Anisa Navarro

GH 101
WEEK 10
PERU – HIV/AIDS

Global Fund Assignment #7a –Final Proposal

Section 1:
My proposed plan is to expand the established healthcare by relocating funding to the public
health sector, and adding more physicians and healthcare locations, so easier access will be
available for those in Peru. The political issues that limit the current situation of improving
healthcare is that Peru is in a state of rebuilding, as the public funds are prioritized to
beautification and environmental needs, (Crabtree 2014). The economic issues that prevent
advancement of healthcare is that everything is privatized, and all public sectors are lacking in
funds, which moves all those who are low income, live in rural areas, or are indigenous without
healthcare access. The constraints on Peru’s ability to provide healthcare services rely on the fact

that even while social spending is spent on public services, these services are out
of reach for poor, indigenous, and rural areas of Peru, (Giugale et. al., 2006). Peru
can have control over its own policies, however, there are many subsectors and
branches that take care of different levels of one issue, which creates the problem of cross-
communication failure, and the ability for nothing to ever be solved. Peru
spends very little on social assistance for healthcare, Healthcare in Peru is limited
to for profit and private organizations, (Giugale et. al., 2006, pg. 23). Peru is going through a
government decentralization that allows for this to occur, it just has yet to take place. The central
government oversees allotting funding for healthcare and education services, however, they are
prioritizing funds to go into other sectors of the government, as they place healthcare, mortality
rates, and their lack of health on a low tier. Some internal obstacles faced by Peru, is lack of
support within community and government for funding public healthcare or having a
community-initiated health program.

Section 2:
Logic model for global Funding program in Peru Targeting HIV/AIDS
Input Strategies & Activities Outcomes
Staff: - The physicians will - Teacher outcome
16 physicians help increase would help the
5 teachers diagnosis of HIV and patients allow for
treatment/medication continued medical
for HIV/AIDS from help, without being
15% to 25% worried of receiving
- The teachers will help medical attention for
educate the population AIDS due to stigma
either at a clinic or - Medical outcomes
school on the reality would be that the with
of HIV to help re the increase of

Stuff:
8 medical centers
20000 Arv treatments
School prevention
HIV/AIDS
Space:
A large health center in every
other city, mobile centers
near a rural city
write the stigma that available physicians
surrounds HIV there will be less wait
time to be admitted
and seen, which
would allow for more
patients to receive
medical attention.
- Opening medical - Previous research
centers will allow for stated there is about 2
more physicians a doctors per every
place of work and 1000 people, which
allow more spread-out means that medical
hospitals in different centers are spread out
areas of Peru. With and less available.
more accessibility Opening more
there can be an medical centers will
increase in how many help alleviate access
people are able to to medical attention,
receive ARV and thus increase the
treatment amount of people who
- The teachers can can now receive ARV
travel and go to treatment or other
different districts to HIV treatment
give information to
the school nurses, and
health teachers about
HIV prevention and
stigma
- With 8 medical - With more medical
centers we can add a centers there can be
medical center to more treatment of
other cities (ex: pregnant mothers
Cusco, Lima, Iquitos, with HIV to prevent
Taona, and in every transmission to their
other center). Within unborn child, and
each medical center more medical
there can be 2 attention to give
physicians. treatment to positive
- Each location will cases to prevent
administer ARV death due to AIDS.
treatment, diagnosis, - Having mobile centers
and treat HIV/AIDS allows for those in
in all ages rural areas to get the
- The mobile centers access to healthcare
will move according they otherwise would
to what rural area not get due to
 needs help the most disabilities, lack of
and will go based on transport, or funding.
need. The mobile
centers will be utilized
to help those who are
unable to reach the
main medical centers
in the city
Systems: - The teachers will This will help
meeting with teachers in travel to different decrease the number
different districts for HIV districts and speak of children who are
prevention/stigma awareness with the head of the positive for
doctor association to keep schools, nurses, and HIV/AIDS, by
communication on health education spreading awareness
progression or decline of teachers to create on how you can get
AIDS awareness of it, and even receive
removing stigma of treatment.
HIV, and good - The doctors
prevention other than communication can
abstinence be told back to
- Doctors’ association where funding is
will be for all received so there can
physicians working be changes in where
with HIV to and how funding is
communicate on what allocated, and what
is needed in their other problems now
community. need fixing.

The overall program in Peru specifically resides in giving ARV treatment to positive cases who
need treatment. Peru’s program is prioritizing prevention and treatment, especially with children,

as to help provide awareness, while also battling stigma that prevents many from receiving a
diagnosis and treatment. The 20,000 ARV treatments will help alleviate the gap between active
cases of needing treatment and received treatment. These all will have to be administered in the
medical centers by a physician but within the 8 new medical centers, there will be 2 physicians
that specifically deal with HIV/AIDS. This is a step up from how medical centers and physicians

