Taking the Long View on HIV Treatment Sustainability

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“Sustainability” is the catchphrase increasingly tossed around in discussions about fighting the global HIV/AIDS epidemic. Now, a new opinion piece in the journal AIDS explores what it would take to achieve meaningful sustainability—outlining some key steps necessary to foster strong, enduring treatment programs in resource-poor settings.

As a backdrop, the authors, including Edward J. Mills, MD, of the University of Ottawa, and Julio Montaner, president of the International AIDS Society, note that the current international financial crisis has put HIV funding streams in jeopardy and report on decreased treatment targets, drug stock-outs, and other developments that threaten the recent gains in transforming HIV from a death sentence to a chronic management disease.

“Under dire circumstances, plans should be in place to ensure that we do not slide back to a time of little hope,” the authors write in AIDS. With indications that foreign policy priorities are shifting in the U.S. and elsewhere, the authors say that it’s time to examine “how to build a long-term response to HIV/AIDS that is less dependent on the vagaries of external support.”

They outline four arenas that merit intense focus for any such effort:

*Increasing human resources in a way that builds domestic production of health workers in Africa;

*Developing training capacity using regional expertise and a “university without borders” to provide training throughout Africa;

*Supporting regional drug production with keen attention to patent pools and related issues; and

*Building research capacity in a way that will increase career opportunities and bolster retention of African researchers.

Executing these steps will require more funding in the short term, the authors concede, “but donors must move beyond taking a 3-year perspective on a lifelong disease.”

Here’s the cite for the piece:

Ensuring sustainable antiretroviral provision during economic crises.
AIDS. 2009 Dec 17;
Authors: Mills EJ, Ford N, Nabiryo C, Cooper C, Montaner J

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