UK response to global HIV epidemic is condemned for lack of coordinati
http://www.100md.com
《英国医生杂志》
The UK government has responded too slowly to the worldwide epidemic of HIV and AIDS and with too little control over how the money it donates is spent, says a highly critical report from the public spending watchdog.
Although the United Kingdom is the second biggest donor to HIV and AIDS programmes, after the United States, the money it donates through the Department for International Development is not always used in the best possible way, says the House of Commons Public Accounts Committee.
The report criticises the department for its delayed response to tackling HIV and AIDS, although it acknowledges that the United Kingdom is not alone in this and that the international community has in general been slow to address the crisis. The government抯 delayed strategy for dealing with the epidemic is also berated for being unclear.
The committee抯 report highlights the fact that the department supports many multilateral institutions that devote little of their budgets to HIV and AIDS. For example, of the ?.4bn ($2.7bn; �2bn) given to multilateral institutions in 2002-3, only an estimated ?7m was spent on HIV and AIDS. Similarly only an estimated ?9m of the almost ?bn provided to the European Union each year is spent on HIV and AIDS.
The department should use its funding to influence how its donations are spent, says the report.
Edward Leigh MP, chairman of the committee, said: "The global HIV and AIDS epidemic is horrifying in scale, tragic for affected individuals, families, and communities, and impedes development for the world抯 poorest countries. Many multilateral institutions supported by DfID spend little of their budgets addressing HIV and AIDS, and DfID should exert more pressure through its funding to influence priorities. DfID needs to give higher priority to tackling the wider social and economic impacts of the epidemic, including household poverty."
The report also highlights the fact that the department抯 2004 strategy on HIV and AIDS recognises the risks to vulnerable groups such as women and children but does little to address those risks.
In addition, the department needs to examine a number of key issues in countries badly affected by the epidemic, it says. These include the effect of recruiting health workers from poor countries to the NHS, thus threatening those countries?own health infrastructure; the unfair distribution of aid among affected countries; and the price of antiretroviral drugs.
"It seems unfair that some countries with lower HIV prevalence rates attract priority status over those with higher prevalence rates," said Mr Leigh. "DfID needs to develop clear criteria to strike the balance between developmental and humanitarian considerations in allocating funding, and between funding other organisations to provide support and responding itself.
"DfID should also look at why the prices of antiretroviral drugs have fallen only half as much in some developing countries as in others and help to negotiate reductions."(Zosia Kmietowicz)
Although the United Kingdom is the second biggest donor to HIV and AIDS programmes, after the United States, the money it donates through the Department for International Development is not always used in the best possible way, says the House of Commons Public Accounts Committee.
The report criticises the department for its delayed response to tackling HIV and AIDS, although it acknowledges that the United Kingdom is not alone in this and that the international community has in general been slow to address the crisis. The government抯 delayed strategy for dealing with the epidemic is also berated for being unclear.
The committee抯 report highlights the fact that the department supports many multilateral institutions that devote little of their budgets to HIV and AIDS. For example, of the ?.4bn ($2.7bn; �2bn) given to multilateral institutions in 2002-3, only an estimated ?7m was spent on HIV and AIDS. Similarly only an estimated ?9m of the almost ?bn provided to the European Union each year is spent on HIV and AIDS.
The department should use its funding to influence how its donations are spent, says the report.
Edward Leigh MP, chairman of the committee, said: "The global HIV and AIDS epidemic is horrifying in scale, tragic for affected individuals, families, and communities, and impedes development for the world抯 poorest countries. Many multilateral institutions supported by DfID spend little of their budgets addressing HIV and AIDS, and DfID should exert more pressure through its funding to influence priorities. DfID needs to give higher priority to tackling the wider social and economic impacts of the epidemic, including household poverty."
The report also highlights the fact that the department抯 2004 strategy on HIV and AIDS recognises the risks to vulnerable groups such as women and children but does little to address those risks.
In addition, the department needs to examine a number of key issues in countries badly affected by the epidemic, it says. These include the effect of recruiting health workers from poor countries to the NHS, thus threatening those countries?own health infrastructure; the unfair distribution of aid among affected countries; and the price of antiretroviral drugs.
"It seems unfair that some countries with lower HIV prevalence rates attract priority status over those with higher prevalence rates," said Mr Leigh. "DfID needs to develop clear criteria to strike the balance between developmental and humanitarian considerations in allocating funding, and between funding other organisations to provide support and responding itself.
"DfID should also look at why the prices of antiretroviral drugs have fallen only half as much in some developing countries as in others and help to negotiate reductions."(Zosia Kmietowicz)