Publications

This paper explores human resources constraints in health service delivery, especially with regards to specific disease control and provides an inventory of strategies that can be used to overcome constraints. This paper is the edited version of the report on the meeting of the Working Group “Priority Diseases” which is one of the seven working groups of the Joint Learning Initiative currently exploring strategies to address the human resources constraints in health services delivery

In developing countries, medicines may account for 30–40% of health expenditure. Many of these payments are made by individuals purchasing medicines for selfmedication and only rarely on prescription. Understanding how and why consumers make the choices they do is the critical fi rst step to intervening to ensure that these precious resources are spent as safely and productively as possible. This manual is a successor to the 1992 WHO publication, How to Investigate Drug Use in Communities, a small but important book that has been reprinted eight times. A year later came How to Investigate Drug Use in Health Facilities. Since then numerous courses have been held and many studies undertaken, with valuable experience gained in understanding the use of medicines in health facilities and communities. This manual’s authors have been leaders in the movement to better understand and improve medicines use in the community

In 2001 UNAIDS initiated the development of a toolkit with techniques and practices for AIDS competence in consultation with the UNAIDS Secretariat, with the UN Theme Groups in different countries and members of the UNAIDS Technical Network on Local Responses to HIV/AIDS. The toolkit aims to further strengthen the capacity and competence of different actors to address HIV/AIDS at local level. Experiences worldwide contributed to the identification and selection of practices and techniques for the toolkit and they meant for all with an interest in furthering local responses to HIV/AIDS. The Royal Tropical Institute (KIT) in the Netherlands manages the project for UNAIDS.

The KIT/ITAD team was invited to carry out an evaluation of DFID’s partnership with WHO within the context of the ISP and the ISP Action Plan, and as a first example of evaluating DFID’s partnership with other multilateral organisations.

Fin 2001, l’ONUSIDA a initié, en consultation avec le Secrétariat de l’ONUSIDA, les Groupes Thématiques des Nations Unies dans différents pays et les responsables du Département Développement de Réseaux Techniques (TND) de l’ONUSIDA, le développement d’un Recueil de Techniques et Pratiques pour le renforcement des Compétences en matière de lutte contre le SIDA. Ce Recueil d’outils a pour but de renforcer la capacité et les compétences des intervenants au niveau local à répondre aux défis posés par l’épidémie liée à l’infection VIH/SIDA.

Leprosy is an infectious disease caused by Mycobacterium leprae and is endemic in many developing countries. The World Health Organization (WHO) has adopted the goal of eliminating leprosy as a public health problem by the year 2005, defined as reducing the national prevalence below 1/10 000.1 Until now, the prevalence decreased mainly due to the introduction and subsequent shortening of multidrug treatment (MDT). Leprosy control strategies are designed to stop transmission through early case detection and treatment with MDT, but do not seem to have the desired effect. The number of new cases—719 330 in 20002—did not decline over the last 15 years, indicating that transmission is continuing at the same level.

No ano 2001, a UNAIDS deu início ao desenvolvimento de uma ‘caixa de ferramentas’ contendo um conjunto de técnicas e práticas para a capacitação na área de AIDS, em um esforço conjunto entre a Secretaria da UNAIDS, com os Grupos Temáticos das Nações Unidas em diferentes países e membros da Rede Técnica da UNAIDS para Repostas Localmente Apropriadas para HIV/AIDS

Important developments have taken place over the past decade in tackling the global leprosy burden. There has been a very significant reduction of over 90% in the total number of leprosy patients registered for treatment through the implementation of multidrug therapy regimes that have dramatically reduced the duration of treatment. However, despite this reduction in registered prevalence of leprosy, there has been no parallel reduction in the global case detection. This is a serious barrier to aspirations to eradicate leprosy in the future.

Dans plusieurs pays d’Afrique de l’Ouest, les gouvernements ont pris l’engagement politique de lancer ou d’approfondir le processus de décentralisation afin, notamment, d’accroître la démocratie locale, de rapprocher les services publics des populations et de promouvoir le développement local. La décentralisation est un processus complexe et de longue haleine qui va bien au-delà d’un réaménagement du territoire. L’Etat doit assurer un transfert effectif des compétences et des ressources financières et soutenir le renforcement des capacités locales de gouvernance et de gestion. La réussite de la décentralisation dépend d’une part de la volonté politique de redéfinir les relations entre l’Etat central et les collectivités territoriales, d’autre part de l’adhésion de la population. Bien que légales, les nouvelles collectivités, surtout les communes, doivent encore acquérir une légitimité auprès de la population

“There has never been such an overwhelming move to increase access to medicines in such a short period”. In one sentence, a conference speaker had given participants a view of the magnitude of the debate that conference organizers, KIT, Share-Net and Aids Fonds, ignited when they asked: “3 by 5: what are the implications?” The HIV/AIDS pandemic had been put in the right dramatic context without using dramatic effects. But by referring to the history of public health care, the speaker went beyond the limitations of the conference question, suggesting that traditional approaches will be far from sufficient to address the problem of HIV/AIDS.