WHO and HIV/AIDS Policy Homework Help

WHO and HIV/AIDS Policy

HIV/AIDS is an international pandemic that poses a great challenge to the entire international community. The World Health Organization (WHO) held the first international conference in 1983 in Geneva to discuss the AIDS pandemic. Subsequently, the WHO established a special programme on AIDS in 1987with a view to mobilize financial support and other resources that would help develop international AIDS control strategy. The executive board named it “Global Programme on AIDS” (GPA) in 1988, and later the UNAIDS programme. The main goal of the Global Health Program is to mobilize and make use of scientific and technological developments to deal with the main causes of illness and deaths in developing nations.
The objectives of the global strategy included general measures aimed at reducing HIV infections, minimizing the personal and social effects of HIV, and mobilizing and integrating national and international efforts against HIV/AIDS (WHO, 2004, 2006). This global strategy has been adjusted from time to time to reflect the changing circumstances of the HIV/AIDS pandemic as well as the changing needs of the HIV/AIDS patients. The WHO strategy emphasizes on the need for prevention but also provides support to treatment and control efforts to HIV/AIDS patients internationally including sponsorship for relevant research. This paper will outline and discuss the HIV/AIDS prevention and treatment policy of the WHO as well as the role of Gates Foundation, Clinton AIDS Initiative, Global Fund AIDS program and PEPFAR.

2.0 Discussion
2.1 The World Health Organization
The World Health Organization (WHO) was established in 1948 as a specialized agency of the United Nations (UN) mandated to coordinate international public health issues. With its headquarters at Geneva Switzerland, the WHO is a member of the United Nations Development Group and it inherited its mandate from the Health Organization (its predecessor), which was itself an agency of the League of Nations. . Ever since its formation, the WHO has been instrumental on the global front in promoting the “health for all” strategy. Towards this end, WHO puts a lot of emphasis on prevention and has pursued a number of essential measures aimed at enhancing primary health care such as controlling outbreak of many infectious diseases including malaria, tuberculosis, influenza and HIV/AIDS among others. Other than these, the WHO also provides sponsorship to programs meant to prevent and treat these diseases, (WHO, 2004, 2006).
In 1992, the WHO HV/AIDS global strategy was modified in order to include efforts to reduce the risk of infection of HIV/AIDS by women in developing countries, treatment of sexually transmitted diseases, provision of health care for AIDS patients and education provision regarding how to overcome HIV/AIDS related stigmatization and discrimination. In 1989, the WHO put in place a Global Commission on AIDS to facilitate establishment of AIDS programs in WHO member countries through provision of multidisciplinary expert policy and scientific guidelines to the Director General. These efforts led to establishment of AIDS programs in all the WHO member countries by end of 1991. A declaration of commitment was adopted by 189 WHO member countries in June 2001, following a General Assembly session on HIV/AIDS. This was intended to establish binding timelines and targets to which the United Nations (UN) and respective governments would be accountable (WHO, 2004, 2006).
A new international alliance was formed and launched in Geneva and Dakar in December 2002 and called “International HIV Treatment Access Coalition” (ITAC). The purpose for ITAC was to enhance the efforts to improve supply and access to antiretroviral drugs to HIV/AIDS growing number of infected people in the low and middle income nations. But even before then, the WHO had earlier on in 1993 identified tuberculosis as closely related to HIV/AIDS and therefore declared it a global emergency and a co-epidemic. At this point, it is important to mention that the WHO has ever since expanded its HIV prevention and treatment policy to cover the other opportunistic diseases such as malaria, smallpox, cholera and other communicable diseases such as influenza, yellow fever, meningitis, viral hepatitis and streptococcal infections (WHO, 2004, 2006).
