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Cost effective means of fighting the diseases of poverty 189thought – not unreasonably – that if American AIDS patients couldget the miracle drugs, why shouldn’t people in poor countries? Previously,international agencies had focused on prevention out of adesire to contain the pandemic, but also because ARV therapies weretoo expensive. However, after voluble and emotive campaigns fromAIDS activists following the Durban AIDS conference, governmentsand global agencies reoriented their strategies towards favouringtreatment.One outcome of this lobbying by pressure groups was thecreation of the WHO’s flagship “3 by 5” programme. But the presumptiontowards treatment has been further institutionalised bythe creation of the President’s Emergency Plan for AIDS Relief(PEPFAR) in 2003, which has been required by the US Congress todedicate 55 per cent of the US $15 billion five year budget for HIV totreatment of individuals with HIV/AIDS. In financial years 2006through to 2008, 75 per cent of those funds are to be spent on thepurchase and distribution of antiretroviral drugs, with only 20 percent of all funding to be spent on prevention. 15The prioritisation of treatment over prevention has had significantopportunity costs, by not curtailing new infections and increasingthe pool of people with the potential to transmit the virus. TheUN’s own statistics indicate that more people became infected withHIV in 2005 than ever before, with an estimated additional fivemillion new infections worldwide. The number of people living withHIV globally has also reached its highest level ever. By the end of2005, global HIV prevalence had risen to an estimated 40.3 millionpeople (UNAIDS, 2006), from a figure of 34.9 million in 2001(UNAIDS, 2004). 4.1 million people were infected in 2005 alone, anincrease from 3.9 million in 2003. According to UNAIDS, HIV prevalenceis increasing in South Africa, China, Indonesia, Papua NewGuinea, Vietnam, Bangladesh and Pakistan. While prevalence ratesin many sub-Saharan African countries seem to be stabilising, veryfew countries are experiencing significant declines in prevalence(UNAIDS, 2006). Figure 2 illustrates the increasing numbers of infectionsglobally.
190 Fighting the Diseases of PovertyTable 2 Regional HIV and AIDS prevalence and infectionrates, 2003 & 2005Region Adults and children newly Adult (15–49)infected with HIV prevalence (%)Sub-Saharan Africa2005 2,700,000 6.12003 2,600,000 6.2North Africa and Middle East2005 64,000 0.22003 54,000 0.2Asia2005 930,000 0.42003 860,000 0.4Oceania2005 7,200 0.32003 9,000 0.3Latin America2005 140,000 0.52003 130,000 0.5Caribbean2005 37,000 1.62003 34,000 1.5Eastern Europe and Central Asia2005 220,000 0.82003 160,000 0.6North America, Western and Central Europe2005 65,000 0.52003 65,000 0.5TOTAL2005 4,100,000 12003 3,900,000 1Source: UNAIDS, 2006.
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Fightingthe Diseasesof PovertyEdite
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Fighting the Diseases of PovertyEdi
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ContentsIntroductionPhilip Stevens1
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viiiFighting the Diseases of Povert
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IntroductionBy Philip StevensIn man
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IntroductionxiiiThis period saw an
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IntroductionxvSimilarly, lowering t
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Introductionxviiincomes (Kenny, 200
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Introductionxixrising overall level
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IntroductionxxiCorruption in health
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IntroductionxxiiiRights, Innovation
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Introductionxxv“Anecdotal evidenc
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Introductionxxviionly account for 0
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1 Wealth, health and thecycle of pr
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Wealth, health and the cycle of pro
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IndiaWealth, health and the cycle o
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South Africa’s healthcare under t
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3 Corruption in publichealthMaureen
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Corruption in public health 65Healt
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Corruption in public health 67where
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Corruption in public health 69◆
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Corruption in public health 71healt
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Corruption in public health 73Figur
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Corruption in public health 75Table
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Corruption in public health 77Table
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Corruption in public health 79level
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Corruption in public health 85physi
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Corruption in public health 87Focus
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Corruption in public health 89by un
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Corruption in public health 91local
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Corruption in public health 93suppl
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Corruption in public health 95The l
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Corruption in public health 97physi
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Corruption in public health 101Figu
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Corruption in public health 103serv
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Corruption in public health 105abou
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Corruption in public health 107prob
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Corruption in public health 109ment
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Corruption in public health 111some
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Corruption in public health 113grou
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Corruption in public health 1152001
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Corruption in public health 117The
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Corruption in public health 119and
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Corruption in public health 121expe
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Corruption in public health 123inco
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Corruption in public health 125Ghan
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Diseases of poverty and the 10/90 g
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Page 243 and 244: 8 The value of vaccinationDavid E.
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SourcesIntroductionAdelman, C., Nor
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healthcare industry. He writes and
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Fighting theDiseases of PovertyHow
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