Adherence to HAART Africans Take Medicines More Faithfully than North Americans 英文参考文献.docVIP

Correspondence Adherence to HAART: Africans Take Medicines More Faithfully than North Americans countries [4]. There are accordingly few data on which to conclude that, for example, patients must give up alcohol, or must undergo directly observed therapy, to adhere to medicines, as some programs require [6,7]. Such measures may indeed be unnecessary. Amir Attaran In rich countries, the study failed to identify any obvious “big ?x” that could turn non-adherent patients into adherent ones. On the other hand, for developing countries, “?nancial constraints” towered above the other reasons why poor patients may fail to adhere to ART. That is cruelly ironic, because the same international development policy makers who rejected the idea that poor people could adhere to ART also worked for ?nancial donors such as USAID and the World Bank, and their passionate arguments against ART stalled the delivery of the one variable that helps adherence— money. Where is the ?aw that allowed speculation to get ahead of evidence in development policy making, and to reach the baseless conclusion that Africans could not adhere to ART, or needed to be commanded paternalistically (e.g., “you must abstain from alcohol”) to adhere to ART, when no such conclusion would be reached for rich people? More to the point, how can one recognize when a particular development policy is so baseless and speculative, the better to abandon it? A serviceable answer, I believe, is that one should be highly suspicious whenever development policy makers sound dismissive of the people whom they are hired to help. The central aspiration of development work is helping the poor and sick become richer and healthier. Such an aspiration is incompatible with speculating that certain foreigners are incapable of enjoying the fruits of development. I believe that the views of Natsios and the World Bank and Thai of?cials, speculating that Africans could not adhere to ART, were dismissive in just this way. In 2001, the ch