Want to end AIDS by 2030? Engage the private sector

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Sara Gorman, PhD, MPH is a public health specialist at a major multinational healthcare company, where she works on global mental health, increasing the quality of evidence in the global health field, and alternative funding models for global health. Her book, Denying to the Grave: Why We Ignore the Facts that Will Save Us, will be released by Oxford University Press in August 2016. The book examines the psychology behind healthcare decision-making and theorizes about public perception of risk. It includes tips for the general public about how to discriminate between valid and invalid science and pointers for public health professionals and doctors on how to communicate with people who do not believe what science has taught us about health. Sara earned an MPH in Health Policy and Management from Columbia University Mailman School of Public Health and a PhD in English literature from Harvard University.

In July 2014, UNAIDS released a report suggesting that the end of AIDS is in sight. The report boldly proposed that AIDS could be eliminated by 2030. In a world where we have many technologies, including diagnostic tests and an array of effective drugs, to fight AIDS, why is there still such a large population of people with HIV/AIDS who never get any treatment, cannot adhere to treatment, or fail to achieve viral suppression?

 

On World AIDS Day, it’s essential to think about some simple solutions that can push AIDS elimination forward. While much focus has rightfully been placed on trying to find an HIV vaccine and on developing indications for antiretrovirals such as Truvada to be used for pre-exposure prophylaxis, today we should both celebrate some of the smaller and more local gains and think about how we can scale these up.

 

Although the public health community does not often think about this, many of these local gains actually come from work done by the private sector, often in collaboration with governments and non-profits. While we tend to think about this kind of support as occurring mainly within the realm of pharmaceutical companies and drug donation programs, it’s becoming ever more vital that we look to some of the innovative ways in which the private sector has contributed to global health and what, beyond monetary aid, these corporations can really bring to the table.

 

For example, Chevron, in partnership with PACT, Born Free Africa, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, launched PMTCT (Prevention of Mother-to-Child Transmission) programs in Nigeria and Angola in 2001 and 2005, respectively. These programs began as voluntary workplace programs. Since 2001 in Nigeria and 2005 in Angola, Chevron has received no reports of incident mother-to-child transmission of HIV among its employees or dependents in areas in which this kind of transmission has been remarkably high. Chevron has since expanded this program to include partnerships with local and federal governments in both Nigeria and Angola to help them set concrete targets for PMTCT and to implement these targets effectively over time. Since the launch of this program in 2012, 659 health facilities have been equipped with PMTCT capacities, more than 5,000 pregnant women with HIV have been accessing antiretrovirals and PMTCT, and 449 local health workers have been trained in PMTCT techniques.

 

As this example demonstrates, private sector engagement in global health, including the fight against AIDS, needs to go beyond donation of financial resources. Private corporations have a great deal of knowledge about supply chains, distribution, and marketing and publicity that can help widen the reach of life-saving technologies in resource-limited settings. But perhaps even more importantly, and less frequently discussed, is the role the private sector can play in local capacity-building. Many small, local non-profits, government agencies, and healthcare facilities in resource-limited settings struggle to stay afloat due not only to a lack of financial resources but also to a general lack of emphasis on building and maintaining sustainable business models. Corporations, especially those that work globally, have an important role to play in counseling and advising these kinds of organizations in skills such as accounting, financing, management, and organizational structure, among other things. As the global health community continues to emphasize health systems strengthening in resource-limited settings, it becomes increasingly important to delineate exactly how these systems can be strengthened and what kind of business knowledge and sustainability expertise is needed to keep these complex systems strong. As we ponder our progress toward an AIDS-free generation this World AIDS Day, we should welcome and help direct newer entrants into the global health landscape to help make the maximum impact for the most people globally.