“Equity in ART? But the whole health system is inequitable”
Malawi is one of the poorest countries in Africa. It has been severely affected by the HIV/AIDS epidemic. HIV/AIDS has created an increasing demand for healthcare, exacerbated by population pressure, chronic poverty and food insecurity. This demand is set against a reduced capacity to supply healthcare. With funding from the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), Malawi is now in a position to commence a programme of provision of anti-retroviral therapy (ART) using a public health approach, within an integrated programme of prevention, care and support.
The Southern African Regional Network for Equity in Health (EQUINET) and Oxfam (GB), in co-operation with IDRC and DFID, have commissioned a series of technical papers on equity in health sector responses to HIV/AIDS in southern Africa. The programme, initiated in February 2003, aims to identify policy issues and options to strengthen equity in health sector responses to AIDS. A regional workshop and review panel identified the key areas for analysis at country and regional level. In line with this framework. EQUINET and Oxfam have commissioned a series of country studies from four countries in southern Africa, a regional study, and theme papers on HIV/AIDS equity issues in relation to health personnel, to food security and nutrition and gender equity. This technical paper analyses the equity issues in HIV/AIDS health sector responses in Malawi, including access to ART. It is based on a review of published and greyi literature on HIV/AIDS, health sector programmes and policies in Malawi. In addition informal meetings were held with 24 key informants representing a range of key
stakeholders in HIV/AIDS, including: people living with HIV/AIDS (PLWHA); Non Governmental (NGO) and civil society organisations; and representatives from the Ministry of Health and Population, National AIDS Commission, donor organisations and development partners. The initial findings of this analysis were presented to a meeting of key stakeholders in HIV/AIDS on 2 July 2003, when recommendations and ways forward for promoting equitable public policy within the health sector were discussed.