Is robbing Peter to pay Paul worth worrying about?
Aug 13 2008 in Finance, Health Systems, HIV/AIDS, Human Resources
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Few health systems topics received more attention at the IAC than the question of whether we should blame the advent of the AIDS virus as the cause of funding and resources being channeled away from the general health system (into vertical programs) or applaud the arrival of AIDS as the catalyst for the activism needed to identify the inadequacies of health care systems. Of course, as you would expect from persons attending an AIDS conference, just about everyone agreed that AIDS advocacy and funding efforts were strengthening health systems in general.
I tend to agree with those who were not concerned about how we arrived here, or the merits of one catalyst for change over another, but who were anxious to move forward. Various health systems and funding systems exist. There will always be vertical and horizontal funding streams. There will always be competing priorities. We should stop wasting time and resources discussing which one works better or which priority is more important. We need to move forward the best we can. As Sigrun Mogedal, Ambassador for AIDS and Global Health Initiatives Norway and Chair of GHWA said: We are in the midst of competing priorities and voices… We have to work across all sectors… We cannot wait until all these things are fixed. We have to live with the complexity and be involved under several streams of activity at the same time.
Here are a few of the comments:
Peter Piot: This stage of the HIV epidemic is a good opportunity to jumpstart our response to the HRH crisis. HIV funding has been the only funding available to also strengthen the health workforce. There are a number of lessons from the HIV/AIDS epidemic response that we can apply to HRH situation: set ambitious targets, don’t move without involvement of civil society, have a rights based approach, and work across sectors.
Craig McClure, Executive Director, International AIDS Society: Greater involvement of people living with HIV – community level mobilization to gain attention to the HIV issue has shown the effectiveness of advocacy from the public to encourage change of governments.
Jacqueline Bataringaya, International AIDS Society: Previously in my experience working as a health worker – it was accepted that there were facilities with no health workers and no supplies, but now in the era of AIDS that has become unacceptable. For that I thank AIDS as an issue. We need to start now helping other most vulnerable people. More research and discussion on the six components of the health system (as defined by WHO) need to be addressed.
One of the few who paused to dwell on the negative impacts of HIV/AIDS on the health system:
Daisy Mafubelu, Assistant Director General WHO: …HIV/AIDS increases the burden of disease and the burden on HRH. But in addition, many countries have lost large portions of health workers to HIV. It is a very stressful psychological burden for the remaining health workers.
