Focus should be on Innovation to end HIV/AIDS

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Innovation in medicine and diagnostics led to more effective medicines. Testing kits became simpler and cheaper. Innovation in procurement and competitive process led to drastic reduction in costs. When the Global Fund was created, it was an innovative financing mechanism that led the way to show that innovation and country ownership can scale up programs and make a difference. When UNITAID was created, it was innovative financing that raised millions of dollars to fund drugs and research through an innovative airline levy. The French led the way and a number of countries joined to help UNITAID. It is one of the most innovative financing mechanism in place. Circumcision was rediscovered as a healthy option which can prevent AIDS without loosing sexual pleasure. Innovation has simplified circumcision and it is beginning to be accepted widely as AIDS prevention step. It is less painful, low cost, and even easy to administer in most resource poor setting. Treatment innovation demonstrated that people on antiretroviral treatment can reduce transmission by 96% among heterosexual partners and by 98% from mother to child.

The AIDS conference in DC in July highlighted the need to accelerate our work to provide treatment to 15 million HIV infected people by 2012. Already, 8 million people are on treatment. UNAIDS advocated for donor coordination and all countries to seriously consider transition strategy to fund AIDS response from national budgets. PEPFAR advocated for country ownership and country leadership as the key to sustainable HIV response. PEPFAR is leading the innovative partnerships with the private sector. At the same time, many more voices asked for more funds when the world spent $16.8billion in 2011 alone.

I believe we need to focus more on innovation. We need simpler drugs which are simpler to administer. We need innovative service delivery arrangements which are efficient and are community-driven. We need innovative approaches to allow local production of drugs so that poorer countries can benefit from cheaper drugs. We also need a new drug so that it acts like an emergency contraceptive pill for people to take before unprotected sex. We need a vaccine soon. New technology for universal testing is needed so that every one can do home testing and then seek help for treatment. We need the pharmaceutical companies to reduce costs of second line drugs which is now hugely expensive. We want national health systems to integrate HIV programs in national systems without increasing costs. It is possible with innovative approaches and technical help. We want advocacy NGOs to innovatively advocate for universal human rights for HIV infected people. It is time for the most urgent work to proceed, we need all 15 million people to be on treatment urgently. Let us ask America and other donors to make innovation as a key criteria for funding. Not cheap talk but a real commitment and demand that everyone commit to this new agenda as a 'game changer'.

Finally, one word of wisdom, we need to stop financing mechanisms from top down allocation of funds to programs which is inefficient, cumbersome, and promotes corruption. Stop believing that you can tell countries what to do and how to do it. That is not innovation.

Rahman is an international health consultant who has worked for international NGOs, foundations, and multi-lateral financing institutions, and managed HIV/AIDS and health portfolio of projects.