Edsel Maurice Salvana on unlocking the door to an AIDS-free generation

Edsel Salvana, clinical associate professor at the University of the Philippines College of Medicine. Photo by: Devex

If you ask Dr. Edsel Maurice Salvana, the international community has all the tools to achieve an AIDS-free generation. The challenge is to make governments to invest in adopting them.

Salvana, a multi-awarded Filipino doctor formally trained in HIV treatment, has long called for a strong public sector response to the disease. He is one the most influential development leaders aged 40 and under in Manila.

Devex is recognizing 40 of these young trailblazers in international development. They are social entrepreneurs, government leaders, development consultants, business innovators, advocates, development researchers, nonprofit executives and journalists.

We spoke with Salvana about his work and the complex interplay of global health advocates, practitioners and government officials.

How did your advocacy work help the Philippines address its HIV epidemic?

Since I returned as a “balik scientist” (returning scientist) of the Department of Science and Technology in 2008, I have been involved in many critical aspects of the HIV response.

I recognized very early on that an HIV epidemic was imminent, and I was very vocal in media about the alarming rise in cases and the untimely deaths of a lot of young people. This media campaign was instrumental in raising awareness, increasing testing behavior, and was a significant factor in the official declaration of an AIDS epidemic in the country.

We set up the Philippine Red Party which raised funds for our HIV clinic at the Philippine General Hospital and, in partnership with the Australian Red Party, resulted in the donation of essential equipment to our hospital where we are taking care of over 300 HIV and AIDS patients.

As one of a handful of Filipino doctors formally trained in HIV treatment, I have passed on these skills to 15 infectious diseases fellows, and we have set up an HIV and AIDS research fellowship, which has generated high-quality research and has given us a better understanding of the current epidemic.

In addition, we have presented our work at some of the most prestigious and rigorous international HIV and AIDS conferences, and I have written several national and international publications on HIV in the Philippines. We are in the process of generating economic data which will argue for a more robust government response to the epidemic due to the tremendous economic cost a generalized epidemic will entail.

How can the health community work better with development organizations and governments to find solutions to the world’s most-pressing health challenges?

I think the health community needs to realize that it can generate a much larger impact on the world’s most pressing health challenges if it engages early and often with development organizations and government. Health care providers, particularly doctors, are used to seeing one patient at a time, and are not necessarily predisposed to seeing the bigger picture.

The health community needs to realize that the impact of well-developed programs and policies eventually does trickle down to their individual patients, and working with the policymakers will ensure a maximum impact of these interventions. A good example is engaging media advocates, since these groups are able to access mass media, ensuring that the message is delivered in a simple, understandable and effective manner, and achieving behavioral change in a large audience.

How close are we to achieving an AIDS-free generation?

The tools for achieving an AIDS-free generation have been developed and are available. The last two years have seen tremendous advances in our understanding of how to drastically limit HIV transmission using a mass treatment approach, and the same “test-and-treat” and “treatment-for-prevention” approach has the potential to restore life expectancy if antiretrovirals are started right away.

The reluctance of governments and health programs in adopting this approach is understandable due to a large upfront cost and the concern for widespread drug resistance and side effects. However, we need to convince our leaders that all these obstacles are not insurmountable.

Read more about the Devex 40 Under 40 International Development Leaders in Manila.