10/28 Readings

In attempting to discuss the future of healthcare in Zimbabwe, Todd, etc. first discuss the dramatic decline in health services and national health statistics between 2000 and 2005. The deterioration of health infrastructure in particular struck me as incredibly dramatic; from the statement that "hospitals in the country were hardly operating" to the fact that Zimbabwe's primary medical school was in fact closed for six months. This article focuses on infrastructure throughout its discussion of Zimbabwe's healthcare future, whether that infrastructure be directly related to health facilities or indirectly related to healthcare. As the authors point out, progress in improving national healthcare will be severely limited unless Zimbabwe's political situation stabilizes and the country is able to re-establish its agricultural infrastructure and its education and water systems. While international funding can quickly supply short term supplies and drug supplies, the key to Zimbabwe's future lies in the process of rebuilding its medical training systems, its health facilities, and its overall basic infrastructure as a country. The authors emphasize the importance of a broad-based, interdisciplinary approach to the problem, identifying the need for human rights organizations and political legislation in the struggle towards improved healthcare. Overall, the article makes it clear that the road to quality healthcare in Zimbabwe will be difficult; however, with a multi-disciplinary approach and significant international support, Zimbabwe's healthcare system can begin to recover. 

Before reading "Spectrum of Adverse Events After Generic HAART..." I was unaware of the extensive appearance of severe side effects due to anti-retroviral drugs. The authors of this study allude to the issue of side effects and their impact on patient adherence to drug regimens, and this is an issue that would be interesting to explore further. I am curious as to how improvements in ARV drugs that could eliminate side effects would impact adherence rates. Improved drugs could potentially dramatically increase adherence and thus success of ARV treatment while also preventing the resistance that results from inconsistent adherence to drug regimens.