In early April, I was privileged to be able to talk to a group of nearly 300 health care providers, lawyers, public health and community leaders about the implementation of the National HIV/AIDS Strategy (NHAS). The event was the 19th annual “Florida Bioethics: Debates, Decisions, Solutions” conference, a day-long meeting hosted by the University of Miami. I was honored to share the stage with Dr. Dwayne Turner who is the current Communicable Disease Director of the Broward County Health Department and the former Associate Director for Planning for AIDS Project Los Angeles. I was especially impressed by Dr. Turner’s comments on the role of communities in the implementation of the NHAS and wanted to share them with readers of AIDS.gov.
Dr. Turner talked about the importance of getting communities ready to “receive” and implement the strategy. An important responsibility of public health leadership, according to Dwayne, is to listen to communities and to go as deep as necessary in order to understand community needs and preferences when it comes to HIV/AIDS and other public health services. He noted that engaging communities in public health decision making is an ethical imperative, especially when those decisions are difficult and may involve discussions of how best to allocate scarce resources to address competing needs. Finally, Dwayne recognized the significant responsibility of public health organizations at all levels of government to “look at the evidence” and, if it becomes apparent that strategic goals and health objectives are not being met, to reorganize, reprioritize, and redirect.
Dr. Turner’s perspectives are very much in-sync with the NHAS which calls upon us, collectively, to take a hard, careful look at our HIV/AIDS policies, programs, and research priorities. The NHAS asks us to redirect existing resources, as necessary, to high-burden populations and to scale up interventions and services that will have the greatest payoff in terms of reducing new HIV infections, improving health outcomes of people living with HIV, and reducing HIV-related health disparities. This will not be easy. Nor will it be painless. But it is, nevertheless, critically important to achieving the goals of the NHAS.