Investing social capital  pg. 2

Fortunately, we live in Haiti. We know that this is something that can occur, and we have developed contingency plans and were able to place medications at various sites in the city, and give phone cards to our patients so that they could call us and know where to go and get their drugs… And this way all of our patients stayed on their medication even during this chaotic period.

What is important for researchers from the United States to consider when conducting studies in resource-poor countries?

I can list 10 very important points. The first one is that the research has to be focused.

It needs to be cooperative with clear advantages for both parties; you cannot just conduct research in a country and not involve a local entity.

The parties involved must be credible. In some cases it could be the reputation of one person that will decide on the fate of the research.

You have to plan long term. It may take 15 to 20 years. This is what it takes for capacity building in human resources, equipment and infrastructure so that when the research is done, there is something left in the country.

It is necessary to share and use the results of the research in the country where it is conducted.

It has to be comprehensive. You should have a holistic approach involving patient care and training whenever possible. We have been focused on the family unit. This has been our strength here at GHESKIO.

The research should be relevant. It should address important public health issues faced by the country where the work is planned.

It must rest on strong ethical standards.

In addition to that you need to have a research where you have collaboration with the government whenever possible but in a manner that is apolitical.

And finally, you need community support.

Dr. Holtgrave, you have spoken recently about why the CDC was unable to achieve its goal last year of halving the annual number of new HIV infections. Can you elaborate?

David Holtgrave, Ph.D.
In the U.S., prevention programs seem to have made a difference in terms of bringing infections down to 40,000 infections a year from a peak of about 160,000 infections a year in the mid-1980s. That drop is an important measure of prevention success.

We think that over the course of the epidemic several hundred thousand infections have been prevented in the U.S.; perhaps as much as a little over a million.

I think the question that you’re raising is a very important one for the U.S. at the moment. CDC set a goal of reducing new infections by half by 2005, from 40,000 a year down to 20,000 a year. Clearly 2005 is over, and CDC’s continued best estimate of the number of new infections a year is (still) 40,000.

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