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Spend More, Get Less? The Health Care 'Conundrum'
On NPR"s Fresh Air, New Yorker staff writer Atul Gawande spoke about his article on the high cost of health care in McAllen, Texas. He found that costs in McAllen were higher than in the rest of the country because doctors ordered more tests and treatments for their patients, which did not result in a better quality of care. Gawande told NPR that "the difficulty comes in the conflict between when medicine is a business versus when it"s a profession. In a grey-zone case, whether a patient should get that endoscopy for heartburn, whether you send them to have a particular operation like a carpal-tunnel release for carpal tunnel syndrome, we make more money, and there is a temptation and a strong incentive to do more rather than less. At the same time, if we"ve crossed the border to the point where over-treatment is actually producing harm, we now have to think about how to rein in that part of what we do, even though it can sometimes mean losing money."
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Northeast Colorado Conference Discusses HIV/AIDS Needs Assessment Findings
Rural Solutions, an organization in northeast Colorado, held the "Community HIV/AIDS Education and Action Conference" as part of its ongoing effort to address issues related to HIV, the Sterling Journal-Advocate reports. At the conference, the organization presented the results of a recent needs assessment of HIV/AIDS services in the northeastern part of the state - conducted in partnership with the Center for Research Strategies and funded through the Colorado Department of Public Health and Environment - which found that HIV prevention services in the area are limited; barriers exist for HIV testing including confidentiality and costs; and mental health and substance use services for at-risk people also are limited, according to the Journal-Advocate (Jones, Sterling Journal-Advocate, 6/17).
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Disney Elevates Heterosexuality To Powerful, Magical Heights
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World Economic Forum On Africa Begins; Reports Examine African Development

New Era examines discussions at the meeting over how "an acute scarcity of financial res is threatening to set back the commendable strides achieved in the global fight against HIV/AIDS pandemic within the next three to five years." The Global Fund To Fight AIDS, Tuberculosis and Malaria"s Director for the Africa Unit Fareed Abdullah said during a news briefing at the conference, "There is no[t] enough money on the table for antiretroviral (ARV) treatments. It is a massive conundrum. The funding gap would start to hit in the period going forward." The "Global Fund"s current estimate of the financial needs are at $4 billion between now and 2012 when it would need to fund the replenishment of ARV drugs," the newspaper writes. If the funding needs are not met, countries in Eastern and Southern Africa "will be severely hit," such as the case in Namibia, where there are signs of "financial gaps in the next five-year plan for the combating of HIV/AIDS." About 22 percent of Namibia"s national health budget is provided by donors. In order to prepare for the impact of the economic crisis on HIV/AIDS programs worldwide, "PEPFAR"s Assistant US Global AIDS Coordinator, Michele Moloney-Kitts, has asked countries receiving donor funding to step up to the challenge through cost savings and efficiency," according to New Era. "We cannot afford to have duplications of efforts, we cannot have [ARV] drugs wasted," says Moloney-Kitts. Still, "Abdullah says it is not just for the donor world to stand aside and watch the situation [of] financial scarcity unfold," the newspaper writes. "We cannot tell countries to stop enrolling HIV infected people. It is not an option to say we have no money," Abdullah said. New Era writes, "Besides funding HIV prevention programmes and ARV treatment, donor money is playing a big role in the supply of health workers in Africa, as the continent faces the migration of health workers to north Europe. (New Era, 6/11). Former Boston Globe reporter, John Donnelly, is live blogging from the conference here for the Center for Global Health Policy. World Economic Forum on Africa Begins; Reports Examine African Development The World Economic Forum on Africa - a three-day event, which this year is focusing primarily "on the world economic downturn and how to lessen its effect on African economies" - kicked off Wednesday in Cape Town, South Africa, VOA News reports. South African President Jacob Zuma opened the forum and said that developing nations do not have the res to respond to the world recession in the same way as industrialized economies. Zuma said, "For most African countries, that are still highly indebted and dependent on aid for their revenues, the continuation of the current crisis will mean increased starvation, poverty and child mortality" (Bobb, VOA News, 6/10). At the forum"s opening conference, Ngozi Okonjo-Iweala, the managing director of the World Bank and co-chair of the forum, said that an additional 53 million people worldwide - 60 percent of whom are in Africa - have been pushed into poverty because of the global economic situation, This Day/allAfrica.com reports. Okonjo-Iweala "stressed the imperative of investing in agriculture," This Day/allAfrica.com reports, and said, "So I think the issue has been how African countries can sustain that momentum in this time of crisis. Africa cannot afford to be seen as a victim in this crisis." African Competitiveness Report Says Economic Crisis Threatens African Progress The forum"s opening session featured the African Competitiveness Report 2009, released jointly by the African Development Bank, the World Bank and the World Economic Forum (Ani, This Day/allAfrica.com, 6/11). The report "showed Africa again languishing at the bottom of global competitiveness rankings because of bottlenecks in infrastructure, finance and communications," the AP/Washington Post reports (Nullis, AP/Washington Post, 6/10). Although there has been progress in recent years in developing Africa"s financial systems and increased economic stability, "the world economic crisis threatens to reverse years of financial progress in Africa as poor infrastructure, access to finance and trade barriers hamper competitiveness," the report says, AFP/IC Publications reports (AFP/IC Publications, 6/10). African Progress Panel Releases Report Highlighting Africa"s "Untapped" Potential The AP/Washington Post reports that a separate report indicated that "Africa would continue to need aid, but that it had enough potential and untapped res to become a net food and energy exporter and to boost intercontinental trade" (AP/Washington Post, 6/10). The annual report is put out by the African Progress Panel (APP), which is led by former U.N. Secretary-General Kofi Annan. According to Inter Press Service News Agency, the APP report says that Africa "cannot tackle the current situation alone. There is a shared responsibility for the crisis that requires joint response based on strong partnerships." Annan said, "Africa has not been affected as profoundly by the economic downturn as other parts of the world." However, he added that "the crisis has underscored the continent"s vulnerability and is undermining the progress made over the past decade or so" (IPS, 6/11). AP/Washington Post writes of the progress: "The numbers of people living in poverty are leveling out, democracy and market reforms are entrenched in many countries, and great strides are being made against killer diseases such as AIDS and malaria" (AP/Washington Post, 6/10). GraÃýa Machel, an APP member and president of the Foundation for Community Development wrote an opinion piece in the Independent highlighting some of the report"s key points (6/11). IRIN/allAfrica.com published an article featuring highlights from the APP report (IRIN/allAfrica.com, 6/10). This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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