HIV & AIDS

Following the economic recession of 2016, the Nigerian government developed an Economic Recovery and Growth Plan for 2017-2020 with three broad strategic objectives: restoring growth; investing in human capital; and building a globally competitive economy that achieves agriculture and food security, industrialization, improved transport infrastructures and energy sufficiency. Of these three objectives, one stands out: recognizing the importance of investing in human capital.

This represents a major shift by the government, as it previously focused mostly on developing infrastructure—a move that came at the expense of other sectors, including healthcare. Nigeria’s healthcare spending as a percentage of GDP remains one of the lowest in the world: about 0.6% of GDP in 2016, according to the World Bank. Per capita health spending by the Nigerian government is US$11, well below the recommended US$86 for low- and middle-income countries to deliver basic health services.

An innovative testing strategy helps more people living with HIV learn their status

“Life can deceive you when you think you feel strong and healthy,” says Godfrey Justin, whose wife, Violet, tested positive for HIV during a routine antenatal visit. After sharing her status with Godfrey, Violet asked that he be tested as well. Godfrey agreed, learned he was also living with HIV and the couple started antiretroviral therapy (ART).

While traditional methods of HIV testing (such as provider referrals and client-initiated testing) successfully reach millions of people each year, only 75 percent of those living with HIV know their status. Reaching the 25 percent who don’t yet know their status — roughly 9 million individuals globally — will require more targeted approaches.

Dr. Mark Dybul, MSH’s newest board member, has been a leader in global health policy as Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria during the Obama administration and as head of the US President's Emergency Plan for AIDS Relief (PEPFAR) during the Bush administration. Dybul is Professor of Medicine and Faculty Co-Director of the Center for Global Health and Quality at Georgetown University Medical Center. He brings tremendous experience and insight into MSH’s work to strengthen systems that improve the health of the world’s most vulnerable populations, including those living with HIV.

As we prepare for the 22nd International AIDS Conference, we sat down with Dybul to discuss the fight against HIV and AIDS, the need for strong systems to support a more effective and sustainable response, and how we must leverage those systems beyond HIV to improve health more broadly. 

Mark Dybul: Building Systems for Health to End HIV and AIDS

This interview was edited for length and clarity.

This blog was originally posted by The Maternal Health Task Force.

In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored.

“Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics. They are often the first stop for women and men who seek FP information or services.”  - World Health Organization

This is why, in 2003, Management Sciences for Health (MSH) helped launch the Accredited Drug Dispensing Outlet (ADDO) Program in Tanzania to address the important role of these informal drug sellers by creating certain standards that, when met, increase the quality of medicines and services in the community. Tanzania’s successful ADDO Program provides a model that other countries in Africa—and now Asia—have adapted and made their own.