Roger England is Chairman of the Health Systems Workshop, Grenada. His analyses and commentaries are lightly sprinkled through the scientific literature. The Writing is on the Wall for UNAIDS was England’s editorial in the British Medical Journal (BMJ), May 2008. England criticizes the rampant “exceptionalism” granted to HIV/AIDS across many domains.
In one strong statement, England writes:
“HIV exceptionalism is dead—and the writing is on the wall for UNAIDS. Why a UN agency for HIV and not for pneumonia or diabetes, which both kill more people?”
England’s article focuses on the billions in HIV/AIDS expenditures, and its affect on the health care infrastructures of impacted nations:
“Although HIV causes 3.7% of mortality, it receives 25% of international healthcare aid and a big chunk of domestic expenditure. HIV aid often exceeds total domestic health budgets themselves, including their HIV spending.”
“[ HIV aid ] has created parallel financing, employment, and organisational structures, weakening national health systems at a crucial time and sidelining needed structural reform.”
“Yet UNAIDS is calling for huge increases: from $9 billion today to $42 billion by 2010 and $54 billion by 2015. UNAIDS is out of touch with reality, and its single issue advocacy is harming health systems and diverting resources from more effective interventions against other diseases.”
Notably, in these deliberations, England is working with the disease statistics and financial expenditures generated by UNAIDS itself (among other authorities). England’s conclusions were made without the “benefit” of the empirical information that I now bring to the table.
For example, in the Republic of South Africa (RSA), UNAIDS estimated that the RSA had 140,000 HIV/AIDS death sin 1997, but the RSA tabulated on 6,635 HIV/AIDS deaths in the annual death tabulations: two orders of magnitude.
Although the health authorities of the RSA have more faith in the WHO/UNAIDS computer models than their own death counts, these findings tend to substantiate, or perhaps augment, the validity of England’s arguments, even allowing for substantial error in measures.
England’s entire BMJ editorial is available free via PubMed Central (U.S. National Library of Medicine) – England R. The Writing is on the Wall for UNAIDS. British Medical Journal. May 10 2008;336(7652):1072.
Responses to “The Writing is on the Wall for UNAIDS – Roger England”:
- Writing on the wall for UNAIDS: UNAIDS replies: De Lay P. Writing on the wall for UNAIDS: UNAIDS replies. BMJ. 2008 May 31;336(7655):1206. [PMID: 18511775] [FREE Full Text]
- Writing on the wall for UNAIDS: Consequences of mythology: Norris J. Writing on the wall for UNAIDS: Consequences of mythology. BMJ. 2008 May 31;336(7655):1206. [PMID: 18511774] [FREE Full Text]
Related Links & Blog Posts:
The Writing is on the Wall for UNAIDS, British Medical Journal. May 10 2008;336(7652):1072 (Free PDF)
The Myth of a General AIDS Pandemic – James Chin, MD, MPH