Noting price reductions for HIV treatments over the past decade have helped increase access for millions of patients in Africa, Jeffrey Misomali, an Aspen New Voices fellow, writes in the Huffington Post’s “Aspen Institute” blog, “However, these new patients used HIV treatment and care services within an ailing health system that could not cope with the increased workload.” He uses Malawi as an example, saying health care workers “have to provide HIV treatment and care services with minimum infrastructure, equipment and limited incentives despite the increase in their daily workload.” He continues, “The reduction of antiretroviral pricing, changes in treatment guidelines outlined by the [WHO], and other major global shifts … [has] opened [the door] to millions more patients without proper development of the existing health systems to handle these numbers.”

“Global decisions on increasing treatment access are a step in the right direction, but the absence of effective health systems could easily undermine the progress made so far,” Misomali writes. Though health care workers are “cop[ing] with the surge in demand,” “the responsibility is on governments and the donor community to quickly strengthen health systems to cope with the next expected increase in patient numbers,” he states. Misomali concludes, “Global decisions have helped developing nations make important steps in the fight against HIV, but it is in understanding and finding solutions to local challenges … that will finally end the HIV epidemic” (10/9).