The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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ResultsThe following results were achieved under the Jamaica Second HIV/AIDS Project.Prevention91% of female sex workers reporting condom use with their most recent client (target: maintain more than ... Show More +90%).59.2% of female sex workers who received HIV testing in the last 12 months and who know the results (target: 50%).40,445 female sex workers and 22,145 men who have sex with men reached through prevention activities (target: FSW 14,955; MSM 14,059).19% of prison inmates reached through prevention activities (target: 15%)Treatment, Care, and Support10,469 men, women and children with advanced HIV receiving antiretroviral combination therapy according to national guidelines (target: 9,000)85.8% of HIV positive pregnant women receiving a complete course of antiretroviral (ARV) prophylaxis to reduce the risk of mother-to-child transmission (target: maintain more than or equal to 80%)1.4% of infants born to HIV infected mothers who are also HIV infected (target: less than 5.0%)More than 95% of antenatal clinic clients counseled and tested for HIV (target: maintain more than 90%)Strengthening Institutional Capacity for Legislative Reform, Policy Formulation, Program Management, Monitoring and Evaluation100% of reported cases of HIV-related discrimination receiving redress (target: 70%)100% of institutions/organizations reached adopting HIV/AIDS policies (target: 93%)Bank Group ContributionThe Bank’s total investment contributions in support of Jamaica’s response to HIV/AIDS include the first loan for US$15 million, which was implemented between March 2002 and May 2008, and the follow-on Second HIV/AIDS Project for US$10 million, implemented between May 2008 and March 2013. PartnersThe project was implemented by the Ministry of Health, its four decentralized regional health authorities, four non-health line ministries, civil society organizations, and the Jamaica Business Council. The project was critical in helping the Government leverage additional donor funds, which included US$44.22 million from the Global Fund and US$26 million from the United States Agency for International Development, President’s Emergency Plan for AIDS Relieve (USAID/PEPFAR). Based on the sustainability study conducted by the Bank in collaboration with the Government and the United Nations Program on HIV/AIDS (UNAIDS), the Global Fund has provided an additional grant of approximately US$2 million to assist Jamaica during the transition from external to domestic financing of the National HIV/AIDS Program. Show Less -
Growing up in Iowa, I was often judged solely on appearance. In stores, strangers would make karate-chop gestures at me, inspired by the popular TV series “Kung Fu.” When I played quarterback for my h... Show More +igh school team, opponents were not above slamming me to the dirt and then piling on racial slurs.These incidents embarrassed me and made me self-conscious. But they are trifling indignities compared with the discrimination that many people around the world face based solely on their sex, age, race or sexual orientation.I raise this in light of the law Uganda enacted this week, which could imprison for life those convicted of homosexuality, and the increased violence against gays in Nigeria after an anti-gay law took effect there this year.These countries are in the news now, but our focus should be much broader: 81 other countries — in the Americas, Asia, Africa and the Middle East — have passed laws that make homosexuality illegal. In the United States, although Arizona’s governor vetoed a bill this week that would have allowed businesses to deny service to gay people, nine states have laws that limit how public school teachers can talk about homosexuality. More than 100 countries discriminate against women. And an even greater number of countries still have laws that discriminate against minority groups.Institutionalized discrimination is bad for people and for societies. Widespread discrimination is also bad for economies. There is clear evidence that when societies enact laws that prevent productive people from fully participating in the workforce, economies suffer.Discrimination against women is a case in point. A World Bank study last year of 143 economies found that 128 countries still have at least one legal difference in how men and women are treated, which constrains women’s economic opportunities. These barriers include laws that make it impossible for a woman to independently obtain an ID card, own or use property, access credit or get a job.In 15 economies, husbands can prevent their wives from working, although in the past two years Ivory Coast, Mali and Togo have reformed such restrictions. Show Less -
