18 February 2013

South Africa: Concentrate On Disease Hot Zones, Dybul Says

analysis

Mark Dybul, Executive Director of the Global Fund, said in an interview that the world has an "historic opportunity" to contain and end HIV, TB and malaria by focusing on their "hot zones."

The interview was conducted by John-Manuel Andriote. Dr Dybul's remarks were contained in an article Mr Andriote published in The Atlantic (online) on 13 February.

Dr Dybul said that a better understanding of the epidemiology of the diseases makes it clear there are "micro-epidemics" rather than "generalised" epidemics, even in hard-hit countries. For example, he said, although South Africa has more people living with HIV than any other country in the world, more than half of them live in KwaZulu-Natal and Gauteng provinces.

"If we can concentrate in these geographies," said Dybul, "we can interrupt new transmissions, getting new transmissions down to very low levels. And we can do it in a rapid time frame, effectively containing the epidemic."

In the interview, Dr Dybul spoke of a new approach to international health and development efforts, which he called a "paradigm shift." Dr Dybul identified four cornerstones of this shift:

a switch by donors from a paternalistic approach to one involving partnerships with countries;

a focus on delivering measurable results;

a recognition that the traditional country-to-country approach was not effective, and that not only governments, but also civil society, faith-based groups and the private sector need to be involved; and

an intolerance of corruption.

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