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Aids and Health Strategy Options : The Case of Cote Divoire

By Brunet-Jailly, J.

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Book Id: WPLBN0000212158
Format Type: PDF eBook
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Reproduction Date: 2005
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Title: Aids and Health Strategy Options : The Case of Cote Divoire  
Author: Brunet-Jailly, J.
Language: English
Subject: Economics, Finance & business, World Bank.
Collections: Economics Publications Collection
Publication Date:
Publisher: The World Bank


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Jailly, J. B. (n.d.). Aids and Health Strategy Options : The Case of Cote Divoire. Retrieved from


In this article we deal with two questions. The first can be stated as follows: To what extent are anti-AIDS measures consistent with other aspects of health strategy? The second relates to issues of equity: Are the choices revealed by an examination of the health strategy really ethical? The two questions are interrelated, because -- resources being limited -- equity demands that all the measures adopted be equally cost-effective. We will therefore begin by examining the most obvious aspects of the problem, which show that the reasoning underlying the AIDS strategy is quite different, after which we will identify the various elements upon which a new approach could be based. -- I. The First Decade: AIDS -- a Ministry of Health Priority? ?From 1987 to 1992, direct and indirect contributions by the Ivorian Government to the PNLS (National Program for Control of AIDS) essentially consisted of paying the salaries of government employees assigned to the Program, together with the maintenance costs of the premises provided. Thus, it provided CFAF 11.4 million (US$22,800) in 1997 for the salaries of seven staff members in the Program. ?From 1993, the Government added a specific item to the General Operating Budget of the Ministry of Public Health. This was intended to cover expenditures on operating costs, IEC (information-education-communication) and prevention, training, publications, and support for NGOs and ministries. Although originally launched to support the AIDS and STD control program, the item was extended in 1995 to include the tuberculosis program.? ([1] page 48.) The funding increased from CFAF 60 million in 1993 to CFAF 450 million in 1995 (with the inclusion of antituberculosis activities), CFAF 650 million in 1996, and about CFAF 800 million in 1997. Its share of the Health Ministry?s General Operating Budget was 0.15% in 1993 (38 billion) and 1.25% in 1996 (52 billion) ([1] page 48). In fact, this item was financed to a considerable degree by EDF. This Fund provided the entire amount of financing from 1993 to 1995, and more than half in 1996 (CFAF 350 million, out of the total CFAF 650 million -- [1] page 48). The total for this line item is not sufficient to finance large-scale activities. In 1996, the grant to the NGO Espoir-CI alone amounted to CFAF 100 million ([1] page 49). Obviously, the total operating costs of CNTS (the National Blood Transfusion Center) could be added to the list of activities financed under this special line item, given that the Center was rehabilitated in 1990/91 because of the problem of blood safety. (The cost of...


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