It is encouraging to see more and more thought being put into figuring out what the global response to HIV has taught us about delivering health care and promoting public health. There has been a particular buzz recently in the lead up to a big UN meeting on non-communicable diseases (NCDs), with short comments in the New England Journal of Medicine, and PLoS Medicine, as well as action by AIDS activists to push for concrete commitments to tackling NCDs, as described in this Guardian article.
The pieces referenced above focus very much on the “top-level” principles; they mention things such as financial political commitment, involvement of communities and advocates, and lessons that can be drawn about taking a “vertical” programming approach and the impact that it can have on health systems; as well as more technical issues such as the importance of good disease surveillance systems and linkages between different services at local level. It is nice to see that the authors of the PLoS article focus not just on the positives but also on the things that were done to respond to HIV that definitely shouldn’t be repeated. Also encouraging is the recognition that much of what has been done in the name of HIV prevention has been based on limited evidence.
An article published earlier this year in Global Public Health goes into more detail, and I hope we see more in-depth studies that explore the different mantras of the response to HIV. I hope in particular that research in this area tells us more about how to maintain the links between health and human rights and how to best serve the needs of highly vulnerable and marginalised people, and that it helps give more structure to some of the more vague mantras such as community action, multisectoralism and leadership.
Also, AIDS hasn’t gone away and current and future programmes also need to learn these lessons… it’s not as if they’re all getting everything right.