INDICES> WHO/AFRO: Medicines and hospitals in Africa (long email)

[Leela McCullough <leela@healthnet.org>]

Indices:  Medicines in Africa (long email)

Source (posted with permisison): HealthLink Bulletin 05 ­ 09-2003
==============================================

Half of Africa has no medicines
*************************************
http://news.hst.org.za/view.php3?id=20030905

Half of Africa's population, mostly the poor and disadvantaged, do not have
access to existing essential medicines and many more are denied new
medicines
for treating common diseases like malaria and HIV according to the WHO
Africa
Region  report released on Monday.

The 2002 Regional Director's Report  of the World Health Organisation says
that
50 000 of the 4.5-million people who need antiretroviral therapy have access
to
treatment despite significant reductions in cost, 6% have access to
voluntary
counselling and 1% have services for the prevention of mother-to-child
transmission.while the  HIV/AIDS epidemic continues to spread relentlessly
in
the African region.

About 29-million HIV-positive people, 70 percent of the global total, are in
Africa, and an estimated 3 million died of AIDS last year. The overall adult
HIV-prevalence is about 9%, while in different regions it varies from 1% to
over 30 %. Botswana, Lesotho, Swaziland and Zimbabwe have adult infection
rates
exceeding 30 % Due to HIV/AIDS, tuberculosis has become a growing problem.
The
average treatment success rate is 68 percent, compared to the target of 85
percent. "Frequent shortages of anti-TB drugs, inadequate human resource
capacity  and insufficient diagnostic and treatment facilities are some of
the
challenges which are frustrating control efforts."

Effective vaccines are available but diseases that they could prevent still
constitute major public health problems in Africa. These include measles
which
is responsible for 445 000deaths annually; pertussis  which causes 106 000
to
190 000 deaths annually, while  yellow fever is still endemic in 34
countries,
causing about 30 000 deaths annually; and mortality from neonatal tetanus is
about 510 per 1 000 live births."

Malaria makes 270 000 people in Africa acutely ill every year, kills over
900
000 and causes significant loss in household earnings. The report says the
annual economic loss from malaria is estimated at $12-billion.

"Due to drug resistance and difficulties with implementation in the African
region, tools, methods and technologies once considered effective for the
management of communicable diseases are failing rapidly.At the same time,
the
acceptance of new and effective drugs and vaccines by national health
systems
has been slow due to inadequate investments."

Also non-communicable diseases, mental disorders and substance abuse,
including
tobacco consumption, are becoming major problems in the region. Countries do
not give such diseases enough attention, and treatment is not universally
available or affordable.

The lack of long-term commitment, coupled with the progressive increase in
non-
communicable diseases, contributes to widening health gaps between and
within
countries, the document states. At 940 per 100 000 live births,  Africa has
the
highest maternal mortality ratio in the world.

The average lifetime risk of maternal death is estimated at one in 14.
However,
more than 75 percent of the 600 000 annual deaths from pregnancy and
childbirth-
related causes could be prevented through timely access to essential
obstetric
care.

The prevalence of female genital mutilation varies, ranging from 10 % in
Niger
to over 98% in Guinea.

According to the report, over 450-million poor Africans do not have access
to
safe water, 490-million do not have adequate sanitation and one out of five
children dies from a communicable disease linked to environmental
conditions.
Poverty causes food insecurity and the consumption of unsafe food.

"The regional office aims to support member states to make health central to
sustainable development through promoting a strategic, systematic and
integrated approach to poverty and other determinants of health." (Source:
SAPA, 1 September 2003).

Africa: Hospitals are getting worse ­ WHO
*********************************************
http://news.hst.org.za/view.php3?id=20030906

Shortages of essential medicines and medical equipment, a staffing crisis
and
inadequate infrastructure are undermining the quality of hospital care
across
sub-Saharan Africa.  This could jeopardise plans to provide anti-AIDS drugs
to
people living with the HI virus, the World Health Organisation (WHO)
Regional
Committee heard this week.

According to a report presented at the WHO meeting, hospitals in Africa
are "getting worse in terms of both the scope and quality of health care
they
provide" - despite receiving a "significant" portion of public resources.
Also
negative attitudes, high turnover of health and care practitioners ,
unprofessional behaviour and have compromised service provision.
"This has led to provision of care far below expected standards, resulting
in
client dissatisfaction, increasing mortality rates, hospital-acquired
infections and other side-effect conditions," the report said.

The number of hospital beds was inadequate in many countries, and unevenly
distributed between rural and urban areas, with availability ranging from
0.9
to 2.9 beds per 1,000 people.

The report points out that lack of national health infrastructure
development
planning and irrational interference in the location of hospitals account
for
this situation.

Health ministers and government officials attending the Johannesburg meeting
were urged to increase funding for their health sectors and allocate more
funds
to hospitals although  they  currently  consume a greater portion of
ministry
of health budgets (sometimes more than 70 percent of the total).

Despite advances made in new health infrastructure, most countries were
still
faced with dilapidated health facilities, where beds, medical equipment and
vehicles were often in disrepair. In addition some hospitals have inadequate
water, sanitation and waste disposal facilities, and are therefore hazardous
to
both health workers and patients
Nevertheless, WHO Director-General Dr Lee Jong-Wook proposed a "3 by 5" plan
to
provide antiretrovirals (ARVs) to three million people living with HIV/AIDS
in
developing countries by the end of 2005 - well short of the numbers of
people
who need the drugs, but a significant improvement in the current levels of
access.

A comprehensive strategy on how to meet the WHO's goal will be announced on
World AIDS Day, 1 December 2003.  He noted that implementing the plan,
however,
would be impossible without sufficient human resources, he warned.
The report recommended that "policy-makers should consider offering flexible
modes of practice, such as allowing health workers in the public sector to
engage in part-time private practice, research or training; and compensating
health workers based on work done, rather than fixed salaries." (Source:
IRIN 3
September 2003)



______________________________________________

Dr. Leela McCullough
Director of Information Services

SATELLIFE
30 California Street, Watertown, MA 02472, USA
Tel: +617-926-9400    Fax: +617-926-1212
Email: leela@usa.healthnet.org
Web: http://www.healthnet.org

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