Thursday, July 23, 2009

International Aids Society Say They Are Doing a Great Job, Thanks for Asking

Why do the International Aids Society want us to believe that HIV funding has not distorted overall health funding and shifted attention from non-HIV issues while their partners at NAM want us to believe the opposite?

The 2009 International Aids Society (IAS) Conference has come up with a rather extraordinary conclusion: that there is “new evidence illustrating how investments in HIV have contributed to reductions in infant mortality and TB incidence, improved access to health services for women, and expanded health systems capacity”. That’s what their blog says, but they don’t appear to cite any evidence.

Spending on health, education, infrastructure and social services have been going down in Kenya since the 1980s. Many of these reductions were recommended by the World Bank and the International Monetary Fund (IMF) in the name of ‘structural adjustment’. Not that the Kenyan government was reluctant to reduce spending; the Moi regime (and the ones that followed it) couldn’t have cared less about public spending as long as the bulk of it went into the pockets of rich swindlers (otherwise known as business people and politicians).

It is true that large sums of money have been spent on HIV related treatment programmes and (far smaller sums) on HIV prevention programmes. But most of them had little or nothing to do with general health. Many of these programmes are standalone concerns, though they often tap into existing health capacity. Ok, they could have had some marginal, accidental positive affects and this requires investigation.

But in what way is this organization claiming that investments in HIV have contributed to health in general? There may be more health employees in the country but the number of GPs, nurses and health workers has not increased along with increases in the population. Worse still, many have been recruited (poached) to work with HIV, exclusively. Which “clinics and hospitals are being refurbished” with HIV funds, where are these “cadres of health workers” being mobilized, who are these health workers whose morale has been “greatly lifted”?

Was the purpose of the IAS Conference to get everyone together to have a great big feelgood session, so they could all pat each other on the backs? Maternal and child health has been disimproving since the 1980s, progress towards the Millennium Development Goals is negative. Who are these well paid and well qualified people trying to fool?

To add insult to injury, the IAS’s two day meeting on ‘Health Systems Strengthening’ was partly sponsored by the…World Bank. This is one of the organisations that has been instrumental in reducing health and other social services! There is recent damning report about the World Bank’s role in dismantling any structures that could benefit people in developing countries and privatising anything some hungry, private sector sharks can screw a bit of money out of. Most of their work has been highly detrimental but hey, they’re still doing it!

There’s a more credible article published by NAM (, which also happens to be a partner of IAS. This article suggests that delivery of health care services has been seriously affected by the HIV/AIDS pandemic. This article is based on data (real data!) from the National Bureau of Economic Research at Princeton University. Maternal and child health has deteriorated since the mid 1990s in countries with high HIV prevalence. This deterioration is linked with a reduction in the number of trained health personnel and the fact that the pandemic “shifted health budgets and other resources towards caring for HIV patients”.

Personally, I prefer the article that is based on data. If the IAS produces data I’ll post it up here and people can make up their own minds what to believe.


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