The WHO underscores need for behavior change in order to prevent spread of HIV/AIDS. The behavioral prevention programs are designed to reduce unprotected sexual behaviors and drug abuse that expose individuals to HIV/AIDS and other related effects, (WHO 2006). Apart from prevention, the WHO recommends simple and standardized treatment and monitoring measures. The WHO considers provision and administration of antiretroviral therapy (ART) a vital measure to ensure access of effective therapy by HIV/AIDS patients especially in settings with limited resources. For this reason, the WHO’s Guideline Development Group (GDG) had established ART guidelines in 2003 to include; how to initiate the ART, how best to monitor the treatment, managing long term toxicities of individual ARVS, identifying the preferred first-line and second-line regimens, and the need for substituting toxicity or switching failure. In 2006, these guidelines were reviewed with a view to elaborate on provisions regarding the second line alternatives; assess special considerations for use of ART with major coinfections such as TB and viral hepatitis, side-effects of ART on drug adherence and salvage strategies to be used., ((Global HIV Prevention Working Group, 2008: WHO, 2004, 2006)
Regarding when to initiate the ART, the WHO advocates for use of clinical parameters together with additional information on baseline and subsequent CD4 cell counts in order to improve decision making on when to initiate and how to monitor the ART. The WHO therefore advocates for national programs to enhance affordable access to CD4 measurement technologies. In implementing the global health strategy, the WHO has teamed up with other organizations including the Gates Foundation, the Clinton AIDS Initiative, the Global Fund AIDS program and PEPFAR whose roles and contributions are discussed in the next sections, (WHO, 2004, 2006).
2.2 The Gates Foundation
The Bill and Melinda Gates Foundation was established in the year 2000 to contribute towards developing sustainable improvements in health, education and poverty reduction efforts. The Bill and Melinda Gates Foundation was driven by the belief that every life has equal value hence the major aim of the Foundation is to help in the attainment of healthy and productive lives for all people across the globe. To this end, the Bill and Melinda Gates Foundation enacted a global health program geared towards harnessing the advances in science and technology with view to help save lives in developing nations. This is perfectly in agreement with the WHO’s global health strategy. Although the foundation largely focuses health problems affecting people in developing nations, the lack of adequate attention and financial support limit their efforts. Therefore the Gates Foundation either supports sustainable delivery where proven tools exist, but where such tools are absent, the Foundation invests in research and development of new interventions including drugs vaccines and diagnostics (Bill and Melinda Gates Foundation, 2010).
The Bill and Melinda Gates is basically a private foundation whose delivery strategy is based on funding technology based solutions targeting a limited number of long-term priorities and solutions. In doing this, the Gates Foundation underscores the value of partnerships. Therefore the Gates Foundation supports other multilateral initiatives such as the Global Alliance for Improved Nutrition (GAIN), and the Global Fund (established to fight AIDS, Tuberculosis and Malaria). The Gates Foundation also works in cooperation with global coordinating groups such as the Stop TB Partnership, the Roll Back Malaria Partnership and the Partnership for Maternal, Newborn and Child health in addressing specific health issues affecting communities. The Foundation emphasizes that its role is complimentary and not a replacement for that of the other key players such as the WHO, (Bill and Melinda Gates Foundation, 2010).
2.3 The Clinton AIDS Initiative
The William J. Clinton Foundation was established by President Bill Clinton in 2002 with a mission to help “alleviate poverty, improve global health, strengthen economies and protect the environment”. This was to be achieved through deliberate measures designed to foster partnerships among the various public and private stakeholders alongside mobilizing resources and goodwill to help attain the desired objectives. One major initiative was to pursue sustainable programs meant to enhance global accessibility to investment, opportunity and lifesaving services across the generations. The Foundation mainly focuses on working with diverse groups to address challenges with respect to education, nutrition, environment, energy and economic empowerment. Basically, the Clinton Health Access Initiative (CHAI) commits itself to strengthen integrated health systems and the expansion of access to care and treatment of HIV/AIDS, Malaria and Tuberculosis in the developing World. The Clinton Foundation is also a solutions-oriented organization and has since its inception helped more than 2 million access medicines and treatment for the HIV/AIDS, Clinton Health Access Initiative (2010).
