chapter 1 context: it shames us & diminishes us all
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Chapter 1Context: It Shames Us & Diminishes Us AllAmanuel, Matt, & Tim
Health Systems Org and Delivery
• User imposed fees (limits access to medical care)• Lack of resources (physicians and nurses) and social
workers as well as difficulty in retaining those in the country
• Lack of power by states to make decisions on health care issues without approval from the Bank and the Fund
• Local groups to provide care for the sick and the orphans (eg. HIV/AIDs+ women groups)
• Government hospital system
Financing
• Grants vs Loans ; interest and debt servicing• Limit on number of nurses and doctors employed by the
public sectors• Limit on % of GNP that can be spent on social sectors
including healthcare • Cost sharing• Sale of public sector corporations• Lack of fulfillment of promises by donor countries (eg.
0.7% of GNP for ODA)
International Coordination
• UN (various sessions – Special Sessions)• WTO talks (various rounds)• G8; London Club; Paris Club• World Bank Multi-country HIV/AIDs Program (MAP) for
Africa• The Blair Commission (health care + other development
aspects)• The MDGs especially ~ reduce child mortality; improve
maternal health; combat HIV aids and other diseases; (international cooperation?)
Barriers
• Colonialism• Irresponsible / Predatory lending• Structural Adjustment Programs• Conditionality• Macroeconomic limits• User fees• Economic protocols
Responsibility
• International Financial Institutions• World Bank• International Monetary Fund
• Donor Nations• Phantom Aid• Technical Assistance• Tied Aid• Administrative Costs
• Dependence
Recommendations
• Relieve the Burden of Debt• Relieve Interference from IMF• Reliance on G8 Commitment • Decrease Phantom Aid Portion [~60% of Total Aid]• Technical Assistance• Tied Aid• Administrative Costs
State of Africa
• Ultimately, the fate of Africa is at the hands of the Africa with the needed support of the international community.
• Africa remains in a tangled web of• International Debt• Extreme Poverty• Agendas of Individual Countries• HIV/AIDS Crisis & Other Disease Prevalence• Lack of Ability to Act Unrestrainedly
• “…whose future is in the hands, at least in part, of those who have always pretended to care, and have never really cared…”
Discussion
• How should the international community support Africa?
Discussion
•What are some ideas for implementation of an African health care system?
• Who?• How?
Discussion
• Is it fair to impose SAPS?
List of Acronyms
• GNP• Gross National Product
• IFIS• International Financial Institutions
• IMF• International Monetary Fund
• MAP• Multi-country HIV/AIDS Program
• MDGS• Millennium Development Goals
List of Acronyms
• ODA• Official Development Assistance
• SAPS• Structural Adjustment Programs
• UNDP• United Nations Development Program
• WEOG• Western European and Others Group
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