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March 13, 2009

Public Delivery of AIDS Treatment In South Asia: A Timidly Heroic Assumption

Posted by Mead Over in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases Tags: , ,

My new working paper makes a foray into disputed territory by examining the case for public sector delivery of anti-retroviral therapy for AIDS in South Asia.

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 recent blog. 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.
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February 11, 2009

Oxfam — This Is Not How to Help the Poor

Posted by April Harding in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases, Uncategorized Tags: , , , , , , ,

April HardingToday I had a flashback to the days when the global health community was divided into two bitterly opposed camps, the pro-public and pro-private. Younger global health professionals may not recall the days when the two camps hurled invective at each other across an unbridgeable chasm that precluded any constructive discussion. It was my anecdote versus yours, underlaid by “my values” (infinitely superior) to yours (highly suspect). The folks at Oxfam, it seems, are feeling nostalgic, and their new report would take us back. The report criticizes the “Blind Optimism” of people and organizations who would work with the private health sector to improve access to health services and mortality reduction in developing countries. It kicks off with the inevitable anecdote of superior performance from a largely public system, in this case Sri Lanka. Undoubtedly old members of the pro-private camp will be tempted to toss back their own stories. But must we slide back to the old unconstructive debates? Must we revert to my anecdote versus yours? The stakes are too high to let this happen.

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