Can investment and technology end AIDS without attention to human rights? We’re reading about prevention — products and policy

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NewWWRHIV Preventives: This UNITAID report looks at the availability, acceptability and affordability for products targeting HIV transmission and acquisition, including female condoms, male circumcision devices (although only one, the PrePex, has received a go-ahead from the World Health Organization, this category is bigger than you might think –in addition to the “Shang Ring” from China, the “Ali’s Klamp” from Turkey is named among 51 devices available in adolescent and adult sizes) and microbicides. The report also looks at other antiretroviral-based prevention methods: pre-exposure, post-exposure, prevention of mother to child transmission, and treatment as prevention, as well as harm reduction commodities: disposable syringes, opioid substitutes, and treatment of herpes simplex virus. Now that science has come up with these approaches, the report finds, barriers of prices, insufficient demand, and supply management need to be addressed.

The AIDS Epidemic Can Be Ended: “In the early days of the H.I.V./AIDS epidemic, it was soon evident that the virus did not discriminate,” this Op-ed piece in the New York Times says, “but that governments and people sometimes did.” Highlighting the murders of a Jamaica transgender teenager and Cameroon gay rights activist Eric Lembembe, along with the confluence of Russia’s repressive laws, policies and environment –surrounding drug use as well as gay rights — and its burgeoning HIV epidemic, Bertrand Audoin of the the International AIDS Society points out that failures to confront human rights abuses add up to poor public health responses. As a result, he adds, scientific advances that could eventually end AIDS remain frequently irrelevant to people who can’t benefit from those advances without putting their lives and liberty on the line. A letter to the editor following the piece points out another consequence of institutionalized discrimination against members of sexual minorities, sex workers and drug users: lack of training and resources to make clinical services responsive to their needs.

A Decade of Remarkable Achievement — Now What? Investments demonstrated by overlapping Africa visits from United States Presidents past and present and furthered by advances in evaluation, efficiency and cost effectiveness have yielded global health accomplishments  while setting the stage for victories. But amid budget constraints and diverging priorities, where the commitments of the last decade will go is the subject of this report from the Center for Strategic and International Studies. It invokes the ghost of the Global Health Initiative, which was intended to unite work towards global health goals, and raises the question of how its successor, the Office of Global Health Diplomacy, will rise to Africa’s challenges ahead in HIV, women’s health, child survival, malaria and polio.

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