Growing recognition of the depths and costs of the AIDS crisis have produced, at the transnational level, a shift away from a largely public production of health care policy to an institutional framework involving a mix of actors.

Private Public Interactions (PPIs) are proposed as win-win solutions to the AIDS pandemic. With an outcome orientation and efficient ‘lean’ governance structure, PPIs are expected to move fast in making medicines available to people living with HIV/AIDS. In practice, fast and effective action is proving to be difficult: funds for implementation of projects are often constrained, with implications for their functioning and the communities they are intended to serve. Other risks have been recognised including strain on existing health infrastructure, inequity in delivery, and questions about accountability and responsiveness to the public.

Through working with academic institutions and NGOs providing care and support and community based organizations of people living with AIDS, HAI is developing a methodology to conduct country situation analyses in a number of pilot study countries. The resulting information will be used to assess the impact of PPIs on access to medicines at the community and country levels, and to inform global data collection and policy.

By December 2005, approximately 1,3 million people in need of ART were actually receiving it.

If we are to achieve universal access to ART by 2010 all those engaged in implementation -at every level - must address the challenges. HAI has developed a policy brief which highlights 10 challenges on the way to achieve universal access to ART by 2010. Healthworkers, policy makers and ART users from 14 countries put forward these challenges during rapid appraisal assessments conducted by HAI, ITPC (International Treatment Preparedness Coalition) and the University of Amsterdam. Read the brief.

Now available, Spanish version of Universal Access: 10 Challenges on the way

Country Working Papers