HIV/AIDS In Developing Countries Requires Continued Attention
Although HIV/AIDS in developing countries requires "continuedattention" and preventing deaths from the disease remains"imperative," other public health needs should not be"ignored," Daniel Halperin, a researcher at the HarvardSchool of Public Health, writes in a NewYork Times opinion piece.
According to Halperin,the "well-meaning promises" of some 2008 presidentialcandidates to nearly double U.S. aid to fight HIV/AIDS worldwide is"missing the mark." Spending more than $50 billion onforeign health assistance "does make sense, but only if it isnot limited to HIV/AIDS programs," Halperin writes. He adds thatin many developing countries, access to clean water is "inadequate,"while shortages of food and basic health services -- includingvaccinations, prenatal care and family planning -- have contributedto larger families, as well as high child and maternal mortality.Large donors -- including the President'sEmergency Plan for AIDS Relief and the GlobalFund To Fight AIDS, Tuberculosis and Malaria -- have not"directly addressed such basic health issues," according toHalperin.
Halperin writes that in Botswana, much of thefunding from PEPFAR and other donors "remains unspent" asits HIV clinics "cannot absorb such a large influx of cash."He adds that in Africa, there is "another crisis exacerbated bythe rigid focus on AIDS: the best health practitioners have abandonedlower-paying positions in family planning, immunizations and otherbasic health areas in order to work for donor-financed HIV programs."
The "AIDS experience" has shown that developingcountries can make complex treatments, such as antiretroviral drugs,accessible to many people, Halperin writes. He adds, "Regimensthat are much simpler to administer than antiretroviral drugs -- likeantibiotics for respiratory illnesses, oral rehydration for diarrhea,immunizations and contraception -- could also be made widelyavailable." According to Halperin, it is "important,especially for the U.S., the world's largest donor, to re-examine theepidemiological and moral foundations of its global healthpriorities." Halperin concludes that the "real-world needs"of Africans -- including the "ubiquitous ravages of hunger,dirty water and environmental devastation" -- should not be"subsumed by the favorite causes du jour of well-meaning yetoften uninformed Western donors" (Halperin, New YorkTimes, 1/1).
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