevention ◽

Treatment Services ◽

Development Goals ◽

Aids Program ◽

Care And Treatment ◽

The Government ◽

Training Programmes ◽

Hiv Aids

This paper explores the pertinent challenges of Government’s HIV/AIDS prevention, care and treatment program in India. Study is mainly based on observations made during field visits, discussion during review meetings at various levels and during training programmes of various functionaries from April 2007-November 2009. The paper also takes into account the observations made on the conclusion of the Mid-term Review conducted by the Government of India in during July- December 2009 after completion of first 2.5 years of the 5-year plan of NACP-III. Additionally, interactions with key program managers involved in implementation and management of HIV/AIDS Program at the state, district and facility levels. Though numerous efforts have been made and continued by the Government and partners, HIV prevention, care and treatment services have not been able to reach to the most-at-risk population, specifically in the rural population. Socio-cultural and managerial issues are the key challenges reported by the most of the key implementers. There is an urgent need to address and strengthen the whole spectrum of health systems through a collaborative approach to achieve the millennium development goals of universal access to prevention, care and treatment services in India. DOI: 10.3126/saarctb.v7i1.3955SAARC J. TUBER. LUNG DIS. HIV/AIDS 2010 VII(1) 1-7

Download Full-text

Kebijakan Pengendalian HIV/AIDS di Denpasar

Kesmas National Public Health Journal ◽

10.21109/kesmas.v8i1.341 ◽

2013 ◽

Vol 8 (1) ◽

pp. 45

Author(s):

Tri Rini Puji Lestari

Keyword(s):

Local Governments ◽

People Living With Hiv ◽

District Health ◽

Aids Epidemic ◽

The Government ◽

Living With Hiv ◽

And Control ◽

The City ◽

Government Perspective ◽

Hiv Aids

Secara nasional, Indonesia telah mengantisipasi epidemi HIV/AIDS, tetapi jumlah kasus HIV/AIDS di Provinsi Bali dari tahun ke tahun memperlihatkan peningkatan yang semakin mengkhawatirkan. Penelitian ini bertujuan untuk mengetahui perkembangan jumlah kasus dan kebijakan penanggulangan HIV/AIDS di Denpasar. Penelitian ini menggunakan metode kualitatif yang dilakukan di Denpasar pada tanggal 11-17 September 2011. Sampel penelitian ini menggunakan informan terpilih yaitu kepala bappeda, pejabat Dinas Kesehatan Kabupaten Denpasar, direktur rumah sakit, puskesmas, ketua komisi penanggulangan AIDS di kabupaten/kota dan pemerhati HIV/AIDS termasuk ODHA. Penelitian menemukan jumlah kasus HIV/AIDS di Kota Denpasar yang tertinggi dan penularan terbesarnya melalui hubungan seks. Namun, dukungan pemerintah daerah dalam upaya pencegahan dan penanggulangan HIV/AIDS terlihat belum maksimal. Padahal kebijakan penanggulangan HIV/AIDS sangat ditentukan oleh cara pandang pemerintah terhadap penyakit HIV/AIDS. Untuk itu, perlu peningkatan pemahaman tentang HIV/AIDS serta pencegahan dan penanganan semua pihak terkait sehingga penanggulangan HIV/AIDS dapat lebih efektif, efisien, dan tepat sasaran.Nationally, Indonesia anticipated HIV/AIDS epidemic, but the number of cases of HIV/AIDS in Bali province from year to year showed an increase in the increasingly alarming. This study aimed to determine the number of cases and the development of policies on HIV / AIDS in Denpasar. This research was conducted using qualitative methods in Denpasar on 11-17 September 2011. The study sample was selected using the informant is head of planning, Denpasar District health officers, the director of the hospital, health center, chairman of the commission on AIDS in the district/city and observer of HIV / AIDS, including people living with HIV. The study found the number of cases of HIV / AIDS in the city of Denpasar is the highest and greatest transmission through sexual intercourse. However, the support of local governments in efforts to prevent and control HIV/AIDS looks not maximized. In fact the policy of HIV/AIDS is largely determined by the government perspective on HIV / AIDS. To that end, should be an increased understanding of HIV/AIDS as well as prevention and treatment of all parties concerned. So that HIV/ AIDS can be more effective, efficient, and targeted.

Download Full-text

Bolivia health reform to boost Morales election hopes

Emerald Expert Briefings ◽

10.1108/oxan-db242092 ◽

2019 ◽

Keyword(s):

Health System ◽

Health Reform ◽

Public Support ◽

Content Type ◽

Fourth Term ◽

The Government

Significance The result was rejected by President Evo Morales, who is running for a fourth term in October regardless. He retains wide public support and looks set to benefit from the opposition’s failure so far to unify around a single candidate. The government intends to launch a new healthcare scheme on March 1, improving provision for millions of Bolivians and further bolstering Morales’s chances of re-election. Impacts Bolivia can expect another year of buoyant growth but sustaining that may prove more difficult in the longer term. A re-elected MAS government could confront opposition majorities in the bicameral legislature. The government’s ambitious health system may prove problematic in its implementation.

