AIDS-free generation requires shared responsibility and innovation

An interesting development took place over last 5 years.  Political advocacy and activists actions led to a sense of country ownership of the problem. We see many countries are now funding a large portion of their AIDS response from internal resources.  Leading among them are India, China, Brazil, South Africa, Namibia, Ruwanda, Thailand, and many others. This is happening because of cost efficiency through lowered drugs and testing kits costs, capacity enhancement, and increased realization that health is linked to economic development. Countries cannot continue to loose agriculture workers, teachers, factory workers, young students, and others. Countries cannot afford to have millions of orphans and manage their well-being. Countries had to step in with whatever resources they have and we now need to facilitate this further for more orderly transition to national programs. Better and cheaper drugs are in the making. Generics are widely available and more work is done to expand this resource. We have a historic opportunity to collectively help countries to improve country ownership so that more countries can fund their own AIDS response. This is priority for sustainable AIDS response.

A second interesting development we see is the concept of shared responsibility and partnership. PEPFAR and UNAIDS have promoted this vigorously and can now see the results all over the world. The concept of AIDS free birth is almost a reality. In a matter of few more years we hope to have zero infected babies. This could not happen if countries and donors did not work together for a shared goal of zero infection at birth.  We also see a sense of partnership among UN agencies, international NGOs, local stakeholders, and donors to fight for a common cause. This was not there 5 years ago.  Partners have come together for smart investments and measuring impact. At the same time, many partners have put the countries at the center of development so that countries can lead and manage their priorities. Any donor who wants to manage countries priorities should be asked to leave this scenario.  Such a donor or partner will spoil the momentum. It took a lot of efforts to instill the shared responsibility concept and we need to do more to improve this so that each country can invest right amount of money and other resources to fully integrate AIDS services in existing health programs.

A third development is the use of science and research to improve implementation and make a quick difference. U.S. government, Gates Foundation, and others have invested heavily in science and research. According to International AIDS Vaccine Initiative (IAVI), there are 30 HIV vaccines tested in human clinical trials worldwide. The United States Food and Drug Administration approved human clinical trials of a Canadian-made HIV vaccine called SAV001-H. Initial human trials show no adverse effects and improved immunity. A genetically-engineered HIV vaccine under study by Texas researchers will be a single dose and may last a lifetime. Primate studies may start in early 2013. If FDA approves, human trials could begin as early as 2015. There are many new possibilities. UNITAID, a UN entity funded by airline levy, is funding a number of research to reduce the price of drugs and testing kits. Clinton Foundation continues to negotiate with drug manufacturers to reduce drug costs and has been quite successful so far.

World AIDS Day (December 1) is a time for renewing our commitment to saving lives and working together. It is a time to once again put “country ownership” and smart investments as central to sustainable AIDS prevention and treatment.
Rahman is an international health specialist with over 25 years health and HIV sector experience. He worked for donors, foundations, and international NGOs.

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