Informing the 2011 UN Session on Noncommunicable Diseases: Applying Lessons from the AIDS Response

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Abstract

In advance of the September 2011 UN Summit on non-communicable diseases (NCDs), Rebecca Dirks and colleagues identify lessons from the AIDS epidemic that can inform the response to the growing epidemic of NCDs.

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Most cited references 4

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Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.

Kiran Patel, Tim Evans, Sania Nishtar … (2010)

National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening. Copyright © 2010 Elsevier Ltd. All rights reserved.

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Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects.

Agnes Binagwaho, David J. Leslie, J. Price … (2009)

With the intensive scale-up of care and treatment for HIV/AIDS in developing countries, some fear that intensified attention to HIV programs may overwhelm health care systems and lead to declines in delivery of other primary health care. Few data exist that confirm negative or positive synergies on health care provision generally resulting from HIV-dedicated programs. Using a retrospective observational design we compare aggregate service data in Rwandan health facilities before and after the introduction of HIV care on selected measures of primary health care. The study tests the hypothesis that non-HIV care does not decrease after the introduction of basic HIV care. Overall, no declines were observed in reproductive health services, services for children, laboratory tests, and curative care. Statistically significant increases were found in utilization and provision of some preventive services. Multivariate regression, including introduction of HIV care and two important health care financing initiatives in Rwanda, revealed positive associations of all with observed increases. Introduction of HIV services was especially associated with increases in reproductive health. While hospitalization rates increased for the whole sample, declines were observed at health facilities that offered basic HIV care plus highly active antiretroviral therapy. Our results partially counter fears that HIV programs are producing adverse effects in non-HIV service delivery. Rather than leading to declines in other primary health care delivery, our findings suggest that the integration of HIV clinical services may contribute to increases.

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Ideas and ideals: ethical basis of health reform in Mexico.

Julio J Frenk, Octavio Gómez-Dantés (2009)

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Author and article information

Journal

Journal ID (nlm-ta): PLoS Med

Journal ID (publisher-id): PLoS

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date Collection: September 2011

Publication date (Print): September 2011

Publication date (Electronic): 6 September 2011

Volume: 8

Issue: 9

Electronic Location Identifier: e1001086

Affiliations

[1 ]FHI 360, Public Health Programs, Arlington, Virginia, United States of America

[2 ]Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America

[3 ]London School of Hygiene and Tropical Medicine, London, United Kingdom

[4 ]Public Health Foundation of India, New Delhi, India

[5 ]FHI 360, Program Sciences, Arlington, Virginia, United States of America

Author notes

* E-mail: rdirks@ 123456fhi.org

Conceived and designed the experiments: PL MM PP. Wrote the first draft of the manuscript: PL RD. Contributed to the writing of the manuscript: PL MM PP RD. ICMJE criteria for authorship read and met: PL MM PP KSR RD. Agree with manuscript's results and conclusions: PL MM PP KSR RD.

Article

Publisher ID: PMEDICINE-D-11-01121

DOI: 10.1371/journal.pmed.1001086

PMC ID: 3167794

PubMed ID: 21909245

SO-VID: 0a1712f2-7f3a-45b4-a1c3-ffc1bc37e856

Copyright © Lamptey et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Informing the 2011 UN Session on Noncommunicable Diseases: Applying Lessons from the AIDS Response

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Abstract

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Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 4

Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.

Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects.

Ideas and ideals: ethical basis of health reform in Mexico.

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