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Open Access Publications from the University of California

Whither India? Ten Lessons Learned from the HIV Epidemic in Africa


Recent reports show that the HIV epidemic is rapidly spreading in parts of the largest Asian countries, namely India and China. Despite its strong foothold, there are still opportunities to minimize the problems if we apply these ten lessons learned from the HIV epidemic in Africa 1) The needed decisions will be controversial and require involvement of the beneficiaries in all aspects; 2) Focus on cost-effective programs especially those that affect the core transmission groups such as participants in transactional sex, intravenous drug use, and men who have sex with men; 3) Secure the commodities pipeline - adequate supplies of condoms and antibiotics are essential; 4) Invest only in projects that can be brought to scale; 5) Ensure appropriate delegation of needed tasks to optimize the effectiveness of health workers; 6) Reexamine the structure and work of international donors to exploit faster and more efficient ways to channel funds into the most effective programs; 7) Reduce the number of large international meetings. They waste resources; 8) Confront the “shell game” trade-off in the allocation of competing resources for prevention and highly-active antiretroviral therapy; 9) Update evidence-based policies and program efficiently; and finally, 10) Increase national and global budgets now. Large investments at the outset of the epidemic have a greater impact on slowing its progress than at a later stage. By applying these lessons, more effective policies and strategies may be able to stem the tide of this deadly epidemic.

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