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On a Never-Ending Waiting List: Toward Equitable Access to Anti-Retroviral Treatment? Experiences from Zambia

Peris Sean Jones
Health and Human Rights
Vol. 8, No. 2, Emerging Issues in HIV/AIDS (2005), pp. 76-102
DOI: 10.2307/4065335
Stable URL: http://www.jstor.org/stable/4065335
Page Count: 27
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
On a Never-Ending Waiting List: Toward Equitable Access to Anti-Retroviral Treatment? Experiences from Zambia
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Abstract

Universal access to anti-retroviral (ARV) medication for HIV/AIDS is the clarion call of the WHO/UNAIDS 3 by 5 Initiative. Treatment coverage, however, remains highly uneven. This sharpens the question of who exactly is accessing ARVs and whether access is challenging inequality or reinforcing it. Issues of distributive justice have long been debated in health policy, but the practical challenges of ARV distribution are relatively new. In exploring what a more equitable process of ARV distribution could involve, this article draws on a human rights framework using case study material from Zambia. /// L'accès universel aux médicaments anti-rétroviraux (ARV) pour le VIH/SIDA est l'axe des efforts mondiaux, en particulier l'initiative WHO/UNAIDS 3 by 5. Toutefois, la couverture du traitement demeure très inégale. Ceci soulève la question non seulement de qui, exactement, a accès aux médicaments ARV, mais aussi de savoir si leur accès s'attaque aux inégalités ou les renforce. Les questions de la justice de la diffusion fait débat depuis longtemps en matière de santé publique, mais les enjeux pratiques de la diffusion des ARV sont relativement récents. Cet article est basé sur des documents d'étude de cas en Zambie pour explorer, au travers du prisme santé-droits de l'homme, ce que pourrait entraîner un processus plus équitable de distribution des ARV. /// El acceso universal a los medicamentos antiretrovirales (ARV) para VIH/SIDA es la consigna que guía los esfuerzos mundiales, incluida la Iniciativa 3 por 5 de la OMS/ONUSIDA. Sin embargo, la cobertura del pago para los tratamientos sigue siendo sumamente irregular, agudizando los interrogantes sobre quién exactamente está obteniendo acceso a los ARV, y también si el acceso está ayudando a acabar con la desigualdad o aumentándola. Los temas de justicia en la distribución se han debatido desde hace mucho tiempo en la política de salud pública, pero los problemas prácticos de distribución de ARV son relativamente nuevos. Usando un marco de derechos humanos, este artículo aprovecha documentos de estudio de casos en Zambia para explorar lo que un proceso más equitativo de distribución de ARV podría implicar.

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