Browsing by Author "Pillay, Karrisha"

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    Contextualizing socio economic rights in post apartheid South Africa
    (1996) Pillay, Karrisha
    The UNDP Human Development Report 1994 informs us that "a fifth of the developing world's population goes hungry every night, a quarter lacks afcess to even a basic necessity like safe drinking water, and a third lives in abject poverty - at such a margin of human existence that words simply fail to describe it" .1 From other sources it can be learned that more than 1 billion people in the world today live in poverty, and some 550 million go to bed hungry each night. More than 1.5 billion lack access to clean drinking water and sanitation, some 500 million children do not have access to even primary. education, and approximately one billion adults remain illiterate. 2 Although these statistics reflect the global situation, it is quite obvious that statistics peculiar to South Africa are just as appalling. In fact, it doesn't require statistics to reveal the magnitude of poverty facing the majority of South Africa's citizens. This is a glaring, obvious, undeniable and blatant fact and, as such, desperately needs to be addressed. A natural concomitant of poverty on this magnitude is gross malnutrition, lack of education, low life expectation and sub-standard housing. It is this poverty that embraces, clutches and clings to so many South African people that the hopes and efforts of escape remain an unattainable ideal glimmering in the distant future. But the tragedy is that for many, in fact most, that vision of liberation from poverty will never come. And so life continues, those surrounded by an abundance of wealth, riches and comfort whilst the rest remain trapped within the impregnable circle of poverty striving in a desperate, but futile, attempt to abandon those shackles.
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    The ART of rationing - the need for a new approach to rationing health interventions
    (2003) Kenyon, Christopher; Skordis, Jolene; Boulle, Andrew; Pillay, Karrisha
    A key element in dealing with HIV/AIDS in South Africa depends on the resolution of the antiretroviral therapy (ART) paradox: while a universal First-World-style ART programme is unaffordable, a rationed treatment programme that includes ART is not only affordable but also vital for basic human rights reasons, to enhance prevention efforts and to keep the fabric of society together. Our recent paper on ART demonstrated how such a rationed programme would be both affordable and highly cost-effective. Traditional rationing mechanisms are unable to provide sufficient guidance as to how to go about this novel form of rationing. An alternative rationing mechanism is therefore proposed which seeks to balance ART in terms of three primary dimensions: total resource allocation to treatment, design of the treatment intervention, and setting targets on numbers to treat. Two secondary dimensions, related to total HIV and social spending, deserve equal attention. The current global context that precipitates and exacerbates the parallel contouring of disease burden and poverty should be constantly challenged.