AIDS 2010

The International AIDS Conference is going on this week in Vienna, Austria. It's a conference that happens every two years, and is a chance for the world's leaders on HIV/AIDS and global health issues to come together. This year much of the discussion is around trying to move closer towards the goal of universal access to HIV/AIDS care and anti-retroviral drugs (ARVs) for treatment. This conversation is occurring against a backdrop of what some see as a shift away from a committment to fight HIV/AIDS by the global community (including the US)in favor of other global health issues.

Without getting into a debate on global health policy and funding, I think it's worthwhile to point out that I think allowing the conversation to be framed as supporting HIV/AIDS or any other global health issue is exactly the debate we need to avoid. Former President Bill Clinton addressed the conference on Monday and I think his remarks sum it up nicely:

Clinton finished by running through six priorities global AIDS funding needed to achieve if the momentum towards global treatment and prevention was to be continued. These were: to avoid false choices between different disease areas; to strive for lower drug costs; to target prevention efficiently; to enact “disciplined, honest, no-backside-covering ways to save the costs of drug delivery;” to create better private donation and investment structures; and “to educate people why this is good.”

“Our only chance,” he concluded, “is that the positive forces fighting HIV are just that little bit bigger than the negative ones

With the very real limitations in funding and resources to address the myriad of global health issues (HIV/AIDS, maternal health, childhood illnesses, neglected tropical diseases, malaria, TB), it's tempting to plant your feet on an "issue" and want to fight for that one. But I think the tendency to digress into territoriality is one of the biggest, and potentially most fractious, challenges facing the global health community.

As I think about starting my PhD, in the very specific area of maternal child health, watching the discussion happening around the AIDS 2010 Conference is a good reminder to me that healthy mothers are only a piece of the picture; the overall goal is healthy and happy people that can live the life they want to.

We've seen in the past that vertical programming (programs that address only one disease or health issue, rather than strengthen the whole system) has been ineffective. Now we need to take the next step and realize that vertical advocacy or vertical funding will be just as ineffective at solving global health issues.