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<div id="post-1151"> <h2>July 24, 2009 </h2> <h3><a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/07/task-shifting-can-be-part-of-the-answer-to-art-access-%e2%80%93-if-health-professionals-don%e2%80%99t-get-in-the-way.php" rel="bookmark" title="Permanent Link to Task-Shifting Can Be Part of the Answer to ART Access鈥擨f the Numbers of Lower Level Health Workers Expand Fast Enough">Task-Shifting Can Be Part of the Answer to ART Access鈥擨f the Numbers of Lower Level Health Workers Expand Fast Enough</a></h3> <h4>Posted by <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/author/mead-over/" title="Posts by Mead Over">Mead Over</a> in <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/category/hivaids-and-other-infectious-diseases" title="View all posts in HIV/AIDS and other Infectious Diseases" rel="category tag">HIV/AIDS and other Infectious Diseases</a>, <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/category/health-product-innovation-and-access" title="View all posts in Health Product Innovation and Access" rel="category tag">Health Product Innovation and Access</a> Tags: <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/tag/art" rel="tag">ART</a> </h4> <p><p>There has been a great deal of discussion at this week鈥檚 IAS <a href="https://web.archive.org/web/20091005161458/http://www.ias2009.org/">Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa</a> of four expensive directions for proposed expansion of access to antiretroviral treatment for AIDS patients in poor countries (ART):</p> <ol> <li><em>ART as entitlement</em>: <a href="https://web.archive.org/web/20091005161458/http://globalhealth.kff.org/Daily-Reports/2009/July/20/GH-072009-IAS-Opening.aspx">Meeting commitments to treat those currently entitled</a> by virtue of having been previously granted access to ART;</li> <li><em>Expanding ART access</em>: Doubling or tripling access to ART so as to provide it to those meeting existing treatment criteria;</li> <li><em>Earlier ART initiation</em>: <a href="https://web.archive.org/web/20091005161458/http://www.bloomberg.com/apps/news?pid=20601124&sid=aOiyFynFWYhw">Expanding treatment access to those with CD4 counts between 200 and 350</a>. (The referenced journal article on South Africa is <a href="https://web.archive.org/web/20091005161458/http://www.annals.org/cgi/reprint/0000605-200908040-00138v1.pdf">here</a>.)</li> <li><em>ART as HIV prevention</em>: There has even been <a href="https://web.archive.org/web/20091005161458/http://globalhealth.kff.org/News.aspx?dr=July-21-2009#book1">discussion</a> of the possibility of expanding ART a great deal further, providing it immediately to people as soon as they become HIV infected in hopes of preventing transmission to others. (The original 2008 Lancet article is <a href="https://web.archive.org/web/20091005161458/http://www.lancet.com/journals/lancet/article/PIIS0140-6736(08)61697-9/abstract">here</a> and first author鈥檚 admirably clear and informative presentation of this idea at the IAS can be downloaded <a href="https://web.archive.org/web/20091005161458/http://www.ias2009.org/pag/PSession.aspx?s=2365#2">here</a>.) <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/07/task-shifting-can-be-part-of-the-answer-to-art-access-%e2%80%93-if-health-professionals-don%e2%80%99t-get-in-the-way.php#more-1151" class="more-link">More…</a></li> </ol> </p> <p class="posted"><a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/07/task-shifting-can-be-part-of-the-answer-to-art-access-%e2%80%93-if-health-professionals-don%e2%80%99t-get-in-the-way.php#comments" title="Comment on Task-Shifting Can Be Part of the Answer to ART Access鈥擨f the Numbers of Lower Level Health Workers Expand Fast Enough">2 Comments</a></p> </div> <div class="br"><br/></div> <div id="post-694"> <h2>March 13, 2009 </h2> <h3><a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/03/public-delivery-of-aids-treatment-in-south-asia-a-timidly-heroic-assumption.php" rel="bookmark" title="Permanent Link to Public Delivery of AIDS Treatment In South Asia: A Timidly Heroic Assumption">Public Delivery of AIDS Treatment In South Asia: A Timidly Heroic Assumption</a></h3> <h4>Posted by <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/author/mead-over/" title="Posts by Mead Over">Mead Over</a> in <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/category/hivaids-and-other-infectious-diseases" title="View all posts in HIV/AIDS and other Infectious Diseases" rel="category tag">HIV/AIDS and other Infectious Diseases</a> Tags: <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/tag/art" rel="tag">ART</a>, <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/tag/flexner-report" rel="tag">Flexner Report</a>, <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/tag/oxfam" rel="tag">Oxfam</a> </h4> <p><p>My <a href="https://web.archive.org/web/20091005161458/http://www.cgdev.org/content/publications/detail/1421119" target="_blank">new working paper</a> makes a foray into disputed territory by examining the case for public sector delivery of anti-retroviral therapy for AIDS in South Asia.</p> <p>Oxfam’s latest publication characterizes as illogical and unethical the view that governments could serve their people by facilitating and regulating a private sector contribution to health care delivery. My colleague, April Harding takes issue with this view in a <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/02/oxfam-this-is-not-how-to-help.php" target="_blank">recent blog</a>. Her blog has engendered more comments than most of our recent blog postings, so this must be a hot topic. Some people seem to harbor a really visceral suspicion and fear of anyone who makes a profit from health care delivery or who proposes that private sector providers could have a role in health care delivery. At the other extreme are those who view public sector health care in developing countries as fundamentally and irredeemably corrupt and incompetent.<br/> <a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/03/public-delivery-of-aids-treatment-in-south-asia-a-timidly-heroic-assumption.php#more-694" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/2009/03/public-delivery-of-aids-treatment-in-south-asia-a-timidly-heroic-assumption.php#respond" title="Comment on Public Delivery of AIDS Treatment In South Asia: A Timidly Heroic Assumption">No Comments</a></p> </div> <div class="br"><br/></div> <div> <div class="alignleft"></div> <div class="alignright"></div> </div> <br/> </div> </div>  <div id="right"> <ul> <li id="text-377439231" class="widget widget_text"> <div class="textwidget"><p><a href="https://web.archive.org/web/20091005161458/http://blogs.cgdev.org/globalhealth/"><strong>Global Health Policy</strong></a> is a group blog discussing the issues facing the donor community on everything from HIV/AIDS financing to pharmaceutical R&D to broader health systems concerns. 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