Thursday, November 20, 2008

African lessons

One theme that keeps coming back at the conference: What lessons can be learned from the fight against AIDS in Africa?.


Shannon Hader, senior deputy director of the HIV/AIDS Administration at the District of Columbia Department of Health, had previously worked for the CDC in Harare, Zimbabwe. In Zimbabwe, she worked for PEPFAR – the US global AIDS program.


``The major lessons from PEPFAR is we can heighten our expectations and go on to achieve great things,’’ she said. Even with all of Zimbabwe’s huge problems – widespread human rights abuses and the world’s highest rate of inflation (by far), to name two – she noted that Zimbabwe has lowered HIV prevalence from 24 percent to 17 percent in the last five years.

When Hader interviewed for her job, Mayor Adrian Fenty asked her what she would do. Hader said she would set higher goals, even though an energized DC testing program had done 45,000 tests in 2006. In her meeting, she compared DC (population 600,000) with Botswana (1.6 million people). While DC tested 45,000 people in 2006, Botswana tested 450,000, she told him.


One of Botswana’s advantages: a national policy for opt-out testing in hospitals, meaning that an HIV test will be administered to all incoming patients unless the patient says no. In the U.S., opt-out testing remains a rarity.

Donna Futterman, director of adolescent AIDS program, at the Montefiore Medical Center in New York, who also is an AIDS researcher in South Africa, said AIDS experts here could learn much from Africans.

``It probably doesn’t need to be said, but when we think of doing international work, a lot of us think what we need to share,’’ she said. Those who work in Africa on AIDS, she said, ``bring back as much in the concept of what needs to be done, as what we bring. We are not just helping others. We are learning from the rest of the world.’’

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