E-drug: WHO and ARV access (cont'd)
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I very much support healthy debates on drug access issues in
E-drug. In that sense I was glad to see Peter Burgess' comments
on WHO's efforts to improve access to TB drugs through its GDF.
Problem is that after reading his comments few people may feel
an urge to respond. I also tend to shrug my shoulders after
reading this kind of contributions. But as my colleagues in the
"alphabet soup of development agencies" (as Peter calls them)
may not want to react, I will.
Peter explains that he is 'terribly' sceptical (not necessary to
emphasise that), and that his background is numbers. He says he
is knowledgeable about Malawi and estimates that there must be
some 2 million TB cases in that country. WHO's global TB efforts
are therefore irrelevant, according to Peter. Odd, as my information
says that "tuberculosis case notification in Malawi has increased
from 7,581 per annum in 1987 to 27,672 in 2001" and "the
number of TB cases per 100,000 population has increased from
95 in 1987 to 275 in 2001". With a population of 11.5 million, it
would mean that there are some 32,000 TB cases per year in
Malawi. That is somewhat less than the 2 million claimed by Peter.
Peter also explains that he is worried that "more money [will go]
for plans and studies and [that this means] another delay in
getting down to the real work." He worries that "other agencies are
planning to use the same delay model so that the real issue of
getting down to practical help can be deferred again."
Development agencies are spending much time on planning and
evaluating their activities. True. At times maybe even too much.
But calling therefore all efforts by them a waste of time and money
is a bit short sighted. Personally I believe that the Lee-led TB
campaign has been one of the more successful in WHO's recent
history, and Lee is about the last person you can credibly accuse
of talking rather than acting.
On his comment that he "does not think for a minute that the
WHO numbers would stand up to statistical and economic peer
review nor competent independent audit", com' on Peter, do your
homework before making such statements. For anyone who wants
to see the numbers, please read the report of GDF's external
evaluation, prepared by McKinsey and available from
http://www.stoptb.org/GDF/default.asp . It explains that the
numbers claimed by GDF are credible, and correct.
Finally, I really hope Peter does not represent the whole ATCnet,
as with his comments he makes it clear that he prefers a
'sitting-on-the-fence' attitude; lamenting how bad things are, but
criticising those who try to do something about it. Not very helpful.
Hilbrand Haak
Consultants for Health and Development
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Access Essential Drugs Monitor #32 at http://www.who.int/medicines/mon/mon32.shtml
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