Transcript PowerPoint Presentation - A New Framework for Globalization

HIV NON-INTERVENTION:
A COSTLY OPTION
A NEW FRAMEWORK FOR
GLOBALIZATION
Jeffrey D. Sachs, PhD
Director, Center for International Development
Galen L. Stone Professor of International Trade
Harvard University
Cambridge, Massachusetts, USA
13 July 2000
Durban, South Africa
The Current Strategy of
Globalization is Failing

The health crisis of the poorest countries
creates a “poverty trap” which can not be
overcome by the technologies or financial
resources currently available to those
countries

Donor support for disease control is
shockingly small

Technological innovation is not directed
towards the needs of the poorest countries
The Current Strategy of
Globalization is Failing

The IMF and World Bank are not designed
for effective implementation of scientifically
based public health strategies, while
specialized institutions such as WHO are
starved for funding and authority

These problems apply to a broad and
interlinked range of diseases, including
HIV/AIDS, malaria, TB, micronutrient
deficiency, diarrheal disease, and ALRI
A New Global Attack on
Infectious Disease



Infectious disease control and related
public health measures should be placed
at the center of the globalization and
development agenda (together with
revised strategies for economic growth in
the poorest countries)
An integrated three-pronged approach is
needed: prevention, treatment, and R&D
Priority should be placed on HIV/AIDS,
malaria, TB, and other major killer
diseases
A New Global Attack on
Infectious Disease

Programs should be based on the
following core principles:
–
Scientific review, monitoring, and
evaluation (under WHO aegis)
–
Donor funding in sufficient amounts
and conditioned on scientific
scrutiny rather than donor politics
–
Projects generated and designed at
local and national levels, sensitive
to the ecological, epidemiological,
and social context of each location
Donor Finance for Disease
Control

Donor support for disease control is
shockingly small, and therefore in need
of a substantial increase

Sub-Saharan Africa will require
approximately $10 Billion per year of
donor support (grant aid) to mobilize an
effective response to HIV/AIDS, malaria,
TB, and other major killer diseases
Donor Finance for Disease
Control

$10 Billion per year would require
approximately $10 per person in the rich
countries per year, or 0.0004 of GDP
(approximately $25,000 per year), or
.04%

US spending on foreign assistance is
especially shocking, at about $1 Billion
per year for the poorest countries, or
roughly $4 (0.01% of GDP) per American
Donor Finance for Disease
Control

The US has enjoyed approximately $6
Trillion of capital gains in the stock
market since January 1, 1996

The heavily indebted poor countries
require a 100% cancellation of their
debts in order to mobilize the resources
for the domestic counterpart of
international support
Donor Finance for Disease
Control

Other donors (foundations, corporate
sector, academia) must also contribute to
a comprehensive effort
Towards an Implementation
Strategy for HIV/AIDS

AIDS control is hampered by a shocking
extent of under-funding and the lack of
needed scientific scrutiny in many donorfunded projects

UNAIDS, centered at WHO, should
manage a global fund of some $4 Billion
per year, with project funding based on
independent scientific review, monitoring
and evaluation
Donor Finance for Disease
Control



HIV/AIDS interventions must combine
prevention, MTCT, and patient care
including combination therapies
The donor community should commit to a
major effort at vaccine development,
using both “push” and “pull” mechanisms
There is an urgent need for greatly
increased clinical trials for combination
therapies appropriate for the economic,
epidemiological, and institutional context
of poor countries