Policy Interventions Can Turn the Tide, Says World Bank ReportWASHINGTON, November 20, 2013 – A new World Bank report warns that risky behaviors –smoking, using illicit drugs, alcohol abuse, unhealthy... Show More + diets, and unsafe sex— are increasing globally and pose a growing threat to the health of individuals, particularly in developing countries. The report looks at how individual choices that lead to these behaviors are formed and reviews the effectiveness of interventions such as legislation, taxation, behavioral change campaigns, and cash transfers to combat them.Risking your Health: Causes, Consequences and Interventions to Prevent Risky Behaviors concludes that legislation and taxation, for example, tend to be effective, especially when combined with strong enforcement mechanisms. Cash transfers also have proven to be promising in some settings. Behavior change campaigns, such as school-based sex education and calorie-labeling laws, are often less effective on their own, unless they are complemented with broader risk behavior change programs.“Risky behaviors not only endanger an individual’s health and reduce life expectancy, they often impose consequences on others,” said Damien de Walque, Senior Economist in the World Bank’s research department and principal editor of the report. “The health consequences and monetary costs of risky behaviors to individuals, their families, and society as a whole are staggering and justify public interventions.”The report finds that despite recent progress in prevention and treatment, the HIV/AIDS epidemic —one of the most devastating consequences of risky sex— remains a heavy burden in Sub-Saharan Africa, especially in its southern cone where between 11 and 26 percent of all adults are HIV positive. Drug and alcohol abuse have been relatively stable over the past decade, but smoking and obesity linked to unhealthy diets are on the rise in many developing countries and have the potential to substantially increase mortality and morbidity. Close to 20 percent of the world’s adult population smoke cigarettes and smoking causes more than 15 percent of deaths among men and 7 percent among women globally. While smoking prevalence is decreasing in the developed world, it is on the rise in many developing countries. Obesity due to both unhealthy foods and physical inactivity is also increasing in the developing world, especially in the Middle East, the Pacific Islands, and Latin America and the Caribbean where many countries are experiencing obesity rates above 20 percent for males and more than 40 percent for females.Engaging in such risky behaviors, according to the report, exerts a significant toll on the individual’s productivity in the long-run. Society suffers as immediate peers of those who engage in risky behaviors may also experience declines in their productivity. Children are at particular risk, for example if they have to stop schooling due to a sick parent or if development of their cognitive abilities is compromised due to early exposure to harmful substances. Furthermore, in most low-income countries, it is difficult to formally insure against these costly consequences, given the rarity of both health insurance and public or private disability benefits. According to the World Bank’s World Development Indicators, 75 percent of private expenditure on health was financed through out-of-pocket payments in low-income countries in 2011. “Individuals’ risky behaviors that cluster amongst the poor ripple throughout entire populations, crippling families’ potential and undermining the great health and economic progress we’ve seen in low- and middle-income countries in recent years,” said Tim Evans, Director of Health, Nutrition and Population at the World Bank Group. “Reversing the tide of these pernicious behaviors by promoting societal conditions for better health choices will pay dividends for families and countries across the globe, ultimately helping us end extreme poverty and promote inclusive and healthy growth.”The report concludes that the costs and spillovers associated with risky behaviors justify public interventions and that certain policies, when done properly, can improve overall welfare. Evidence suggests that legislation tends to be effective, especially when enforcement mechanisms are strong. Tax policies can be efficient mechanisms to prevent smoking and alcohol consumption. Most of the evidence comes from developed countries, but emerging evidence from developing countries –such as from China and Indonesia for tobacco taxes and from Kenya for alcohol prices— points in the same direction. Show Less -
Potentially preventable risk factors including poor diet, high blood pressure, and alcohol use help fuel changing disease burden in Latin America and Caribbean regionWASHINGTON, September 4, 201... Show More +3 - With the exception of young men, most people in Latin America and the Caribbean are living much longer today than 40 years ago. The mortality rate has dropped by at least 80 percent for children 4 years old or younger and by more than 50 percent for women between the ages of 20 and 44. For men between the ages of 15 and 19, however, the mortality rate has increased by 1 percent, largely due to deaths from road injuries and rising violence.These are some of the findings released by the World Bank Group and the Institute for Health Metrics and Evaluation (IHME) in a new report, The Global Burden of Disease: Generating Evidence, Guiding Policy. Latin America and Caribbean Regional Edition. The report also highlights the fact that the Latin America and Caribbean region (LAC) faces increasing threats from chronic disease, violence, and road traffic injuries. In the region, health loss from heart disease grew by 36 percent between 1990 and 2010, while interpersonal violence, depression and low back pain grew by 35, 40 and 57 percent, respectively.The report is based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), a collaborative effort of researchers from 50 countries around the world led by IHME at the University of Washington in the United States and supported by the Bill & Melinda Gates Foundation. The report finds that, similar to global trends, communicable, maternal, nutritional, and newborn diseases are becoming less important in LAC as non-communicable diseases kill more people prematurely and cause increasing disability.