An AIDS-free generation can only be achieved by fulfilling three prerequisites, according to U.S. Global AIDS Coordinator Eric Goosby. The global health community must continue to support the President’s Emergency Program For Aids Relief, promote country ownership and target country needs with a robust multilateral approach, he said June 25.
In his remarks at the Brookings Institution in Washington, Goosby defended PEPFAR as a key ingredient for success in stemming the pandemic, and making country health systems stronger overall.
The global health community needs to stop viewing PEPFAR as a “one-off” program that detracts from other health issues, and instead give it credit for expanding the whole pie, Goosby said. The benefits of PEPFAR reach further than AIDS alone by funding laboratories and clinics, and technicians, doctors and nurses who are instrumental in dealing with numerous health concerns.
Goosby also emphasized the need for greater country ownership in delivering health services. This is the only way to achieve sustainability, he argued. Overall leadership must come from the country itself, beginning with a needs identification and prioritization, and finding multiple funding sources.
“The United States cannot be the ministry of health in all the countries we work,” he said.
African nations pledged to spend 15 percent of their general expenditure on health at the Abuja Summit in 2001, but few countries have met that goal.
This does not mean the international community, and the United States in particular, should stop funding health initiatives abroad, Goosby said. It is almost impossible, he added, to overstate the United States’ contribution in “turning the tide” on AIDS — also the slogan for the 19th International AIDS Conference to be held in Washington, D.C., next month. But to achieve the “AIDS-free generation” aspired to by advocates — and the Obama administration — last year, Goosby said there must be a robust multilateral response targeted toward individual country needs.
Goosby recognized slowdowns and challenges in meeting this lofty goal. Male circumcision projects are difficult to implement and the prevention of mother-to-child transmissions needs to be scaled up — two PEPFAR priorities. Legal restrictions on PEPFAR to fund commercial sex workers and others have kept certain marginalized groups out of the conversation on AIDS, a barrier Goosby conceded was a tough issue but one his office was trying to raise.
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