Guided Reflection #4

  1. Is the use of this treatment as it stands right now a viable global health initiative? Why or why not?

I think that the use of this treatment as it stands right now is a successful global health initiative. HIV and AIDS are among the top killers in many countries and there is no cure. The fact that this PrEP treatment provides a way for people to be protected from the virus while still being able to engage with their family, friends, and loved ones that might already be infected is amazing. There are so many people currently infected with no cure that the next best step to take right now is to protect those are aren’t infected, and that is exactly what this pill does. While the patient adherence isn’t the strongest due to the fact that you need to take one pill every single day, the people that aren’t 100% with their pill can still get more protection than not taking it at all. It has little to no side effects, none of which are serious. The generic version of the pill is also extremely affordable. Some women in developing country cultures don’t have a choice of with whom and when they have sex. A pill like this would help them immensely to stay protected, and to protect any future children they might have as well. A successful global health initiative makes an important change for an important issue, and this PrEP pill does just that. Unlike the 2003 U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program, which was a huge waste of resources and money. That initiative focused on trying to force abstinence on younger women in sub-Saharan Africa. The PEPFAR initiative “allocated $45 million to abstinence education in 2013” (Gorman 2016). These efforts did not change much and that money essentially was wasted. The proper research was not done beforehand to figure out what would be the most helpful for that culture and area, which later found to be medicine to treat and prevent HIV/AIDS instead of abstinence programs.

  1. What improvements would you make to the PrEP preventative treatment?

One improvement that I would make to the PrEP treatment is to make it so you didn’t have to take one pill every single day. For people in developed countries with access to medical care and a good quality of life, even this is a difficult task. Let alone in a developing country where there main concerns are primitive things like food, clean water, and a safe place to live. Patient adherence to treatment will likely be low with a drug that you need to take every single day in order to be effective (PrEP 2016). I would change it to make it something that required less maintenance, perhaps once a month or even once every few months. I would also give different options for taking the medicine. Right now it is only a pill, and some people might not be able to take pills. Injectable shot, pill, gummy, tablet, patch, etc. That might be more expensive, but at least it gives people the option to choose how you want the medication to be administered. It is also true that “PrEP can be even more effective if it is combined with other ways to prevent new HIV infections like condom use, drug abuse treatment, and treatment for people living with HIV to reduce the chance of passing the virus to others” (PrEP 2016). I think that in order for the PrEP treatment to be successful, it needs to be combined with some sort of education factor. For example – if the person taking PrEP is living with/around a person infected with HIV, perhaps bring both of them in for an educational session on safety and tips for prevention of spreading the disease. Also, in areas where this pill is administered, provide some sort of education for the town/city in the form of a class, brochure, hand out, etc. so that the general public can be educated on HIV safety.

  1. Considering our list of characteristics that make a successful global health initiative, what three characteristics do you identify that are essential to a strong global health program? How so?

I think that the three most important characteristics of a strong global health initiative are as follows: 1.) Affordability 2.) Patient Adherence to Treatment and 3.) Accessibility to the treatment. First and foremost, if the portion of the global health initiative whether it be medication, tools, education, etc. it must be affordable for the person funding the project and the person purchasing the product. Many global health initiatives have funding for the initial phases of the project, but it is important to have the funds to be able to continue it so the effects are long lasting and not just a short-term success. Also, if medication or any sort of treatment is involved, cost is a huge factor. Many people in both developed and developing countries barely have the income to survive, let alone pay for medication or appointments. A successful initiative will be cost-effective for everyone involved. Second, patient adherence to treatment means that the people being affected are going to be able to continue the treatment correctly and effectively. If the medication they provide is too difficult to take or to remember to take, the effects aren’t going to be worth it. If the tool or project the initiative provides is too difficult to use or breaks easily, the people using it wont stick with it. In cases where patient adherence is low, money and time are wasted and the problem isn’t being solved. Lastly, accessibility is very important. In the countries where they are geographically isolated, or the people live very far from the nearest health center or doctor, it becomes close to impossible to keep up with check ups or refill medication on a frequent basis. Whatever initiative is in place needs to account for how accessible the resources they are providing are for the people they wish to help. If they are inaccessible, the initiative needs to take the steps to make sure people can get the resources they need easily. It also helps if the initiative isn’t something that needs to be replaced or refilled often, so that if people are in an isolated area, they wont have to make the effort frequently to get to a more centralized location.

Works Cited

Gorman, Christine. “U.S. Anti-AIDS Abstinence Efforts in Africa Fail to Prevent HIV.”    Scientific American. 4 May 2016. Web. 24 May 2016.

“PRE-EXPOSURE PROPHYLAXIS (PrEP).” PRE-EXPOSURE PROPHYLAXIS (PrEP). Web.          24 May 2016.

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