East African Business Week (Kampala)
Ben Moses Ilakut
17 December 2007
Kampala — As the world continues to face numerous global health challenges, including HIV/AIDS and other infectious diseases, limited access to clean water, and lack of affordable and accessible health care, a just-released survey has shown that a majority of Ugandans are bothered most by health concerns that any other problem.
The survey indicates that Uganda has the highest percentage of people (61%) in the 47 countries surveyed who cite health as their top personal concern.
Mali was ranked 2nd with 49% of the people interviewed indicating that health was their major life concern while Tanzania (43%) came third. Other countries in descending order of ranking are Ivory Cost 41%, Senegal 40%, Nigeria 40%, Ghana 37%, South Africa 36%, Kenya 35, and Ethiopia 235.
But on a very positive note, more than half of the people interviewed in Uganda, Senegal and Tanzania say there is only a little or no stigma and discrimination against people living with HIV/AIDS.
The three are the only countries out of 47 surveyed where a majority expresses this view.
Otherwise, across the world, majorities in nearly every country surveyed believe that there is at least some discrimination against people living with HIV and AIDS in their country, with some interesting variations by region, and by country within specific regions. In sub-Saharan Africa, for instance, majorities or pluralities in Nigeria, Ghana, Ivory Coast, South Africa, and Mali say there is a lot of prejudice and discrimination.
In Uganda alone 1,122 people were interviewed. The survey was conducted jointly by the Kaisser Family Foundation and the Pew Global Attitudes Project and examines how people around the world perceive and prioritize health in their countries and gauge the efforts of donor nations.
People in 47 countries were polled on a series of health questions, giving them an opportunity to share their views on health as a priority for their government and in their own lives.
Specifically, the survey looked at what people consider to be the top problem facing their country, such as HIV/AIDS, crime, pollution and political corruption. It also examined the top public health priorities in low and middle income countries, such as preventing and treating HIV, fighting hunger and malnutrition, and accessing health care.
An additional question about foreign aid assesses whether people think that wealthier countries are doing enough to help poorer nations with problems such as economic development, reducing poverty, and improving health.
The survey was recently discussed at an event sponsored by the Center for Strategic and International Studies in Washington, D.C.
Uganda is generally one of the poor countries in the world whose efforts to prevent HIV/AIDS spread have been praised globally. Currently the HIV prevalence rate is estimated at 6% having risen slightly from 5%. The countries' level of awareness and attitude to the disease is among the best in the world following the "openness with which the disease has been tackled."
Indeed the Kaisser survey indicates that Uganda has the lowest percentage of people (20%) in all African countries surveyed who say there is a lot of prejudice and discrimination against people with HIV in their respective countries.
The research, however, indicates that 65% of people surveyed in Uganda say HIV is a bigger problem now than it was five years ago, while 74% say Uganda is making progress on HIV prevention, and 73% say Uganda is making progress on HIV treatment.
Among all countries surveyed, Uganda has the highest percentages of people who say there were times this year when they were unable to afford health care (76%), food (66%), and clothing (71%).
To assess health as a national concern, Kaisser Foundation compared the shares of the public who see the spread of HIV and other infectious diseases as a "very big problem" with the shares who name other national concerns, such as crime, pollution, education, and immigration, as very big problems.
HIV and other infectious diseases were cited as a major concern across much of the world, named as a very big problem by majorities in 28 of the 47 countries surveyed, and ranging from a high of 88% in South Africa and Tanzania to a low of 5% in Sweden.
Countries hardest hit by HIV, such as those in sub-Saharan Africa, are much more likely to name disease as a top problem, according to the survey.
Disease stands out as a particularly dominant concern in Ethiopia, where nearly nine in ten people (87%) say it is a very big problem, 34 percentage points ahead of the second-ranked issue (poor quality drinking water).
Outside of sub-Saharan Africa, concern about HIV and infectious diseases ranks lower on the list. In Latin America, Asia, Eastern and Central Europe, and the Middle East, HIV and infectious diseases rank fifth on the list of 11 problems, behind issues such as crime, corrupt political leaders, illegal drugs, pollution, and, in the case of the Middle East, terrorism.
In the wealthier countries of Western Europe, the spread of HIV and other infectious diseases does not rank in the top five concerns.
Generally, little is known about how people, particularly those living in countries that bear the brunt of the world's health challenges, perceive and prioritize health in their home countries, and how they regard efforts to address critical public health challenges.
According to the Kaisser Foundation, this survey provides one of the first chances to evaluate whether the health priorities of people in developing nations are the same or different than those of their governments and of the international organizations that work in global health and development, and the degree to which efforts to raise consciousness of issues such as malaria, HIV, tuberculosis, and clean water are cutting through with their target audiences.
The key findings of the survey indicate that there is great variation across the world in the priority placed on health compared to other problems.
Another key observation is that over the past five years, there has been a decline in the share of people in low- and middle-income countries who report going without food or health care due to cost; however, huge gaps between rich and poor nations still persist.
Among low- and middle-income countries, health priorities also vary, with HIV/AIDS, for example, topping the list in sub-Saharan Africa and Asia, while other health issues rise to the top elsewhere.
When given a list of various health issues, almost all countries surveyed rate all of the health priorities quite high. In fact, in 23 out of 34 countries, majorities say every one of the nine health priorities asked about should be "one of the most important" for their government to address, and in five countries, two-thirds or more say every health priority should be one of the most important.
Most countries that face especially severe problems with a particular issue (such as HIV, malnutrition, access to clean water, or chronic disease) tend to rank that issue higher on the list of health priorities.
Another key finding was that foreign aid resonates most with recipients, who generally give donor nations more credit compared to non-recipients, and even compared to residents of donor nations themselves. Still, people in all countries say donors should do more.
This report comes only weeks after Prof. Jeffrey Sachs, a leading American lobbyist, and advisor to the UN secretary general Ban Ki-Moon called upon rich nations to give more money to HIV/AIDS and on all governments to raise their health budgets to the recommended 15%.
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