Healers Abroad Americans Responding to the Human Resource Crisis in HIV/AIDS (2005) / Chapter Skim
Currently Skimming:
3 New Routes of Engagement Against Global HIV/AIDS
3 New Routes of Engagement Against Global HIV/AIDS
Pages 68-85
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From page 68... ...
. In actuality, the last 3 years has witnessed dramatic breakthroughs in global HIV/AIDS assistance and control efforts: a sharp drop in the price of antiretroviral drugs, simplified drug delivery, greater political commitment among leaders in donor and recipient governments, greater involvement of the private sector, and major international initiatives.
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From page 69... ...
The chapter concludes with observations drawn from a survey (commissioned by this committee) of American nongovernmental organizations engaged in HIV/ AIDS projects in one or more PEPFAR focus countries (for a full report, see Appendix D)
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From page 70... ...
, which is involved in HIV/AIDS research in the PEPFAR focus countries; the Health Resources and Services Administration, which has experience expanding HIV/AIDS and other health services in resource-poor settings in the United States and is providing some assistance in several of the PEPFAR focus countries; and the Office of the Secretary/Office of Global Affairs, which plays a coordinating role for HIV/AIDS efforts within DHHS. Other agencies involved in PEPFAR include the Department of Defense, the Peace Corps, and the Departments of Labor and Commerce.
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From page 71... ...
Early Assessments PEPFAR's strengths -- its extraordinary leadership and financial commitment, swiftness, and focused efforts within a relatively small number of countries -- have catalyzed hope and mobilized action within the current focus countries and partner agencies. Nonetheless, the challenges facing PEPFAR are great.
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From page 72... ...
13) Another early review of PEPFAR, conducted by the Center for Strategic and International Studies in collaboration with the Kaiser Family Foundation, raised concerns related to PEPFAR's large disbursement through a collection of disparate funding mechanisms not prepared to provide urgent responses; the need for real-time monitoring and evaluation, as well as longer-term progress reports based on reliable data systems; and the need to coordinate with non-HIV/AIDS disease control activities already in place in the PEPFAR focus countries, organized by other local and international groups (Nieburg et al., 2004)
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From page 73... ...
This plan, known as the 3 × 5 initiative emphasizes revised, simplified, and standardized guidelines for ART in resourcepoor settings; support for buying, financing, and supplying antiretrovirals and diagnostic technology; and training strategies for health professionals and lay health workers. According to the most recent progress report on the 3 × 5 intiative, released in December 2004 by the second half of 2004, the number of people on ART in developing and transitional countries had increased from 440,000 to an estimated 700,000 (WHO, 2004)
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From page 74... ...
74 for data of ART Kuwait, and stimatesE Number apan,J Preliminary Receiving cases. 4,000 table.
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From page 75... ...
It has been noted that adherence rates of these patients are high. Based on these successful experienc es, community health workers appear to be an excellent option for the future of health care in resource-poor settings, especially for the management of diseases such as HIV/AIDS.
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From page 76... ...
76 HEALERS ABROAD tive. Such partnerships help facilitate local coordination, but they can also hinder access to funding by subgroups of HIV-infected stakeholders already marginalized within their own country, or by groups proposing public health interventions incongruent with government policies (Kerr et al., 2004)
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From page 77... ...
. Examples of activities focused on fostering human resources for health include the International AIDS Education and Training Center on HIV (I-TECH; see below)
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From page 78... ...
and PEPFAR focus country partners, although partnerships between focus countries (southsouth) with or without a third country (trilateral)
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From page 79... ...
, currently conceived as a network of individuals with expertise in health care and HIV/AIDS who will work in established twinning partnerships or in programs in other PEPFAR focus countries. Assignments will range from 3 months to 3 years, although most are expected to last 3 to 6 months (Smith, 2005)
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From page 80... ...
Similar NIH-funded programs are now operating in a variety of resource-limited settings, including PEPFAR focus countries. These programs have invested in the training of local investigators and clinicians through structured twinning between American academic centers and international sites; they have also provided equipment (such as flow cytometers and polymerase chain reaction [PCR]
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From page 81... ...
The Pfizer Global Health Fellows program is an innovative response that goes beyond conventional industry donations of cash and drugs (see Box 3-3)
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From page 82... ...
Applicants are selected on the basis of their potential to train others after completing the program. IDI also provides 1-week and weekend training programs for nurses and other health professionals and main 4 DiflucanTM, or fluconazole, is an antifungal drug used to treat cryptococcosis, an opportunistic fungal infection that frequently causes meningitis in AIDS patients.
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From page 83... ...
-- Lack of clarity regarding project goals -- Lack of local supervision of volunteers -- Dependency on local partners5 -- Negative local reactions to the size, perceived dominance, arro gance, and/or resources of very large organizations 5For example, in some cases American health professionals may attract more patients than indigenous providers because they are perceived to have superior knowledge and skills.
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From page 84... ...
Presentation at the December 1, 2004, Workshop of the IOM Committee on the Overseas Placement of U.S. Health Professionals, Washington, DC.
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From page 85... ...
Presentation at the February 14, 2005, Workshop of the IOM Committee on Options for the Overseas Placement of U.S. Health Professionals, Washington, DC.
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