July 30, 2013
Noting "[i]t's been 13 years since the international community adopted the Millennium Development Goals [MDGs], an ambitious, self-imposed 'report card' for global development that helped focus attention and resources on issues like HIV and AIDS," Jonathan Quick, president and CEO at Management Sciences for Health (MSH), and Jonathan Jay, bioethicist and senior writer at MSH, examine the global AIDS response and the future of global health in a Devex opinion piece. They highlight a "rapid scale-up" of antiretroviral therapy (ART), citing a recent UNAIDS report that found treatment today "reaches nearly 10 million," up from just 300,000 in 2002, and note the WHO last month "revised its recommendations for developing countries to promote an earlier start to treatment." They write, "'Raising the bar' to treat them all would substantially curb new HIV infections and would help bring the epidemic under control, but it's a formidable task at a time when donor countries' global health budgets are flatlining and new health priorities continue to emerge."
"The global AIDS movement has got far to go, and to continue its progress, it must join counterparts to strengthen health systems in developing countries -- a change of course for a movement that has been highly successful, often moving fastest when it moved alone," they continue. They discuss the U.S. response through PEPFAR, highlight "deliberations around the Sustainable Development Goals, which will replace the MDGs when they expire in 2015," and describe the need for better health systems for HIV care, writing, "Strengthening local health systems could be pivotal to achieving universal ART." They conclude, "The next era of global health should not be defined by winners and losers, but by ambitious, systematic, country-led reforms that maximize health and eradicate poverty. ... The 'go fast' era is over -- with a long road ahead, the global health community must go together" (7/30).