Sierra Leone
TCS Daily has an excellant article by Roger Bate, fellow at AEI, regarding the sad state of affairs in Sierra Leone's healthcare program. It describes a healthcare system that has seen a large shift in healthcare, from one that primarily focused on childhood diseases and disease prevention, to one where the majority of healthcare workers are now treating AIDS patients. This is largely due to outside influence from the WHO, when seeing that Sierra Leone had an AIDS problem poored relief dollars into fighting it. Since the healthcare workers could get paid three times more to treat AIDS than working on the traditional and successful childhood programs they switched as well, providing a nationwide shortage of childhood workers.

In my opinion, the WHO needs to realize that the last thing it needs to spend its money on is AIDS, for several reasons.

a) You can have a much larger impact per dollar focusing on easily prevented childhood illnesses. Steady access to vaccines, bednets, and electrolytes would save millions of more lives than purchasing AIDS drugs.

b) Treating AIDS patients does no good as long as culture propagates the spread of the disease, a combination of high rape rates, lack of prophalaxis, and high rates of AIDS with males in the military make it uneffective.

c) The study doesn't look at the numbers of people that actually take their drugs and follow their treatment regimes, but given the availability and lack of education of the people in general I imagine it's not high, thus exacerbating the problem through mutation and antigen drifts.

d) Once you can face the massive problems of preventable childhood illness and malnutrition, you are provided with a healthy and able workforce that will help to bring the nation out of poverty.

I think Bill Gates and the rock stars of the world need to make stipulations about where their money goes and what should be done with it. Sure, AIDS is "it" disease right now, but not treating the underlying causes of the AIDS epidemic is only going to make it worse, and no amount of money will fix that.