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19:57
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Family wellness, not HIV prevention
Mary Jane Rotheram-Borus1, Dallas Swendeman, Diane Flannery
1Global Center for Children and Families, University of California, 10920 Wilshire Boulevard, Suite 350, Los Angeles, CA 90024-6521, USA. Rotheram@ucla.edu
AIDS and Behavior
|January 17, 2009
Summary
HIV exceptionalism diverts resources from local health needs. Shifting to integrated, community-led prevention infrastructure can improve global health outcomes.
Area of Science:
- Global Health
- Public Health Policy
- Infectious Disease Prevention
Background:
- Disease-specific programs, exemplified by HIV exceptionalism, attract disproportionate funding and talent, potentially distorting local health priorities.
- The success of HIV programs in mobilizing global health resources highlights a unique historical context but raises concerns about sustainability and equity.
- Existing approaches often perpetuate polarization between disease-specific initiatives and broader public health needs.
Purpose of the Study:
- To propose a paradigm shift in global health strategy, moving away from disease exceptionalism towards integrated prevention.
- To outline fundamental changes required for creating a robust prevention infrastructure that addresses diverse local health challenges.
- To foster a more equitable and effective allocation of resources in global health.
Main Methods:
- Conceptual analysis of HIV exceptionalism and its impact on global health resource allocation.
- Development of a framework for horizontally integrated prevention services at the local level.
- Proposal for a 'family wellness' metaphor to reframe health services.
- Emphasis on implementing evidence-based prevention programs (EBPP) using common principles rather than specific program replication.
- Integration of private sector expertise to enhance the design and delivery of prevention programs.
Main Results:
- Advocacy for a move beyond disease-specific silos towards a unified prevention infrastructure.
- Identification of four key shifts: local integration, wellness metaphor, principle-based EBPP, and private sector engagement.
- Potential for improved health outcomes by tailoring prevention to local needs and enhancing accessibility.
- A proposed model that leverages community leadership and evidence-based strategies.
Conclusions:
- Sustained improvements in global health necessitate a move away from HIV exceptionalism and towards integrated, community-driven prevention.
- Adoption of a family wellness approach and principle-based EBPP can create more engaging and accessible health services.
- Collaboration with the private sector can enhance the design and delivery of effective prevention strategies.
- Reorienting global health efforts to address multiple community health challenges is crucial for long-term impact.
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