“The rapid shifts in disease burden place poor people in low- and middle-income countries at high risk of not having access to appropriate services and incurring payments for health care that push them deeper into poverty,” said Timothy Evans, Director of Health, Nutrition, and Population at the World Bank Group. “The data in these new reports are critical inputs to the efforts of policymakers in countries towards universal health coverage that aim to improve the health of their people, communities, and economies.” The report details preventable risk factors that account for a substantial amount of premature death and disability in the region. These include dietary risks, which include not eating enough fruit, whole grains, nuts and seeds, and eating too much salt. Improving Latin Americans’ diets could substantially reduce ischemic heart disease, stroke, and diabetes, as well as colon and rectal cancers. “Health care providers in Latin America and the Caribbean are seeing very different problems today than they did 20 years ago,” said Dr. Christopher Murray, IHME Director and one of the lead authors on the study. “Data on potentially avoidable causes of health loss, or risk factors, can help policymakers and donors prioritize prevention strategies to achieve maximum health gains.”The report also highlights other critical health issues: injuries from traffic accidents and violence. Brazilian men, for instance, lost nearly 3 million years of healthy life in 2010 as a result of interpersonal violence. In Mexico, loss of healthy life caused by interpersonal violence ranked the highest in 2010, while road traffic injuries ranked third.“While the region has made great progress fighting infectious diseases and saving children’s lives, many of these same children, particularly males, die violent deaths when they reach adulthood,” said Rafael Lozano, Director of Latin American and Caribbean Initiatives at IHME and a lead author on the study. “Lack of economic opportunities coupled with easy access to guns has helped make violence the number one cause of health loss in countries such as Venezuela, Honduras, and El Salvador.”Among countries in the region, the leading causes of disease burden were as diverse as HIV/AIDS in Belize and Jamaica, diabetes in Dominica and Mexico, and ischemic heart disease, or coronary artery disease, in Cuba, Costa Rica, and the Dominican Republic. When comparing rates of diseases and injuries across countries and taking into account differences in population growth and ages, Costa Rica, Cuba, and Chile performed best while Guatemala, Guyana, and Haiti performed the worst.Detailed findings for Latin America and the Caribbean and each country in the region are available online in a series of country profiles and data visualization tools. Anyone can search by condition or country on the IHME website at http://www.healthmetricsandevaluation.org/search-gbd-data.The World Bank commissioned the first Global Burden of Disease analysis as part of its World Development Report 1993. Earlier this year, IHME presented GBD 2010 findings in meetings hosted by the World Bank. Bank officials saw how the GBD analysis could be applied to the Bank’s work in specific countries and began working with IHME on six regional reports, including the one on LAC.Building on the success of GBD 2010, IHME is expanding its network of researchers from around the world with expertise in specific diseases, injuries, and risk factors. Through this broader network, IHME hopes to strengthen the country-level assessments that are produced and make GBD updates more frequent. Application information is available here.In LAC, the World Bank partners with countries and organizations to tackle the main causes of burden of disease through knowledge, convening, and financing services. A regional study focusing on lessons learned from initiatives promoting healthy lifestyles and preventing chronic diseases will be published in November. That same month, together with the Pan American Health Organization, the World Bank will bring together policy makers and experts to highlight the importance of multi-sectoral efforts to promote healthy living.The World Bank Group and Health, Nutrition, and PopulationThe World Bank Group is a vital source of financial and technical assistance to developing countries around the world, with the goals of ending extreme poverty and boosting shared prosperity. Improving health is integral to achieving these goals. The Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable health care; protect people from falling into poverty or worsening poverty due to illness; and promote investments in all sectors that form the foundation of healthy societies.The Institute for Health Metrics and EvaluationThe Institute for Health Metrics and Evaluation (IHME) is a global health research organization at the University of Washington that provides rigorous and comparable measurement of the world's most important health problems and evaluates the strategies used to address them. IHME makes this information widely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to best improve population health. Show Less -