Getting Health Priorities Right: Towards a Sustainable Global AIDS Response


This article is part of a series on global AIDS issues to be published
by RH Reality Check throughout December.  To find other articles in this series, search "global AIDS 2009." 

We cannot simply
confront individual preventable illnesses in isolation. The world is
interconnected, and that demands an integrated approach.”
— President Barack Obama, May 5, 2009

On
World AIDS Day, U.S. Global AIDS Coordinator Eric Goosby unveiled a five year strategy for global HIV/AIDS
relief. Citing a shift in focus
from an emergency response to sustainable in-country programming, Goosby told
reporters at a
press briefing that the new strategy
will expand prevention programs and work towards strengthening national health
systems.

Goosby’s
call for a more sustainable approach to fighting HIV/AIDS globally is indicative
of the growing movement towards aligning global health investments and
long-term health system strengthening. 
In other words, the guiding principle for global health donors going
forward should be that prevention and treatment for HIV/AIDS can no longer
happen in isolation. 

Beginning with the
commitments made at the
International Conference
on Population and Development
in 1994, and
increasingly over the past 15 years, the international community has recognized
that providing a broad constellation of health services in a single location
will ensure a higher quality of care and positive health outcomes.  For women, that means ensuring access
to comprehensive sexual and reproductive health services. 
 

Consider, for example,
the circumstance of an HIV-positive woman in rural Botswana. In Botswana, which has the second
highest HIV/AIDS prevalence rate in the world, most new infections occur in
women. In order to
obtain treatment, she must travel 30 kilometers by foot to a U.S.-funded
clinic. The woman must travel
another 50 kilometers to find a clinic that offers contraceptives that will
enable her to control her own fertility or receive screening to detect cervical
cancer, a disease that disproportionately affects women living with
HIV/AIDS.  Both clinics require
separate staffing, infrastructure and overhead.

Currently,
there are a number of global health initiatives that are prioritizing health
systems strengthening. The US Global Health
Initiative

if successful, will seriously invest in women-centered approaches that can help
provide for better sexual and reproductive health outcomes, and leverage
significant support from other government donors and multilateral partners. 
The International Health Partnership is trying to build up strong health
systems with coordinated investments in disease-specific responses, such as
HIV, in a number of countries, primarily in Africa. Specific health-related
initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria,
as well as maternal health, family planning, and child health initiatives, also
need to examine how far they will go to expand their mandate to include broader
health systems issues.
in 1994, and increasingly over the past 15
years, the international community has recognized that providing a broad
constellation of health services in a single location will ensure a higher
quality of care and positive health outcomes.  For women, that means ensuring access to comprehensive
sexual and reproductive health services. 

Civil
society’s meaningful participation in building stronger health systems is
crucial to both better health outcomes and greater accountability on the part
of policymakers. The UNAIDS Operational Plan for addressing women, girls,
gender equality and HIV will be rolled out shortly. During the three years it
has taken to create a tool that both civil societies and countries can use to
guide national efforts, civil society has been a strong advocate for an
Operational Plan that both highlights the role that gender inequality plays in
the pandemic and includes civil society organizations—including women’s rights
organizations, sex workers, women living with HIV, and sexual and reproductive
rights organizations— in decision-making processes.  Going forward, civil society can use the plan to hold UNAIDS
and national AIDS programs accountable to the needs of women and young
people.

The
world is now at a pivotal point of defining concrete actions to transform their
funding and policies into tangible changes in women’s lives.  Our program partners across Asia,
Africa, and Latin America know what’s needed and what works. Access to sexual
and reproductive health services is integral to good health for men, women, and
young people, and underlies our ability to make headway in confronting other
health issues as well.  Foreign
assistance donors and countries where they partner are shaping programs to
integrate and invest in sexual and reproductive health – taking steps to end
the political stigmatization of these programs and focus instead on the
real-life health benefits.

All
donors, including the United States, need to do more to increase investments in
sexual and reproductive health services, including comprehensive sexuality education;
support bold diplomatic programs for the human rights of women; and engage
local organizations led by women and youth.

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

To schedule an interview with contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.