SciDev.Net

In June 2006, the UN emphasised the crucial role of food and nutrition in mitigating the effects of HIV/AIDS. This briefing paper explains how these issues are intertwined, and analyses why there has been little action in this area so far.

When food is scarce, women tend to get the smallest portion, leading them seek food elsewhere. This might include selling sex for food, putting them at a higher risk of HIV infection. Malnutrition can also weaken the immune system, making it easier to pick up infections but harder to get rid of them.

According to the report, health and food authorities each see it as the other's responsibility to integrate nutrition into HIV programmes. Donors and national policymakers have also been reluctant to support initiatives for integration. The first challenge, says the report, is raising awareness of the UN endorsement to secure action. Donors and governments should work to strengthen links between policies — the responsibility to reduce HIV/AIDS must not rest with the health sector alone. Finally, nutrition indicators should be included in clinical surveillance and reporting.

This briefing paper highlights the challenges in harmonising efforts to provide universal HIV/AIDS care. The 'Three Ones' principles, set in place to make the global fight against HIV/AIDS more efficient, advocate one action framework to coordinate all partners, one national AIDS authority and one country-level monitoring and evaluation system.

But, as the report points out, limited capacity in developing countries and a lack of incentives for donors to revise their practices are barriers to implementing these principles. There are also tensions between national ownership and accountability to donors.

By looking at countries that have been most successful in fighting the disease, such as Botswana and Malawi, the report outlines the keys to improving access to HIV/AIDS care.

Empowering national leadership is vital: what is needed are national HIV/AIDS strategies that have explicit priorities, are evidence-based, and link to other development plans. The multilateral donor community also needs to improve its delivery of technical support.

For this report, malaria and HIV/AIDS specialists were consulted on interactions between the two diseases and how having both affects people's health. They said there is still much to learn about the biological and clinical effects that malaria and HIV/AIDS have on each other. But some conclusions are already clear: integrating healthcare services is essential to reducing the burden of both diseases where they are prevalent. Health services providing HIV/AIDS prevention, treatment and care can serve as access points for malaria prevention and control. Likewise, new laboratory capacity to support HIV treatment and monitoring can also be used for malaria diagnosis. More research and debate is needed, however, before formulating new public health policies. 

For this report, malaria and HIV/AIDS specialists were consulted on interactions between the two diseases and how having both affects people's health. They said there is still much to learn about the biological and clinical effects that malaria and HIV/AIDS have on each other. But some conclusions are already clear: integrating healthcare services is essential to reducing the burden of both diseases where they are prevalent. Health services providing HIV/AIDS prevention, treatment and care can serve as access points for malaria prevention and control. Likewise, new laboratory capacity to support HIV treatment and monitoring can also be used for malaria diagnosis. More research and debate is needed, however, before formulating new public health policies. 

A policy working paper concerning the demand for an HIV vaccine usefully compares studies conducted globally and nationally, concerning both public and private sectors, in order to help inform future healthcare strategies and financial planning, and investment from industry in HIV vaccine research and development.

This policy brief highlights key issues in assessing the demand for an HIV vaccine, including what factors influence demand, such as efficacy and cost of vaccine candidates and acceptability among target populations, and differences between public and private sectors in their willingness to pay for a vaccine and political commitment.

This is a useful policy paper that assesses the total level of spending needed for AIDS vaccine research and development in the near future and the gap between current and projected spending. It considers the main stumbling blocks in vaccine research and development that could be significantly overcome with sufficient increase in spending: identification of high-quality candidate vaccines, increasing the number of such candidates entering clinical trials, and speeding up the establishment of clinical trials with faster recruitment of volunteers and regulatory approval.

Peter Piot - executive director of UNAIDS - weighs up the policy strategies for making an international concerted effort to shift the course of the global HIV/AIDS epidemic, following commitments made at the June 2001 UN General Assembly Special Session on AIDS.

Simultaneously combining prevention and care strategies at multiple levels, eradicating social ills such as stigma and discrimination of HIV-infected individuals, and combining public and private finance, will be needed to avert this global catastrophe.

This IAVI policy document advocates the need to ensure global access to future HIV vaccines. It starts from the premise that true access cannot be assumed for people living in the poorest nations or who belong to high risk groups.

IAVI's five-point action plan demands that any future vaccine be introduced simultaneously in both the industrialised North and developing South, that the necessary infrastructure be created to administer and monitor vaccines, and that vaccine development and distribution is funded by partnerships between the private and public sector.