In his thoughtful essay, “HIV & AIDS: A Crisis on Pause,” John Callaghan outlines compelling reasons that some key stakeholders in the fight to contain global HIV & AIDS believe a stasis now exists in the fight that threatens the very real and lifesaving progress made over the last two decades.
Yes, millions of people living with HIV & AIDS in Africa and elsewhere around the world today are alive thanks to antiretroviral therapies—thanks also to the peculiar alchemy of partnerships among global health organizations, pharmaceutical companies, NGOs, religious organizations, activists and country governments and their health ministries that helped fuel the success witnessed in global HIV & AIDS control to date.
Callaghan also poses the pivotal question: “So, how do we avoid a reversal?”
Three suggestions come quickly to mind:
First, abandon the sloganeering: Getting to Zero (Obama administration), 90-90-90 (UNAIDS), Test and Treat (WHO), PEPFAR Blueprint: Creating an AIDS Free Generation (Obama administration) Ending the HIV Epidemic: A Plan for America (Trump administration).
As Elvis Presley famously crooned, “A little less conversation, a little more action…”
Trite and repetitive slogans are more about branding and may unwittingly feed into what President Clinton observed as a sense of complacency emerging about the epidemic, with people thinking the battle is over where they live.
Second, realistically assess with a cold hard eye and hold accountable leadership in the HIV & AIDS fight at home and abroad on an ongoing basis and not let leaders coast on perceived achievements or accomplishments. People also need to overcome orthodoxy in their thinking when identifying and cultivating future leaders and partners if they are ever to be truly able to control global HIV & AIDS.
Globally, there remains a sclerosis and timidity in holding leaders accountable, as evidenced by the ongoing tenure of embattled UNAIDS executive director Michel Sidibé, whose organization’s credibility and efficacy were severely damaged by the parallel crises of sexual harassment and a lack of accountability and transparency under his leadership.
Lastly—and perhaps most crucially—few aspects of the global HIV & AIDS response are more important than the availability of accurate data. Without this information, estimates for funding will be incorrect, appropriate resource allocations cannot be determined and strategic targets will not be achieved. Even though key agencies in the HIV & AIDS response are beginning to address the vast information gap, more attention and focus must be placed on data quality if there’s any chance of defeating HIV & AIDS globally.
A case in point, I offer the “given” that roughly 21.7 million of the 36.9 million people worldwide living with HIV & AIDS are accessing antiretroviral therapy. The AIDS Healthcare Foundation doubts these widely held numbers on treatment, recognizing there is quite likely double counting of patients in the tally from multiple worthy and well-intentioned stakeholders providing some element of care, treatment or services.
But here, data should be king.
Accurate data must be the bedrock on which planning for the future of the HIV & AIDS response is based. Anything less contributes to the complacency President Clinton warns against—a complacency that dilutes a proportional, appropriate and truly effective global response to HIV & AIDS.
Michael Weinstein, President
AIDS Healthcare Foundation
Los Angeles, California