Data in the AIDS response
Christopher Murray, Professor of Global Health, University of Washington
Over the course of the past two decades, we have learned that through concerted action the world can unite to address an epidemic that seemed impossible to overcome. With smart investments, global coordination and leadership from UNAIDS and others, we have stopped the rise of the AIDS epidemic to a very substantial extent. That was a tremendous achievement, but it has been followed by a period of great uncertainty.
After the initial enthusiasm around battling a new epidemic, the funding for the response has stalled, decreasing by 1% between 2013 and 2014. The needs for prevention, diagnosis and treatment, meanwhile, remain massive and unmet. We now need to figure out how to match our funding requirements even more closely to the interventions that are likely to provide the greatest impact.
Fortunately, the use of data analysis to combat the epidemic has been critical from the start of the response. UNAIDS was formed in part to address a chasm in adequate information gathering. Over time, data analysis and reporting in the response have proven to be great examples of how using limited information and improving it over time can drive funding, attention and political response.
Had we waited until we were able to perfect the analytical process for measuring the impact of the epidemic, millions more people would undoubtedly be dead or suffering for our lack of action. Now, in this new era, we have an opportunity to assess our successes, learn from our mistakes and make even more substantial improvements in how we account for both.
One challenge we must meet is developing a better understanding of how to maximize the effectiveness of antiretroviral therapy. At the Institute for Health Metrics and Evaluation, we found wide variation in the quality of antiretroviral therapy treatment programmes. Further research is urgently needed so that national health systems can learn from the best-performing programmes.
In many ways, the effort to end the AIDS epidemic is exhibit A in how to successfully combat a disease. That makes it all the more crucial that we pay close attention to progress in new cases, death rates and management of the disease as a chronic condition.