Download Full-text

IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462316000039 ◽

2015 ◽

Vol 31 (6) ◽

pp. 390-398 ◽

Cited By ~ 6

Author(s):

Noor Tromp ◽

Rozar Prawiranegara ◽

Adiatma Siregar ◽

Deni Sunjaya ◽

Rob Baltussen

Keyword(s):

Health System ◽

Priority Setting ◽

Product Information ◽

Group Discussion ◽

World Health ◽

People Living With Hiv ◽

Individual Level ◽

Aids Epidemic ◽

Study Results ◽

Hiv Aids

Objectives: This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia.Methods: Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences.Results: Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders’ preferences for the importance of criteria are similar.Conclusions: Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

Download Full-text

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

AIDS and Behavior ◽

10.1007/s10461-018-2166-6 ◽

2018 ◽

Vol 22 (9) ◽

pp. 3071-3082 ◽

Cited By ~ 12

Author(s):

D. Panagiotoglou ◽

◽

M. Olding ◽

B. Enns ◽

D. J. Feaster ◽

...

Keyword(s):

Health System ◽

System Capacity ◽

Aids Epidemic ◽

Us Cities ◽

Hiv Aids

Download Full-text

The benefits of HIV/AIDS intervention in the workplace: A case study

South African Journal of Economic and Management Sciences ◽

10.4102/sajems.v5i1.2670 ◽

2002 ◽

Vol 5 (1) ◽

pp. 180-202

Author(s):

F. Le R. Booysen ◽

J. Molelekoa

Keyword(s):

Social Responsibility ◽

Private Sector ◽

Aids Epidemic ◽

Active Population ◽

The Government ◽

Hiv Aids

Over the next ten years, as the AIDS epidemic takes its toll on the economically active population, employers will incur considerable costs. However, relatively inexpensive interventions, if implemented now, can yield substantial returns and save business considerable amounts of money. Thus, social responsibility can be argued to make economic sense. Worrying, though, is that there also appears to be a general apathy on the part of business, especially amongst small and medium-sized enterprises. A lot needs to be done to change the attitude of business and get business actively involved in the fight against HIV/AIDS. The private sector can and need to do its share in an integrated, coordinated response to HIV/AIDS, thus contributing to the initiatives on which the government, NGOs and communities have already embarked.

Download Full-text

Tantangan Pencapaian Millenium Development Goals (MDGs) Bidang Kesehatan di Indonesia

Kesmas National Public Health Journal ◽

10.21109/kesmas.v1i5.296 ◽

2007 ◽

Vol 1 (5) ◽

pp. 232

Author(s):

Budi Utomo

Keyword(s):

Health Care ◽

Health Indicators ◽

Care Program ◽

Aids Epidemic ◽

Contagious Diseases ◽

Health Area ◽

Main Challenge ◽

The Government ◽

Intervention Policy ◽

Hiv Aids

Laporan pemerintah tentang pencapaian MDGs di Indonesia sampai tahun 2002 merefleksikan komitmen dalam mensejahterakan rakyat. Kesehatan yang dijabarkan dalam berbagai indikator tujuan 4, 5, dan 6 dilaporkan membaik. Tulisan ini menelaah status pencapaian, mencari penjelasan latar belakang pencapaian, dan menilai prospek pencapaian MDGs utamanya bidang kesehatan. Hasil telaah menunjukkan sebagian besar indikator kesehatan membaik, tetapi lamban. Walau menurun, angka kematian ibu dan anak masih tinggi. Penyakit infeksi dan masalah gizi masih prevalen. Akses masyarakat terhadap pelayanan kesehatan masih rendah. Biaya masih menjadi penghambat utama pelayanan kesehatan bagi mereka yang membutuhkan. Program pemberantasan penyakit menular, termasuk HIV/AIDS, malaria, dan TB masih dihadapkan pada banyak hambatan. Prevalensi malaria dan TB masih tinggi, sementara epidemi HIV/AIDS di beberapa daerah sudah mulai masuk kedalam populasi rendah. Gambaran ini menyiratkan prognosis pencapaian MDGs di Indonesia yang kurang menggembirakan. Tantangan utama pencapaian MDGs bidang kesehatan adalah bagaimana pemerintah dapat menerjemahkan komitmen dan kebijakan intervensi efektif yang sudah tersedia menjadi program rutin pelayanan kesehatan yang dapat langsung menyentuh masyarakat, terutama mereka yang paling membutuhkan, yaitu masyarakat miskin.Kata kunci: Pencapaian MDGs, bidang kesehatan, masyarakat miskinAbstractGovernment’s report on achievement of MDGs in Indonesia until 2002 reflects commitment towards people’s welfare. Health area as explained in indicators of goals 4, 5, and 6 were reported as improved. This review examines achievement status, elucidates background explanation about those achievement status, and assesses prospect of MDG achievement, particularly in health area. The review shows that most of MDG’s health indicators improved but in a slow manner. Funding is still posed as the main constraint of health care of those who needed it. Eradication program of infectious and contagious diseases, including HIV/AIDS, malaria, and TB faces many hurdles. Malaria and TB prevalences are still high , while HIV/AIDS epidemic in several areas has shown infiltration and spread among low socio-economic population groups. This situation reflects a not very good prognostic of MDG achievement in Indonesia. The main challenge of MDG achievement in health area in Indonesia is related to question on how the government could translate commitment and effective intervention policy into routine health care program that directly touch the people, especially those who need most: the poor.Keywords: MDG achievement, health area, the poor

Download Full-text