Fighting AIDS in Sub-Saharan Africa: is a public- private partnership a viable paradigm?

In their most recent study, the United Nations AIDS Program estimates that about 22 million people around the world have died from AIDS, and about 40 million more are currently infected with the HIV virus. About 83% of AIDS deaths and 71% of HIV infections have occurred in war-ravaged, poverty-stricken Sub-Saharan Africa. This pandemic is ripping apart the social and economic fabric of this part of the world. The only remedy for this crisis is both prevention and cure. Only through massive education can early and sustained prevention efforts prevent future infections. And only by giving those infected with HIV effective treatments will people be prevented from dying of AIDS in the future. Without a bold, concerted action, not only will millions die in Africa, but the entire world will suffer. To allow sub-Saharan Africa to become socially and economically devastated will have a major impact on the economies of every country of the world. The African Comprehensive HIV/AIDS Partnership (ACHAP) is one answer to the problem. ACHAP, is a joint initiative between the government of Botswana, the Bill and Melinda Gates Foundation and the Merck Company Foundation. This public-private partnership has provided a new sense of optimism for fighting this devastating pandemic. ACHAP offers all interested parties a multifaceted paradigm that addresses not only the need for ARV medications, but also the other social and medical facets of the HIV/AIDS problem facing sub-Saharan Africa. If a coordinated effort can be launched in the other sub-Saharan African nations, using ACHAP as a paradigm, then there is the possibility that the fight against AIDS could be won.

Clinical ethics is of necessity a two-way street, one in which ethical paradigms influence practitioners and researchers whose expertise, in turn, necessarily educates the non-clinical ethicist.