[afro-nets] How have global health initiatives impacted on health equity?

["Ana Lucia Ruggiero" <ruglucia@paho.org>]

Cross posted from EQUIDAD@listserv.paho.org

How have global health initiatives impacted on health equity?

What strategies can be put in place to enhance their positive impact and mitigate against negative impacts?

A literature review commissioned by the Health Systems Knowledge Network WHO Commission on the Social Determinants of Health

January, 2007- Johanna Hanefeld, Neil Spicer, Ruairi Brugha, Gill Walt

Available online as PDF file [32p.] at:
http://www.who.int/social_determinants/resources/csdh_media/global_health_initiatives_2007_en.pdf

"…..This paper explores the impact of Global Health Initiatives (GHIs) on health equity, looking specifically at GHIs involved in HIV/AIDS and focusing on gender equity. Three GHIs are examined in detail, these are: the US President's Emergency Fund for AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria (GF). The paper concentrates on low and middle - income countries as they overwhelmingly form the focus of GHI expenditure on HIV/AIDS.

The paper further focuses on gender as HIV/AIDS disproportionately affects women and the poor, and an estimated 70 percent of the world's poor are women. Women also carry the greatest burden of caring for others living with HIV/AIDS and orphans….."

The paper proposes nine key recommendations. GHIs should:
-• Address explicitly the causes of gender inequities in access to health.
-• Assess the impact of different interventions on social inequities.
-• Include measures that are sensitive to gender and other equity priorities in setting targets and monitor progress towards these.
-• Enhance the collection of gender-disaggregated data.
-• Use national policy processes for empowerment in order to facilitate reater participation.
-• Address GHIs' impact on health systems and human resources.
-• Harmonise activities and programmes across GHIs to build on comparative dvantage.
-• Integrate social equity in access to health services within broader, acroeconomic and development policies.
-• Monitor and evaluate GHIs impact on social equity.

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Mrs Ana Lucia Ruggiero  
mailto:ruglucia@paho.org