The 131st Annual Meeting (November 15-19, 2003) of APHA |
Tiphani Burrell, MA, MPH, Yale School of Medicine, Department of Epidemiology and Public Health, Yale University, 60 College Street, New Haven, CT 06510, (203) 624 8064, tiphani.burrell@aya.yale.edu and Esther Lwanga, MPH, Global Health, Yale University School of Epidemiology and Public Health, 60 College St, New Haven, CT 06510.
Worldwide, malaria causes more than 300 million acute illnesses annually while 42 million are infected with HIV, two-thirds being in developing countries. Increasingly, all sectors of society are being affected, including education, agriculture, the military and the private sector. These challenges to health continue to undermine the development gains of recent decades with decreases in life expectancy, infant and child mortality and work force depletion.
Donor funds that support programs aimed at mitigating the impact of these diseases are limited, necessitating efforts to maximize human and financial resources. Sustainability refers to the capacity of a program to operate effectively on a largely independent financial basis. A tenfold increase in resources will not necessarily translate into a tenfold improvement in health gains unless there are major changes in organization and approach. In the implementation of a program, a number of factors must be considered to determine whether sustainable solutions have been included in the strategy. These include a consideration of financial sustainability as well as local and national government support.
The purpose of this paper is to propose options for improving program sustainability by providing examples from Jamaica and Uganda. Strategies based on global governance mechanisms for addressing HIV and a home-based management approach to malaria control will be described and implications and recommendations will be posited. Results of key informant interviews and literature reviews emphasize the need for a horizontal approach, understanding the social and economic etiology of disease, a sustainability framework and a multisectoral response.
Learning Objectives:
Keywords: HIV/AIDS, Management and Sustainability
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.