New England Journal of Medicine Features Opinion Pieces on International AIDS Prevention, Treatment Programs
Today's issue of the New England Journal of Medicine features three opinion pieces on AIDS prevention and treatment strategies in resource-poor settings. Summaries of the articles appear below:
- President Clinton, "Turning the Tide on the AIDS Pandemic": "Until we build the human and physical infrastructure needed to deliver effective [antiretroviral] treatment, programs will not be successful," Clinton, who founded the William J. Clinton Presidential Foundation, which works with Caribbean nations to procure cheaper antiretroviral drugs among other AIDS-related activities, writes. The capacity to distribute and maintain antiretroviral treatment must be "built into the mainstream health care infrastructure," a move that will require "strong and sustained political will and leadership" and "management systems," he says. The international community must work to mobilize "human and financial resources" and to "facilitat[e] the sharing of learning among projects" in different countries (Clinton, NEJM, 5/1).
- Helene Gayle, "Curbing the Global AIDS Epidemic": In order for HIV prevention programs to be successful, "multiple, complementary preventive strategies, and investments must be made," Gayle, director of the Bill & Melinda Gates Foundation's HIV/AIDS and tuberculosis program, writes. These strategies must be flexible enough to "rapidly assess and overcome logistical barriers" to the implementation of new technologies such as microbicides and to address the "likelihood that improved [access to antiretroviral] treatment will lead" to an increase in high-risk behavior (Gayle, NEJM, 5/1).
- Steven Reynolds et al., "Antiretroviral Therapy Where Resources Are Limited": "Failure to provide the resources necessary to train health care providers, ensure reliable laboratory monitoring, and optimize treatment guidelines may limit the public health benefit of global efforts to expand access" to highly active antiretroviral treatment, Reynolds and colleagues from Johns Hopkins University and NIH write. "[S]imply providing affordable access to these drugs is insufficient"; the international priority should be to combine access to prevention programs with increased access to clinical care from trained providers equipped with proper laboratory equipment and country-specific treatment guidelines, they state (Reynolds et al., NEJM, 5/1).