Rapporteur reports
Leadership report by Rebecca Hodes
The introductory remarks of the Health Minster of Mexico focused on his state’s advances in access to health insurance within the broader context of unacceptable inequalities within global health systems.
Minister Frenk argued that strengthening health systems was highly relevant in the fight against AIDS, and emphasised the importance of a rights-based approach to healthcare delivery. Frenk painted an optimistic picture in which improvements in global health would promote a renewed ethic of human rights and equal opportunities for the inhabitants of both the rich and poor worlds. He concluded: ‘In a turbulent world, health remains one of the truly unifying goals’.
Former US President Clinton gave an overview of current issues in HIV, detailing the work of his Foundation with regard to each of these. He highlighted the necessity of lowering drugs prices and improving laboratory services in strengthening health systems. He also emphasised the importance of increasing access to testing, second line antiretrovirals, and effective methods of prevention (including condoms, male circumcision). He also supported the continued fight for microbicides and vaccines.
Clinton emphasised the importance of ‘synergizing’ HIV and TB treatment, and making treatment more accessible for poor, rural people. He spoke of innovations in technology which would transform lab diagnostics, but that funding requirements were daunting and that donors must be committed and reliable.
In response to protesters whose placards indicted homelessness and poverty, Clinton responded that much work also remains to be done in high-income countries. He discussed the high and escalating rates of HIV among African Americans, but ended on an upbeat note by describing how the world’s people would eventually slay the ‘dragon’ of AIDS and ‘dance’ and ‘dream’ together.
Track E report by Stefan Baral
Health policy has traditionally been operationalized by a horizontal approach where resources are applied to improving the health care system or a vertical approach where the focus is on increasing disease-specific capacity. The fight to curb the HIV and AIDS epidemics are most efficient when the best of both of these two strategies are integrated into a single diagonal approach. Mexico enacted such an approach with comprehensive health care reform including the adoption of evidence-based prevention and harm reduction strategies which likely played a role in limiting the severity of its HIV epidemic in the general population.
In the last two years, there have been vast improvements in global health aid including the PEPFAR reauthorization of 48 billion USD over 5 years, increases to the GFATM, the Gates foundation, and other large multilateral donors. And with this funding, there have been advances in the fight against the HIV pandemic including less children being infected and more being treated. However, there are huge challenges in curbing HIV epidemics among the world’s most vulnerable populations making the pandemic increasingly more concentrated among these populations of gay men and other MSM, IDUs, and sex workers. And this global trend of the HIV pandemic holds true in Mexico where the general population prevalence has indeed been limited, but the HIV prevalence among men who have sex with men is estimated at 25%. Discrimination and stigma have been consistently described as obstacles to limiting HIV spread, but this is not enough. Translating this fight against stigma into investment in evidence-based prevention strategies targeting the most at risk populations commensurate with their level of HIV risk is also a necessary component in fighting the HIV pandemic.
Bill Clinton: “When resources are scarce, we save lives when we use them better”
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