Publications by authors named "John Fieno"

Efforts are currently underway by major orchestrators and funders of the global AIDS response to realise the vision of achieving an end to AIDS by 2030. Unlike previous efforts to provide policy guidance or to encourage 'best practice' approaches for combatting AIDS, the end of AIDS project involves the promotion of a clear set of targets, tools, and interventions for a final biomedical solution to the epidemic. In this paper, we examine the bureaucratic procedures of one major AIDS funder that helped to foster a common vision and mission amongst a global AIDS community with widely divergent views on how best to address the epidemic.

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Background: Despite a global recognition from all stakeholders of the gravity and urgency of health worker shortage in Africa, little progress has been achieved to improve health worker coverage in many of the African human resources for health (HRH) crisis countries. The problem consists in how policy is made, how leaders are accountable, how the World Health Organization (WHO) and foreign donors encourage (or distort) health policy, and how development objectives are prioritized in these countries.

Methods: This paper uses political economy analysis, which stems from a recognition that the solution to the shortage of health workers across Africa involves more than a technical response.

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As the search for more effective HIV prevention strategies continues, increased attention is being paid to the potential role of cash transfers in prevention programming in sub-Saharan Africa. To date, studies testing the impact of both conditional and unconditional cash transfers on HIV-related behaviours and outcomes in sub-Saharan Africa have been relatively small-scale and their potential feasibility, costs and benefits at scale, among other things, remain largely unexplored. This article examines elements of a successful cash transfer program from Latin America and discusses challenges inherent in scaling-up such programs.

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The dramatic evidence that male circumcision has a substantial effect in preventing HIV infection might be the most important medical finding in the course of the AIDS epidemic since the introduction of highly active antiretroviral therapy (HAART). The transition from clinical trails to implementation of a general adult male circumcision (AMC) program is beginning, and this paper uses an AMC cost model (in Microsoft Excel) to estimate the cost of a rapid scale-up of an AMC program in Mozambique, a country with a generalized epidemic and low rate of male circumcision. There are three major findings: (1) Even the most modest of AMC programs would place great stress on human resources, and task-shifting might lead to more accidents or adverse events that would increase the cost per AMC.

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