US Global AIDS Research Articles

Deborah L Birx: on a mission to end the HIV/AIDS epidemic

Ambassador Deborah Birx is the US Global AIDS Coordinator and in charge of the US President's Emergency Plan for AIDS Relief (PEPFAR) and the US Government's engagement with the Global Fund. She is also the US Special Representative for Global Health Diplomacy and aligns the government's diplomacy with foreign assistance programmes on global health issues. Speaking to her on the day after the US elections, she was upbeat about PEPFAR's future. “We are very lucky to have an incredible programme that has bipartisan support now and from the beginning. I have been a civil servant for a long time—29 years in the military. I know transition sometimes makes people concerned. This is my sixth one, but there is always something incredibly good that happens. So I am always hopeful and believe both Republicans and Democrats see themselves in this programme and will continue to guide it forward,” she said.

Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa.

After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs.

PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean.

The US President's Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country's readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts.

The impact of HIV care and support interventions on key outcomes in low- and middle-income countries: a literature review--introduction.

The impact of HIV care and support interventions on key outcomes in low- and middle-income countries: a literature review--introduction.

Eric Goosby: the UN special envoy for tuberculosis

Eric Goosby: the UN special envoy for tuberculosis

Global Action to reduce HIV stigma and discrimination

Global Action to reduce HIV stigma and discrimination

Alex Coutinho: transforming HIV care in Africa

Alex Coutinho: transforming HIV care in Africa

Mark Dybul to pilot Global Fund through financial crisis

At the end of a turbulent year at the Global Fund, Mark Dybul, the former US Global AIDS Coordinator, has been elected Executive Director. David Holmes reports. Mark Dybul: taking the helm at the Global Fund2012 was a year of soul searching at the Global Fund to Fight AIDS, Tuberculosis and Malaria. A disastrous funding round in the autumn of 2010 followed by a period of public blood-letting a year later, when an independent report criticised the fund's ability to safeguard its grants against fraud, led to the declaration in January by the then executive director Michel Kazatchkine that he was stepping down. Months of uncertainty followed as the fund's board sought a successor, until their announcement in November that they had finally found their man: Mark Dybul. Full-Text PDF Donors continue to hold back support from Global FundThe Global Fund remains millions of dollars short of what it needs to operate as governments continue to withhold donations over in-country corruption allegations. Ann Danaiya Usher reports. Full-Text PDF

Eric Goosby: US Global AIDS Coordinator and head of PEPFAR

Eric Goosby: US Global AIDS Coordinator and head of PEPFAR

How PEPFAR’s Public-Private Partnerships Achieved Ambitious Goals, From Improving Labs To Strengthening Supply Chains

The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, is widely recognized as one of the most ambitious and successful bilateral programs ever implemented to address a single disease. Part of the program's success is attributable to the participation of the private sector, working in partnership with the US and local governments and implementing organizations to maximize the reach and effectiveness of every dollar spent. We examined key public-private partnerships that grew out of PEPFAR to identify features that have made them effective. For example, PEPFAR's Supply Chain Management System took advantage of private industry's best practices in logistics, and a partnership with the medical technology company BD (Becton, Dickinson and Company) improved laboratory systems throughout sub-Saharan Africa. We found that setting ambitious goals, enlisting both global and local partners, cultivating a culture of collaboration, careful planning, continuous monitoring and evaluation, and measuring outcomes systematically led to the most effective programs. The Office of the US Global AIDS Coordinator and PEPFAR should continue to strengthen their capacity for private-sector partnerships, learning from a decade of experience and identifying new ways to make smart investments that will make the most efficient use of taxpayer resources, expand proven interventions more rapidly, and help ensure the sustainability of key programs.

Physician, Researcher, And Policy Maker Takes On HIV/AIDS

From his days as a young physician in San Francisco to his current role as the US Global AIDS Coordinator, Eric Goosby has seen the damage done by HIV and has dedicated his career to lessening it.

Robin Gorna takes the helm at the International AIDS Society

Robin Gorna takes the helm at the International AIDS Society

Elizabeth Mataka: UN Special Envoy for HIV/AIDS in Africa

One Sunday morning last year an elderly Zambian woman four grandchildren in tow showed up at Elizabeth Matakas door. "Im looking for Mrs Mataka-people said she will help me. Shes the one who helps grandmothers" the woman said. She had found exactly the right person. Mataka herself a grandmother of three heads the Zambia National AIDS Network (ZNAN) and helps coordinate funds fl owing in from donors. And earlier this year she was elevated to the highest levels of the global response to the pandemic. In April 61-year-old Mataka was elected Vice Chair of the Global Fund to Fight AIDS Tuberculosis and Malaria. The next month she got a surprise midnight call from New York with the news that she had been chosen to replace the outgoing United Nations Special Envoy for HIV/AIDS in Africa Canadian diplomat Stephen Lewis. (excerpt)

Mark Dybul: US Global AIDS Coordinator in charge of PEPFAR

In August 2006 Mark Dybul was sworn in as the new US Global AIDS coordinator to oversee the US response to the global HIV/AIDS crisis and specifically to direct the implementation of the Presidents Emergency Plan for AIDS Relief (PEPFAR). The plan--a 5-year US$15 billion initiative--is the largest programme ever launched to target a single disease. "The President saw tackling the HIV/ AIDS pandemic as a moral imperative to save lives restore hope and to build local capacity to transform the African subcontinent. I want to make clear that the President sets the direction and the goals and that I wouldnt be here if it wasnt for him" Dybul says. Billy Pick a USAID colleague and a friend of Dybuls told The Lancet "Mark is determined to make PEPFAR work but he is not big on being in the limelight. He is very passionate about science and his patients and fully embraces the embodiment of an academic researcher. Facts and evidence are what matters to him. He is not seen as a politician so there is no agenda". (excerpt)

US Global AIDS Effort Criticized

US Global AIDS Effort Criticized

Implementation of a quality systems approach for laboratory practice in resource-constrained countries

Under the direction of the US Global AIDS Coordinator's Office, Department of Health and Human Services, the CDC Global AIDS programme helps resource-constrained countries to address the global HIV/AIDS pandemic. Activities include laboratory capacity and laboratory infrastructure development in 25 resource-constrained countries. Medical practitioners and public health programme leaders in industrialized countries rely on the use of quality laboratory data for evidence-based medical decision-making to determine policy for the implementation of disease control measures, to monitor disease to determine the impact of control programmes, and to support surveillance activities. In these countries, laboratory data to support decision-making processes have a level of quality attributable to laws, regulations and guidelines developed over many years. However, resource-constrained countries have not had similar experiences. Few countries have developed laws, regulations or guidelines, nor is there a data-use culture (e.g. evidence-based medicine) for those in the decision-making environment in resource-constrained countries. The strengthening of laboratory capability and capacity in resource-constrained countries is an important goal to improve accurate and reliable data for the diagnosis, treatment and monitoring of disease.A process for the implementation of a quality systems approach for a laboratory is presented: (i) acknowledgement of the need to improve the laboratory programme in the country at the Ministry of Health and at all decision-making levels within the provinces/states of the country; (ii) assessment of capabilities, capacities, infrastructure, and training needs; (iii) implementation of a national meeting of laboratorians; (iv) designation of a national Quality Assurance Office and leadership within that office; (v) the development and provision of technical training.