Personalized public health: An implementation research agenda for the HIV response and beyond

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 Jan 2020)

 

Personalized public health: An implementation research agenda for the HIV response and beyond
Elvin H. Geng, Charles B. Holmes, Mosa Moshabela, Izukanji Sikazwe, Maya L. Petersen
Editorial | published 31 Dec 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003020
[Excerpt]
The third factor
We have arrived at a moment in the global HIV response where implementation research is ready to take center stage. Treatment has been scaled-up globally over the past ten years and, as a result, HIV-related mortality and incidence have fallen by more than 50% since a peak in the early 2000s [1]. Despite progress, however, antiretroviral therapy (ART) must still reach perhaps another 15 million persons living with HIV in the coming years. Progress in prevention also remains well below targets. The formula needed for success—past, present and future—consists of three main factors: first, the efficacy of available interventions to treat and prevent HIV; second, adequacy of financing; and third, the effectiveness, efficiency and quality of implementation. As to the first factor, well-tolerated, potent and affordable medications for HIV treatment and prevention already exist: tomorrow’s novel products will likely offer only incremental benefits, and do so through affecting barriers to implementation (e.g., injectable cabotegravir). Regarding the second, donor funding for the global HIV response has leveled out over the past decade and domestic allocations in low- and middle-income countries have not reached needed levels: a large surge in funding is unlikely [2]. Perhaps more than ever before, success in the global HIV response depends on the third factor in the equation: the effectiveness, efficiency, and quality of implementation.