[e-drug] Sachs' unfashionable Rx for third world aid (8)

["Paul Lobb" <paul.lobb@gmail.com>]

E-DRUG: Sachs' unfashionable Rx for third world aid (8)
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  I think Sach's point is that donors are spend tens of billions on
HIV, loans and drug revolving funds when for a few billion dollars a
year we can begin to  wipe a few tropical diseases off the globe.
This has the potential to improve peoples lives to a greater extent
than treating the popular diseases.

Does it really make sense to spend dollars treating somebody for HIV
when he is going to die of a tropical worm that costs cents to treat?
We want to be seen to be doing the big things but if nobody does the
small things the big things don't really make any impact.

I agree with Carolyn Green that user fees for HIV treatment are
counter productive.  HIV is a public heath issue and every person on
treatment is reduces the spread of the disease and increases the
productivity of society. On the other hand we need to ensure that
there is commitment to providing these drugs for life. Any break in
supply or barriers to supply such as the later introduction of a user
fee could cause non-compliance resulting in potential wide scale drug
resistance.

We need to be realistic money does not grow on trees, there will never
be enough. Take look at the long term picture. If your treatment
program is stretched beyond capacity by fund limitations or population
growth/migration, how do you decide who gets life saving drugs and who
to tell to look for alternatives. It is much fairer to the people on
the ground to start off with some sort of fee for those who can pay
and exceptions for those who cannot afford to pay on the understanding
that if their circumstances improve they can contribute to their
future treatment. The introduction of user fees to a free service at a
later stage is very painful.

I really don't know the answers but I know that living in a fantasy
land does not help anybody.

-- 
Paul Lobb B Pharm (Hons)
email paul.lobb@gmail.com
unaffiliated pharmacist