#e36f1e;">Part one of the blog series: Spotlight on Global Health Initiative Plus Countries [6]

Originally appeared in Global Health Magazine. [10]

Over the last several decades, millions of dollars have been invested in capacity building interventions, and the chorus of capacity building enthusiasts continues to grow. Yet, both in description and practice, capacity building remains somewhat fuzzy. In many developing countries, one of the greatest obstacles to achieving the health MDGs - in particular those relating to child survival, maternal health, and combating major diseases such as HIV & AIDS - is the deep, persistent lack of organizational capacity among those responsible for attaining these goals.

Some of the essential capacity components that are often lacking include human capacity - adequate numbers of skilled, motivated and well distributed health providers who are supported by strong leadership; financial capacity - money management skills, financial accountability, and costing expertise; systems capacity - information and logistics, monitoring and evaluation, and governance structures and processes.

Pick up any American newspaper these days, and all of the stories coming out of Haiti are negative: earthquake relief work is going slow, displaced people are still living in tented camps, men and women are still struggling to find work.  And while these facts can’t be disputed, there are many other stories that are being left untold.  Working in Haiti [15] earlier this month, I encountered six women who are on the front lines of the battle against Haiti’s HIV & AIDS epidemic, who shared their stories with me.

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During the opening ceremony of the International AIDS Conference [20], International AIDS Society President Julio Montaner declared “Consensus has arrived. Treatment and prevention are one thing and they are the way forward.” He went on to assert that Treatment 2.0 [21] “is the most effective way forward to deliver on the universal access pledge.”

Later in the ceremony UNAIDS Executive Director Michel Sidibe proclaimed “Treatment 2.0 radically simplifies treatment to maximize the number of people who can benefit.”

Originally posted on Global Health TV's website.

Watch Video Coverage of Dispelling Myths About Haiti [25]

The Global Health Council and its partners held a press conference at the International AIDS Conference in Vienna, to bring the attention of the media back to Haiti six months after it was devastated by earthquake.

Experts such as Dr. Paul Farmer, Dr. Jonathan Quick from Management Sciences for Health, Jeff Sturchio from the Global Health Council, and Dr. Jean William Pape from GHESKIO discuss the struggles and successes being made in the troubled nation - and try to dispel a few myths too.

The AIDS 2010 conference theme “Rights Now, Right Here” [20] was delivered loudly, clearly, and passionately throughout the week in Vienna as delegates discussed the practical and urgent implications for truly gaining universal access to HIV treatment, prevention, and care. Over 10 million HIV positive people are without access to treatment, without universal access, the MDGs will not be achieved by 2015.

Human rights violations are a barrier to learning about the epidemic or receiving critical prevention information. Some HIV positive people are subject to unethical surveillance. Human rights violations contribute to transmission of HIV (such as from rape in prisons or domestic violence) and, in too many countries, being HIV positive is a criminal offense. Stigma, discrimination, and persecution are all huge barriers to HIV testing, care, and support. Universal access to human rights by all is what will lead to universal treatment, prevention, and care, not the reverse. Realizing the full protection of human rights is the first step to enhancing efficiency in these programs. The right to live life free of stigma and discrimination and the right to health care including treatment, prevention, care, and needle exchange and substitution treatment are essential.

By Muku Mugwagwa

Last week , the keynote speaker at the opening plenary of the 2010 International AIDS Conference in Vienna, Austria,  was former President Bill Clinton. He took charge of the stage to address how to move forward in the global fight against AIDS. HIV & AIDS has become a chronic disease – we must transition our efforts from an emergency response to one we can sustain. [30]

Clinton began his speech on an optimistic note, stating that the fight against AIDS has managed to raise more funding than any other epidemic in the world. In particular, Clinton highlighted the efforts of UNITAID [31] as an effective avenue for stimulating broad based private funding. Small donations from campaigns such as Project Red [32]prove that small donations from a large mass of people can go a long way in the fight against HIV & AIDS.

At the International AIDS Conference in Vienna, Austria [20], my colleagues and I gathered to discuss the principles of smart integration [35]and its challenges, successes, and recommendations for implementation. 

Smart integration means coordinating HIV & AIDS programs with other health programs that have operated independently in the past; providing comprehensive services at all levels of the health system – from households to health facilities and across the continuum of prevention, treatment, and care; and building stronger partnerships between public and private sectors.

There are three perspectives of integration that must be kept in mind when discussing integration – the client, provider, and the efficiency. Smart integration is important now because AIDS has become a chronic disease and we need to move away from the emergency response interventions.

On July 19, here in Vienna at the XVIIIth International AIDS Conference [20], positive results were announced from the CAPRISA 004 Phase IIb microbicide trial [38]of 1% tenofovir gel, which was tested in 889 South African women. Overall, there were 39 percent fewer infections among women who received the gel compared to women who received the placebo –and the results showed 51% efficacy of the gel against transmission of herpes simplex virusto women.  Of note, recent vaccine trials and microbicide trials have set as a limit of efficacy 30% in order to be considered “effective”, which generally means that the FDA will approve them.  

The South African Minister of Health, Dr. Aaron Motsoaledi, provided a clear picture of a new era of HIV & AIDS care, treatment, and prevention in South Africa at the International AIDS Conference on Tuesday morning.

All of South Africa is united behind one goal of fighting HIV & AIDS,  he said.  Dr. Motsoaledi stands behind a firm commitment to human rights, “access to care, treatment, and prevention is a human right.”

He is working with the Government of South Africa to ensure universal access in their country. “Human rights are not a threat to democracy, but a sign of good governance,” he said.

29% of South Africa’s population has HIV & AIDS, “The new infection rate seems to have stabilized, but this number is extraordinarily high, and unacceptable,” said Dr. Motsoaledi

The Government’s national strategy plan has two targets to reach by the end of 2011. First, to reduce the number of new infections by half; and second, to provide care and support to 85% of those effected by HIV & AIDS.

This past April, the Government of South Africa started a testing campaign; the goal is to test 15 million South Africans. The leaders of the national government paved the way for the movement by getting tested first.