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Health systems for HIV treatment and care
  1. Alan Whiteside
  1. Correspondence to Professor Alan Whiteside, Director, Heard, University of KwaZulu-Natal, Westville, Durban 4013, South Africa; whitesid{at}ukzn.ac.za

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This supplement is timely and important. The original call for papers suggested the issue would focus on topics such as: allocative and technical efficiency in drug delivery; health system studies on feasibility and outcomes of bringing treatment to scale; studies of the integration of antiretroviral therapy (ART) programmes with tuberculosis and the general healthcare systems; and the political economy of different models of ART delivery in different countries. The articles that were submitted, and make up this supplement, address these issues only to a limited extent. Importantly, they open new avenues of enquiry. It is extremely interesting to see what has emerged from the call. These papers reflect where academics believe current thinking and priorities are.

HIV has been recognised for three decades now. In the first decade of the epidemic, activities centred around understanding the disease and its aetiology, and the main interventions were focused on HIV prevention, both medical and behavioural. It is often forgotten that one of the important early successful HIV prevention strategies was the provision of safe blood, and Zimbabwe was the third country in the world to screen its blood supplies. The second decade saw the development of triple therapy and a medicalisation of the response particularly in the developed world. The third decade was a time of massive scale up of interest in and funding for HIV and AIDS.1 The amount of money available for HIV rose from $3 million in 1996, the year UNAIDS was established, up to $15.6 billion in 2008; there was a slight increase in 2009, but the level of funding fell in 2010 and the signs are that this trend has continued. The Global Fund to Fight AIDS, TB, and Malaria (GFATM) and the US Presidential Emergency Plan …

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