While the battle against HIV/AIDS attracts more donor fundingglobally than all other diseases combined, it has not divertedattention from fighting unrelated afflictions - such as malaria , measles and malnutrition - and may be improving health services overall in targetedcountries, according to a study on Rwanda published in the May 2012edition of the American Journal of Tropical Medicine and Hygiene. A six-year investigation of health clinics in Rwanda by researchersat Brandeis University infuses fresh evidence into a long-standingdebate about whether the intensive focus on HIV/AIDS, which in 2010alone killed 1.8 million people, is undermining other healthservices, particularly in African countries that are at theepicenter of the pandemic. For example, between 2002 and 2006,one-third of funds from wealthy countries earmarked for health andpopulation programs abroad were committed to fighting HIV/AIDS. "We found that when health clinics in Rwanda expanded AIDS services, these efforts had no adverse effects on other types ofhealth care," said Donald S. Shepard, PhD, a professor at Brandeis'Schneider Institute for Health Policy and the study's lead author."There is even evidence that clinics that have received funding forHIV/AIDS services provide better care for all patients, includingsuperior prevention services, than do clinics without AIDSprograms." Shepard and his colleagues note that their study differs from pastefforts to analyze the issue because their investigation focused onthe actual performance of health centers rather than on "inputs"such as overall spending on facilities or staff. For example, forthe Rwanda study, the researchers collected data on the number ofvaccines administered, visits for child growth monitoring, andnon-HIV/AIDS hospitalizations. They concluded that "for most indicators examined, there wereneither prominent diversions nor enhancement effects" after AIDSservices were inaugurated in the health centers. However, there wasevidence that the health centers that offered AIDS servicesprovided better preventive care than those that did not, includingsuperior delivery of childhood vaccinations. For several years advocates for childhood immunization, tuberculosis control and those seeking a general improvement in health servicesin poor countries have expressed concern that HIV/AIDS preventionand care activities are crowding out other deserving public healthprograms. Meanwhile, on the opposite side are advocates who arguethat the sharp increase in HIV/AIDS funding is a rising tide thatlifts all boats, bringing improvements in such areas aslaboratories, disease surveillance, human resources, andinformation systems that generate broad benefits across the healthcare system. The authors noted that this study was designed to answer concerns,such as in the Bulletin of the World Health Organization in 2006 about HIV funding "crowding out resources," for the many other health issuesin the world's poorest people. The debate has become more heatedsince 2008 when the economic crisis squeezed public spending inindustrialized countries, thus intensifying competition forinternational aid among a number of worthy causes. Shepard and his colleagues, including researchers from the publicpolicy consulting firm Abt Associates, explored the issue bycomparing the state of treatment and prevention services at 25rural health centers in Rwanda that launched comprehensive HIV/AIDSinterventions between 2002 and 2006 to 25 centers that did notengage in these activities. They noted that Rwanda is a particularly good location to considerthe impact of HIV/AIDS funding on health services because thecountry has received a substantial investment from internationaldonors to address the disease, and its experience has been used tosupport both sides of the debate regarding the impact of AIDSspending. In 1996, the HIV infection rate in Rwanda was 6.9 percentamong the rural population; the latest data show a 2.3 percentprevalence of disease in rural populations and 95 percent coverageof anti-retroviral treatment. "Rwanda's progress against HIV/AIDS has not come at the expense ofaddressing other health needs," Shepard added. "While thedifferences between the health centers was not large, we did findindications that the AIDS funding may be having spill-over effectin terms of improving overall quality of care," Shepard said. Forexample, Shepard and his colleagues speculate that bysimultaneously providing AIDS services along with a variety ofother family health care interventions, the clinics that offer AIDStreatment may have more encounters with children who wouldotherwise miss their vaccinations. The researchers were not able to measure other ways in which theAIDS funding could have benefited health services overall by, forexample, streamlining drug procurement or improving informationsystems. They also acknowledge that the central finding - that theAIDS funding did not have a negative effect on non-AIDS healthservices - could be attributed to the fact that Rwanda has done anexceptional job of integrating AIDS services into the nationalhealth system. However, they note that the experience in Rwanda adds to a growingbody of evidence from several countries that AIDS-related fundingis not adversely affecting non-AIDS services. For example, a studyfrom Ethiopia found that while the increase in AIDS funding mighthave encouraged health professionals from the public sector to takepositions with non-governmental organizations, mortality ratesnationwide nonetheless dropped, immunization rates increased, andpre-natal care improved. "What is at the heart of this research is that the sciencecommunity is unified by its commitment to improved health for all,"said James W. Kazura, MD, President of the American Society ofTropical Medicine and Hygiene, which publishes the journal, andDirector of the Center for Global Health and Diseases at CaseWestern Reserve University. "To reach that goal, evaluating theeffectiveness of all our disease control efforts will helppolicymakers to make appropriate, evidence-based decisions." Additional References Citations. The e-commerce company in China offers quality products such as Box Beam Welding Manufacturer , China Membrane Panel Production Line, and more. 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