Targeting AIDS or targeting poverty? a US government experience.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no.. E11477)
Fung CG US Agency for International Development, Washington DC, United States
As the majority of international donors have embraced an explicit poverty reduction approach, funding that was once targeted at vertical programs now have to shift its focus to "who" it is targeting, not just the "what." The result of this policy switch has been some confusions over the effectivenes of fighting HIV/AIDS. Added to this debate has been the voice of Thabo Mbeki, who insists that AIDS is first and foremost a disease of poverty. The heart of the question then becomes, what is a more effective way of approaching AIDS prevention, vertical programs or a poverty reduction approach? US Agency for International Development has been working on AIDS related programs for about two decades. The focus has always been vertically-oriented until very recently. Under international pressure, the agency has taken on a rigorous comparative study on the effectiveness of its existing paradigm of vertial health programs versus the poverty reduction approach. AIDS, being amongst the most prominent health projects, is analyzed from a policy as well as a implementation perspective. Uganda, Mali, Honduras, and Romania are beign used as test sites of the study. As the field work is still ongoing, to state lessons learned now is premature. However, preliminary data suggests that a poverty reduction approach in AIDS programs may in fact improve the outcome of traditional preventive and treatment programs, as long as it takes into account issues of public goods and spill over effects from a macro perspective. The recommendations will be relevant to donors and NGOs alike, and will focus on the pragmatic aspect of implementing HIV prevention and AIDS treatment programs in developing countries.
Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Poverty, HIV Infections, Government, Developing Countries, Public Policy, Centers for Disease Control and Prevention (U.S.), United States Health Resources and Services, Administration, Politics, Financing, Government, Honduras, Mali, Romania, Uganda, economics
