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Publication(Washington, DC, 2004) Over, Mead ; Heywood, Peter ; Gold, Julian ; Gupta, Indrani ; Hira, Subhash ; Marseille, ElliotThe three policies analyzed in this document include a minimalist policy in which the government strengthens private sector delivery, an intermediate policy of providing treatment for mothers who have AIDS and their spouses, and a generous policy of providing treatment to the poorest 40 percent of all AIDS patients. In January 2004 the Indian government adopted an AIDS financing policy which contains elements of all three of the hypothetical policies analyzed in this book. This study's projections of the total financial cost of the program and of the cost-effectiveness of the three options can help the government and its partners to plan the scale-up of the existing treatment program, to optimize the mix of components in order to improve its cost-effectiveness and to design monitoring and evaluation measures which provide feedback on program performance.
Publication(Washington, DC, 2004) World BankWith almost half the world's population, Asia will determine the future of the global human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic. If prevalence rates in China, Indonesia, and India increase to numbers similar to those seen in Thailand and Cambodia, the rate of HIV/AIDS would double globally. Such growth would be devastating for individuals-and for the region's health systems, economies, and social fabric. HIV/AIDS is therefore a multisectoral development challenge and, consequently, a corporate priority for the World Bank. This report outlines a strategic direction for the World Bank in its multisectoral response to HIV/AIDS in the East Asia and Pacific (EAP) Region. It describes the risk of a large-scale HIV/AIDS epidemic in the region. It also spells out what can be done to avert the growth of HIV/AIDS-and what government, civil society, and other partners are doing. And it identifies how the World Bank can assist at the country and regional levels. The World Bank will work with countries, civil society, the private sector, donors, and other key players to formulate country-specific strategies that try to respond to the needs of the population.
Publication(Washington, DC: World Bank, 2003-08) Yazbeck, Abdo S. ; Peters, David H. ; Yazbeck, Abdo S. ; Peters, David H.The richness of the research papers in this volume makes it difficult to quickly capture the main themes and implications of their research. But three repeated themes can be highlighted: equality of public spending, the role of the private sector, and the role of consumers. On the theme of equality in public expenditures, research in Bangladesh, India, Nepal, and Sri Lanka shows that in some parts of South Asia-such as south India and Sri Lanka-governments do a much better job of distributing subsidies in the health sector than other regions. The research overwhelmingly documents the dominance of the private sector in Bangladesh and India and finds a very strong private sector in Sri Lanka. The research also highlights different policy instruments available to the government for working with the private sector to achieve health sector outcomes. A third general theme is the role of consumers and the mechanisms available to them to influence health services delivery. The authors in this volume have supported the belief that individuals and households can make a difference in how health services are delivered. While the three themes summarized above cut across several of the chapters in this volume, a more basic theme underlies all the chapters and is the main motivation for conducting health policy research. That theme is that empirical research can and should challenge basic assumptions about the health sector and will provide policymakers some of the tools needed to improve and monitor the performance of the sector.
Publication(Washington, DC: World Bank, 2003) Garcia Abreu, Anabela ; Noguer, Isabel ; Cowgill, KarenHIV/AIDS in Latin America falls within the framework of a low endemic setting. In the majority of the countries, the epidemic is still concentrated in high-risk populations: men who have sex with men (MSM), injecting drug users (IDUs), commercial sex workers (CSWs), prisoners, and people with sexually transmitted infections (STIs). The exceptions are Honduras and southeastern Brazil, where the epidemic has reached the general population. Heterosexual sex is the primary mode of transmission in Central America, with sex between men predominating in South America, and injecting drug use playing a significant role in the Southern Cone. Survey respondents also identified other populations with increased vulnerability in which interventions would be crucial-young people and women. Although the number of men living with AIDS outweighs the number of women in all countries, the gender gap is closing, and in some countries, the effect of AIDS on rural communities is increasing rapidly. In low endemic settings, the main priority is the highest risk groups, and activities to address HIV/AIDS should be focused on (1) strengthening efforts to prevent new infections in these populations, and (2) providing care and support strategies, which in turn create incentives for early detection of infection and/or risky behavior. Epidemiological surveillance plays a key role in the control of the epidemic through the measurement of frequency, distribution, and evolution of HIV/AIDS among populations; identification of high-risk groups; and evaluation of the effectiveness of prevention efforts.