Program 6 Access to health care
In most poor countries the accessibility, affordability and quality of health care is limited. Relatively speaking poor families spend a high proportion of their income on health care and, because of the costs, are able to make less use of the supply. Women suffer most in this situation since reproductive health care is often unattainable and unaffordable.

In many countries the health care systems do not function properly. Public health care has to contend with a chronic lack of resources. The church health institutions find themselves forced to increase the patient’s own contribution, with the result that fewer people can make use of the services. In addition health care also has to contend with staff shortages. In East and this is intensified by the HIV/AIDS crisis.
The national government policy is strongly influenced by international donors, such as bilateral donors, the World Trade Organisation, World Bank and the IMF, which want to strengthen the free market of private health care.

Many people, because of their age, physical or mental limitations, are socially, economically and politically marginalised. This includes large groups of elderly people, children, people with a handicap or groups in which poverty has been handed down from generation to generation.

Poor people are more vulnerable to an HIV infection while AIDS again leads to long-term sickness, so that families become poorer and poorer. This has enormous consequences for the development of the people and areas affected. So AIDS is mainly a development problem.

Inequality in the balance of power between men and women is an important factor in the spread of AIDS. Girls often find themselves in a vulnerable position, just like the millions of children, whose parents died of AIDS. The stigma of AIDS continues to be a major obstacle in the implementation of AIDS programmes.

In recent years the amount of funding has increased considerably thanks to global initiatives such as Global Fund, MAP and PEPFAR. As a result, many more people have access to AIDS inhibitors. On the other hand, the huge amount of money in some countries has also lead to a proliferation in activities, mutual competition and sometimes an undermining of the broader health system.