FXB Center for Health and Human Rights, Harvard School of Public Health, USA.
Health Hum Rights. 2008;10(2):105-19.
The aim of this article is to support efforts to hold governments accountable for their commitments to respond to HIV and AIDS. It describes a new approach to ranking countries' responses in order to facilitate cross-country comparisons. The method uses the United Nations General/Assembly Speecial Session on HIV/AIDS (UNGASS) Declaration of Commitment as its point of departure and was designed to rank countries in terms of their efforts to fight HIV and AIDS. Three indicators of the country response were analyzed. (1) prevention of mother-to-child transmission (PMTCT) coverage; (2) antiretroviral (ARV) coverage; and (3) the ratio of orphans to non-orphans attending school An assessment of this nature must acknowledge the unique situation of each country, depending on its infrastructure and access to resources. To account for these differences, a regression analysis with contextual control variables was carried out to identify the variation resulting from controllable factors. It is this variation which is used to examine countries' relative response to HIV as it considers what was actually achieved relative to what was expected given the context. The results highlight the efforts of not only some well-reputed, strong actors but also some unexpected front-runners. The results also point to a group of countries which are lagging behind in all regards. Comparisons between the three indicators show great variations in the focus of countries' efforts. Rating countries' relative response to HIV highlghts countries that do well in spite of diffcult circumstances. The article argues that these "relative overachievers" should be examined more closely so that lessons may be learnt from their efforts. The rating also draws attention to countries where the response is comparatively weak, and where governments, as lead actors in the AIDS partnership, bear the greatest responsibility.
本文旨在支持各国政府为履行应对艾滋病毒和艾滋病的承诺而作出努力。它描述了一种新的方法来对各国的应对措施进行排名，以促进国家间的比较。该方法以联合国大会艾滋病毒/艾滋病问题特别会议（UNGASS）的《承诺宣言》为出发点，并旨在根据各国防治艾滋病毒和艾滋病的努力来对各国进行排名。分析了国家应对措施的三个指标：（1）预防母婴传播（PMTCT）的覆盖面；（2）抗逆转录病毒（ARV）的覆盖面；（3）在校孤儿与非孤儿的比例。对这种性质的评估必须承认每个国家的独特情况，取决于其基础设施和获得资源的情况。为了考虑到这些差异，进行了带有背景控制变量的回归分析，以确定可控制因素所产生的变化。正是这种变化被用来审查各国对艾滋病毒的相对应对情况，因为它考虑了在考虑到背景的情况下，相对于预期而言实际取得的成就。结果突出了不仅一些声誉良好、实力强大的行为体，而且一些出人意料的领先者的努力。结果还指出了在所有方面都落后的国家群体。对这三个指标的比较表明，各国努力的重点存在很大差异。对各国相对应对艾滋病毒的情况进行评级突出了那些在困难环境下表现良好的国家。本文认为，应该更仔细地研究这些“相对表现出色者”，以便从他们的努力中吸取经验教训。评级还提请注意应对措施相对较弱的国家，以及作为艾滋病伙伴关系中的主要行为体的政府，应承担最大的责任。
