Dr. Wafaa El-Sadr, director of ICAP and Columbia University Mailman School of Public Health professor of epidemiology and medicine, and Dr. Miriam Rabkin, director for health systems strategies at ICAP and associate professor of epidemiology, served as guest editors of the special AIDS Supplement: Fostering HIV Program Quality to Achieve Epidemic Impact. The issue, currently online, will be released in its print version at next week’s 8th International AIDS Society Conference in Vancouver. The special supplement includes articles that focus on the quality gap in HIV care and treatment services, and offer insights into novel approaches and large-scale successes.
As guest editors, Drs. El-Sadr and Rabkin co-wrote the opening article “Putting Quality at the Heart of HIV Programs” advising that without a focus on quality the global HIV epidemic cannot be controlled.
Over the past decade the world has achieved a successful scale-up of HIV programs – including in some of the poorest countries. Worldwide, more than 12 million people have started antiretroviral therapy and approximately 7.6 million deaths have been averted since 2005. While scale-up of treatment and prevention services has led to a 38 percent drop in new HIV infections since 2005, many more milestones remain including the elimination of mother-to-child- transmission of HIV.
Attention to quality of programs and ensuring that first-rate improvement activities are adopted, scaled up, and sustained will be a crucial part of any strategy to achieve the goal of an AIDS-free generation in our lifetime, noted the authors.
“Without attention to both coverage and quality, aspirations for an AIDS-free generation may remain unrealized,” according to Dr. El-Sadr. “However, monitoring of program quality remains a challenge for HIV programs in countries with weaker health systems. In addition, the diversity of approaches to quality improvement can create inefficiencies and barriers.”
Co-editors of the supplement are Dr. Pierre Barker, Institute for Healthcare Improvement, Cambridge, MA, and University of North Carolina Gillings School of Global Public Health; Dr. Yogan Pillay, National Department of Health, South Africa; and Dr. Deborah Birx, Office of the U.S. Global AIDS Coordinator. The authors report no conflicts of interest.