By Ariana Childs Graham, International Policy Associate at the Sexuality Information and Education Council of the United States, http://www.siecus.org/
To read the report, "Making Prevention Work: Lessons from Zambia on Reshaping the U.S. Response to the Global HIV/AIDS Epidemic," click here.
A recent study, released this past spring by Stanford University researchers Eran Bendavid, MD, and Jayanta Bhattacharya, MD, PhD, was released in the Annals of Internal Medicine, which presented findings that the U.S. effort to curb the global HIV/AIDS epidemic has been a mixed bag. The study, “The President's Emergency Plan for AIDS Relief in Africa: An Evaluation of Outcomes,” found that significant progress has been made in the areas of care and treatment, a laudable accomplishment of the first phase of implementation. However, the report also confirmed what too many of us have involved in the fight against HIV/AIDS have foretold for far too long – we have not made any significant progress in curbing new infections because our prevention efforts have failed.
For those of us who closely follow the global HIV/AIDS pandemic, the numbers of new infections coming out of the countries in Africa hardest hit by HIV/AIDS confirms in real life, the findings of the Stanford report: without the right policies and adequate resources, the HIV/AIDS epidemic continues to wreak havoc. No single government or organization, international or otherwise, is solely responsible for the current situation in Zambia. Rather, it is the result of a failure to integrate sound, responsible policies at the international level while prioritizing effective execution of strategies on the ground. In other words, where none are to blame, all are to blame.
While PEPFAR does a great deal of good now, particularly in the areas of treatment and care, the prevention portfolio must be reshaped and fine-tuned into a tool to turn the tide in this global conflict against HIV/AIDS. A look at the particular case of PEPFAR’s impact in Zambia highlights the realities faced by those struggling against the HIV/AIDS epidemic, recommending where attention needs to be paid and suggested next steps. Zambia has an estimated HIV prevalence of 15.2 percent in a population of approximately 12 million, making it one of the Sub-Saharan African countries most affected by the HIV/AIDS pandemic. The high prevalence of HIV throughout the country has contributed to the decline in life expectancy which dropped to the astonishingly low number of 38.7 years in 2008.
The Sexuality Information and Education Council of the United States (SIECUS) has long been critical of the prevention paradigm in the Bush Administration’s global HIV/AIDS efforts and at the end of this month, will release Making Prevention Work: Lessons from Zambia on Reshaping the U.S. Response to the Global HIV/AIDS Epidemic. This report is based on interviews and on-the-ground research by SIECUS staff to Zambia, and offers seven concrete recommendations for moving forward.
While advocates based in the United States can’t presume to put ourselves in the shoes of the dedicated workers and volunteers who are have given countless hours of their lives to curbing the HIV/AIDS epidemic in Zambia every day, we can take care of business on our side – strengthening the largest source of money on earth to fight HIV/AIDS, the President’s Emergency Plan for AIDS Relief (PEPFAR). During the last 20 or so years, our knowledge about HIV/AIDS treatment and prevention has come light years, and there is no reason why we cannot lower rates of transmission and ensure access to treatment if we finally take the steps that are necessary to show that we are serious in our fight.
Dr. Eric Goosby, nominated by President Obama at the end of April, is poised to assume the role of the Global AIDS Coordinator, and with this pending new leadership at the helm, now is the time to take a close and introspective look at our global HIV/AIDS efforts and make an informed and deliberate choice about how to proceed.