2.4 The Global Fund AIDS program
The Global Fund was established in 2002 with a view to help fight AIDS, Tuberculosis and Malaria through an innovative financing framework designed to disburse funding for programs which minimize the effects of diseases. The policy of the Global Fund is to provide financial support to individual country governments and in-country stakeholders determined primarily by the proposals and implementation plans presented by the applicants. The Global Fund as grown to become one of the biggest aid providers in the world; providing an estimated 20% of world’s HIV/AIDS funding, and 66% funding for Tuberculosis and malaria, (Schocken, 2005).
2.5 President’s Emergency Plan for AIDS Relief (PEPFAR)
PEPFAR is a U.S Government initiative aimed at saving the lives of HIV/AIDS patients all over the world. The initiative focuses mainly on improving the health women, newborns and children. It aims at developing sustainable country-owned programs to address HIV/AIDS within a wider health and development context. PEPFAR aims at expanding prevention, care and treatment. To this end, PEPFAR has invested heavily in innovation and operations research tailored towards impact evaluation, service delivery improvement and result optimization. PEPFAR has contributed in a major way in supporting life-saving antiretroviral treatment globally, (PEPFAR 2008).
3.0 Summary
The WHO‘s HIV/AIDS prevention and treatment has been designed to enable the WHO work with countries in order to prevent HIV infections through encouraging change of behavior and enhancing access to prevention facilities and prevention programs. The WHO policy also aims at expanding availability of treatment for HIV/AIDS patients across the globe. The WHO therefore focuses on measures to encourage and improve access to HIV testing and counseling as well as strengthening the health care systems to ensure delivery of sustainable HIV/AIDS services. Furthermore, the WHO endeavors to improve HIV/AIDS information systems. To this end, the WHO focuses on ensuring appropriate HIV surveillance, monitoring, evaluation and operational research. The WHO has established a global health strategy which aims at working with the developing world to attain the desired health results. The partnership with and complimentary efforts of the other organizations including Gates Foundation, Clinton AIDS Initiative, Global Fund AIDS program and PEPFAR have played a significant role towards the attainment of the goal of delivering global health improvement programs. It was important that these policies were expanded to cover not only HIV/AIDS, but also Tuberculosis, Malaria and other communicable diseases, (Global HIV Prevention Working Group., 2008: WHO, 2006).
4.0 Recommendations
HIV/AIDS presents a global challenge that requires maximum attention from the entire international community. Tuberculosis and malaria have been equally challenging as far as global health is concerned. Because of this, the initiatives by the WHO and contributions made towards improving health of the people across the world are very significant and must be supported by all countries both financially and morally. Millions of people suffering from HIV/AIDS, Tuberculosis, Malaria and other diseases have significantly benefited from the global health programs thanks to these organizations, (WHO, 2006). My opinion is that there is need to enhance accountability in individual nations so that funds assigned to such important life-saving initiatives do not end up being misappropriated by corrupt officials. Perhaps the Performance based funding approach (PBF) used by the Global should be adopted by other organizations and/or partnerships for purposes of accountability. There is need to support and invest more in research and innovation to improve the services aimed at improving global health gains pursued by these organizations.

5.0 References:
Bill and Melinda Gates Foundation, (2010). Global Health: Strategy overview. Retrieved on 29/10/2011 from http://www.gatesfoundation.org/global-health/Documents/global-health-strategy-overview.pdf
Clinton Health Access Initiative (2010). About The Clinton Foundation. Retrieved on 29/10/2011 from www.clintonhealthaccess.org.
Global HIV Prevention Working Group. (2008). Behavior Change and HIV Prevention: (Re)Considerations for the 21st Century. Retrieved on 29/10/2011 from www.globalhivprevention.org
PEPFAR (2008). The U.S. Commitment to Global HIV/AIDS. Retrieved on 29/10/2011 from http://www.pepfar.gov/
Schocken C, (2005). Overview of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Retrieved on 29/10/2011 from http://www.theglobalfund.org/en/
World Health Organization (2004). Scaling up antiretroviral therapy in resource-limited settings: Treatment guidelines for a public health approach; 2003 edition. Geneva: World Health Organization.
World Health Organization (2006). Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. –2006 rev; Geneva, Switzerland