Preparing for the future of HIV/AIDS in Africa: a shared responsibility

Preparing for the future of HIV/AIDS in Africa: a shared responsibility

Sharing responsibility in preparing for the future of HIV and AIDS in Africa

HIV and AIDS is a catastrophe globally, but nowhere more so than in sub-Saharan Africa. In this context, an IOM (the Institute of Medicine) committee identified strategies for both African nations and the USA to build African capacity to prevent, treat, and care for HIV/AIDS. These capacities comprise human, scientific, technological, organisational, institutional, and/or resource capabilities.

The committee’s conclusions contain the following: 

  • the burden of morbidity and mortality in Africa cannot be alleviated through treatment alone.
  • treatment can reach only a fraction of those who need it, and its costs are unsustainable.
  • greater emphasis must be placed on preventing new infections.
  • for African nations, the focus is to strengthen health care systems by making the most of existing capacities, such as health care workers on the ground and local institutions.
  • for the USA, strategies focus on supporting partnerships—particularly institutional partnerships—so Africa can move forward independently toward a sustainable and healthier future.

Moreover, the committee concludes that no single strategy can meet the challenge of HIV and AIDS; countries will need to adopt multi-pronged approaches.

Recommendations include:

  • African countries, supported by donors, should develop and implement methods for measuring the level of and change in new HIV infections to enable better planning and evaluation of prevention programmes.
  • the U.S. government should support countries in assessing the implications of alternative national HIV and AIDS policies so policy makers can make informed decisions on related trade-offs.
  • African countries should establish a negotiated contract with U.S. agencies that includes programmatic targets and delineates each partner’s responsibilities and expectations.
  • both donors and governments should establish effective mechanisms to ensure that requirements such as transparency, accountability, and responsibility are met.
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