Marseille 2007
| Abstract #296 - Swiss HIV/AIDS policy in the phase of normalisation | ||||
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Session: 29.4: Lessons learned for tomorrow's strategies (Parallel) on Tuesday @ 11.00-12.30 in Auditorium/Overflow Chaired by Lisa Power, Yves Souteyrand Authors: Presenting Author: Ms Frey Kathrin - University of Zurich, Switzerland |
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| Additional Authors: Dr Neuenschwander Peter, Prof Kbler Daniel, | ||||
| Aim: HIV/AIDS policies in Western Europe entered the phase of normalisation since the mid-nineties. The overall objective of our research project was to describe and to explain the development of HIV/AIDS prevention policies in Switzerland in the phase of normalization, as well as to assess the capacity of HIV/AIDS policy communities to meet current and future challenges in limiting the spread of HIV. | ||||
| Method / Issue: We used a research design based on comparative qualitative case studies of HIV/AIDS policies at the national level as well as in seven cantons (sub-national territorial units). More particularly we focused on five domains of HIV/AIDS policy: (a) targeted prevention for migrants, (b) targeted prevention for sex workers, (c) prevention at schools, (d) counselling, and (e) clinical treatment for persons living with HIV. Quantitative secondary data were used for completing the accounts made in the case studies (esp. epidemiological data, as well as data on government expenditures). | ||||
| Results / Comments: The national HIV/AIDS policy strategy did not change significantly in the last ten years. The three central intervention levels large public information campaigns, targeted information and prevention, individual prevention and counselling have remained at the core of the national strategy. The cantonal AIDS-help organisations cope in different ways with normalisation challenges. While some NGOs continue to focus on their core business HIV/AIDS, others undertook a strategic shift and started to integrate other STIs and/or sexual health issues in their services. The budget for HIV/AIDS prevention at the national level has decreased dramatically from 13m Swiss francs in 1996 to 8m Swiss francs in 2003. In three cantons public spending decreased as well, whereas in two cantons public spending was stabilised. In two other cantons however, the public resources for HIV/AIDS increased significantly. NGOs engaged in the field of HIV/AIDS nowadays are more dependent on public funds as donations went back dramatically. They were forced to adjust their structures and activities to business management criteria. Thus, former activist self-help organisations have changed to professional health organisations. The overall tense financial situation has not yet led to a disappearance of existing prevention services. However, in recent times it has been much more difficult to cope with new challenges of the epidemic and to develop adequate prevention interventions (esp. for MSM and Sub-Saharian migrant groups). | ||||
| Discussion: Public health specialists are aware of the fact that preventing new HIV infections is much cheaper than treating them with expensive drugs. Furthermore, as the medical and the prevention system in Switzerland are financed through two independent mechanisms, allocational conflicts between doctors and prevention specialists do not occur. Insofar, our results show no indications for a return to Old Public Health in the fight against HIV/AIDS. | ||||
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