Expanding access to ART in Sub-Saharan Africa: an advocacy agenda for health systems development and resource generation

Abstract

English: Providing universal, effective and sustainable access to ART in sub-Saharan Africa (SSA) requires a broader advocacy agenda encompassing the development of health care systems and the generation of much larger resources for the health sector. Presently, health care delivery in SSA is characterised by a patchwork of poorly co-ordinated and governed public, NGO and private services, a situation which contributes to the undermining of national stewardship and coherent health planning. The challenge of expanding access to ART in SSA cannot be divorced from the challenge of liberating countries from poverty. The international public health community needs to use its voice and its authority to support ongoing campaigns to, for example, eradicate the debt burden and to raise public finance at the global level.

Afrikaans: Die aspirasies van universele, doeltreffende en volhoubare toegang tot ART in sub-Sahara Afrika (SSA) vereis ‘n breër voorspraakagenda wat die ontwikkeling van gesondheidsorgsisteme en die generering van veel meer hulpbronne vir die gesondheidsektor omvat. Tans word die lewering van gesondheidsorg in SSA gekenmerk deur lapwerk van swak gekoördineerde en bestuurde openbare, NGO- en privaatdienste wat bydra tot ondermyning van nasionale rentmeesterskap en samehangende gesondheidsbeplanning. Die uitdaging van uitbreiding van toegang tot ART in SSA kan nie geskei word van die uitdaging om lande uit armoede te lig nie. Die internasionale openbare gesondheidsgemeenskap moet sy stem en gesag gebruik om huidige veldtogte te ondersteun, byvoorbeeld, om die skuldlas uit te wis en om openbare finansiering op die wêreldvlak te mobiliseer.