in Peru now, since the 2 per 1000 people referred to all diseases/illnesses, while these physicians
are for treating, and diagnosing HIV. The monitoring I will use in Peru’s program is the
communication between all the physicians who are working with positive HIV cases. The
communication will be recorded, and data tracked, so we can constantly review the state of HIV
in Peru, and re-prioritize what needs to be fixed, changed, or added. This database can only be
accessed by the physicians, and those helping implement the program. This is to prevent sharing
of patient information, with the public, as this information is private. The education of HIV
prevention to those in schools, will help share information on other ways HIV is transferred. The
education will be holistic, and will not just end with abstinence, but communicate about needle
usage, pregnancy transfers, etc.
Section 3:
There are a multitude of policies and programs in place either internationally or nationally that
are aiding Peru in the medical fight against HIV/AIDS. Some that the most influence and have
been able to provide the most help in Peru are The Global Fund. They have invested thousands
of dollars to Peru to be able to create, expand, and educate in regards of HIV. Another initiative
that has been able to aid Peru in its response to HIV, is UNAIDS. In comparison to The Global
Fund, UNAIDS main and only priority is to deal with all things regarding the HIV epidemic. For
the main national agency that is involved in the national response to HIV is the CSO – Civil
Society Organizations, even while it has begun to decline, is one of the main national initiatives
for Peru. There is a lack of greater governmental support for these organizations, which creates
the predicament of being able to expand and continue national agencies, without over relying on
international agencies. The goals of the international agencies are well known and clear to the
public, as they have the support of numerous government entities. In terms of Peru’s national
agencies, the goals are somewhat unknown, however the principles were based off the Ministry
of Health. (Cáceres et. al. 2009). Beyond these programs, there is also the ministry of health that
is apart of the Peruvian government that works to promote healthcare, and advance preventative
healthcare for diseases. They have been established in Peru since 1968 and are responsible for
providing 60% and more of the established healthcare (WHO, 2012).

Involvement of beneficiaries of the program: The issues that will arise in this area is that due
to the established stigma and shunning of those with HIV/AIDS diagnosis, those who suffer from
side effects or who are suspected to have HIV/AIDS will not reach out to get a diagnosis or
continue treatment due to the possibility of being exiled socially. There is an extreme need for
the anyone working with the HIV patients, and family members to be extremely cautious to not
perpetrate any more negative stigma or hatred towards positive HIV people. By having those
within the same culture, we can bypass the cultural disconnect, that pushes doctors and patients
to not be able to communicate efficiently and prevent miscommunication.
Community participation: Community participation can be an issue for the program if those in
the community to do not support the expansion and prevention of AIDS, or if they do not wish to
be educated on how to prevent, and support those with HIV/AIDS
Gender equality issues: Gender equality issues that can arise is that it is more common for
Transgender men, Gay men, or sex workers to get HIV/AIDS. Despite it impacted those of all
genders, due to the pre-existing marginalization that occurs with these demographics, it creates
an environment where they are already shunned from society, and thus when diagnosed with
HIV/AIDS – the community, and government already spare no care for their wellbeing. Other
gender equality issues are that many women and girls are behind in schooling and education,
rendering them illiterate. This creates an issue when we need teachers to help aid the program, as
it would create the need to hire people to help teach our teachers how to become literate. (Project
Peru, 2021).
Social equality issues: Social equality issues is that the government as it expands puts more
emphasis on the higher income brackets of the community, as they expand private sectors. Other
issues are that indigenous and rural communities have zero to no access, as they are pushed to
the outskirts of the land. Other social equality issues are that there is a huge wage gap between
the poor and rich, and men and women. This creates a disproportionate climb to wealth as those
who are struggling are never able to get to a stable place economically to rise. (Project Peru,
2021).
Human resources development: The progress this proposed plan will incite in Peru, if
successful will be astronomical. The proposed plan will create more jobs, as teachers are needed
to educate the public, and will be done based on who is able to volunteer to learn and teach
others. There will also be needed drivers, janitors, and other workers to keep all the mobile
centers, and large medical health centers up and running. With the intersectionality of all these
possibilities of employment, and the prioritization of healthcare, there will be more people who
are healthy and bodily able to continue to work and feed into the economy.
Section 5
Potential opposition of the HIV/AIDS proposals would be that there is already a stable and
established private healthcare sector, and thus no need to put effort into the public one.
Opposition can also be found in lack of communication and effort on behalf of the community,
as there is needed community support to build and expand healthcare in rural communities.
Whether this be the members of the community supporting the proposition in front of the
government, or members of the community volunteering time to get everything settled and
applying to be the teachers and physicians needed. One way that we will work to combat
whatever opposition is met can be through incentives. If the government was to give more
support, there will be less mortality and morbidity rates, which allows more of the population to
enter and stay in the work force, which increases economic gain. Unfortunate, we cannot reach
the government through advocating for the health of the citizens but rather address economics.
Section 6:
If the proposal was not funded, the state of the healthcare in Peru, would continue to stay
stagnant, as the government will not allocate funding to the public health sectors without a
change of mind from the government officials. In a matter of taking public health care matters in
the hands of the Ministry of Health, without waiting for public government officials to grant the
healthcare sector more funding, we shall be able to provide the necessary changes needed to
prevent cases of HIV/AIDS and prevent an increase in mortality rates.

References:

Cáceres, Carlos F MD, PhD; Mendoza, Walter MD. The National Response to the HIV/AIDS
Epidemic in Peru: Accomplishments and Gaps-A Review, JAIDS Journal of Acquired
Immune Deficiency Syndromes: May 2009 - Volume 51 - Issue - p S60-S66 doi:
10.1097/QAI.0b013e3181a66208

Crabtree, J. (2014). Funding Local Government: Use (and Abuse) of Peru's Canon System.
Bulletin of Latin American Research, 33(4), 452-467.

Giugale, M., Newman, J., & Fretes-Cibils, V. (2006). Opportunity for a Different Peru. Herndon:

World Bank Publications.

7. (n.d.). Peru Medical Devices. International Trade Administration | Trade.gov. Retrieved

December 6, 2021, from https://www.trade.gov/market-intelligence/peru-medical-devices.
Peru. UNAIDS. (2020, December 18). Retrieved October 25, 2021, from

https://www.unaids.org/en/regionscountries/countries/peru.

Women in Peru. Project Peru. (2021, February 21). Retrieved December 6, 2021, from
https://projectperu.org.uk/about-peru/women-in-peru/.

World Health Organization. (2012, March 27). Peru. World Health Organization. Retrieved
December 6, 2021, from https://www.who.int/workforcealliance/countries/per/en/.