- Email: [email protected]
Does the world need another AIDS authority? – Author's reply
Correspondence
to harmonise best international practices and minimise the proliferation of different approaches. At the same time, countries are heterogeneous, and WHO guidelines—although useful as general guidance for clinicians in the field— are intended mainly for national HIV/AIDS programme managers and policy-makers. Because country-level adaptation of global guidelines is essential to ensure that they reflect local laws, resources, and practices, WHO and UNAIDS work closely with countries in such adaptation processes and also provide support for advocacy, policy development, training, resource mobilisation, and monitoring and assessment of HIV/AIDS programmes. WHO acknowledges the need to package its products effectively and is reviewing its website to ensure that HIV/AIDS guidelines and other tools, policy documents, and information products are more accessible. We believe that statistics and technical guidance from WHO and UNAIDS have been important for the global scale-up of HIV prevention, treatment, care, and support. Nevertheless, the HIV/AIDS field is too large and dynamic for any one organisation to claim a monopoly over information or guidance, and we welcome new contributions to it. See Series page 2001
*Kevin M De Cock, Purnima Mane [email protected] Director, Department of HIV/AIDS, WHO, CH-1211 Geneva, Switzerland (KMDC); Director, Policy, Evidence and Partnerships, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland (PM) 1 2
3
4
e-mail submissions to [email protected]
1960
Billingham D. Does the world need another AIDS authority? Lancet 2006; 368: 1639–40. WHO. Antiretroviral therapy for HIV infection in adults and adolescents in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006. WHO. Antiretroviral therapy for HIV infection in infants and children in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006.
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WHO. Guidelines on co-trimoxazole prophylaxis for HIV-related infections among children, adolescents and adults in resourcelimited settings: recommendations for a public health approach. Geneva: World Health Organization, 2006.
Author’s reply Angela Obasi and David Tovey write that Delon Human “is not part of the BMJ Knowledge team and does not speak on their behalf”. I apologise for failing to appreciate this. In email interviews with me, Human gave the impression that he did have an association with the project and at no point was it made clear to me that he did not. However, in my World Report I clearly attributed all of Human’s views and quotes to him personally. Obasi and Tovey also write that my report gave a “grave misrepresentation” of Tovey’s views. However, I have an email from Tovey in which he remarks that the way “WHO and other groups” collate their evidence “leaves them open to criticism” and thereafter discusses the strength of his project’s evidencegathering. I did not state any more or less than this in my report. I never stated that Tovey himself had personally criticised WHO or UNAIDS. Obasi and Tovey state that their reviews were never meant to be guidelines in themselves but to influence future guidelines. This is quite true and my original copy reflected this fact. Unfortunately, editing within the news agency for which I work, and prior to submission to The Lancet, altered the sense of the piece. For this I can only apologise. Obasi and Tovey also state that I suggested that they support a call for a new single HIV/AIDS authority. I did not mean to imply a single authority in the organisational sense, but a single source of authoritative information. This could have been made slightly clearer in my report and The Lancet’s choice of headline was unfortunate in this regard. I understand why Kevin De Cock and Purnima Mane might be feeling
aggrieved at the criticism directed towards WHO and UNAIDS. These criticisms were not my own view however, and were directly attributed to Delon Human. It is clear that my report could have been more balanced. This was difficult, however, given the strict word-limit imposed. I received quotes from the BMJ team on why they thought their method was superior, and included them in my draft. They were then (with hindsight regrettably) edited out. I hope that WHO and UNAIDS do not feel undermined by my report. It was never my intention nor, I believe, that of Human, to criticise unnecessarily the work of the organisations. The intention was rather to highlight areas where they could improve their effectiveness, and I am proud that I felt able to raise these issues.
Dan Billingham [email protected] Kastnergasse 9/22, A-1170 Vienna, Austria
Centers for Disease Control and Prevention and authorship We write to clarify the circumstances referred to in the Editorial “Reviving reproductive health” (Nov 4, p 1549)1 regarding the US Centers for Disease Control and Prevention (CDC) review of the article “Global control of sexually transmitted infections”.2 With every article submitted for scientific clearance, CDC follows a rigorous peer-review process to ensure that scientific communications authored or coauthored by our scientists make clear distinctions between science and opinion. We do this so that recommendations about health protection and disease prevention are based on scientific evidence. Our peer review of this article concluded that the line between science and opinion was blurred. We recommended that the opinion be www.thelancet.com Vol 368 December 2, 2006
to harmonise best international practices and minimise the proliferation of different approaches. At the same time, countries are heterogeneous, and WHO guidelines—although useful as general guidance for clinicians in the field— are intended mainly for national HIV/AIDS programme managers and policy-makers. Because country-level adaptation of global guidelines is essential to ensure that they reflect local laws, resources, and practices, WHO and UNAIDS work closely with countries in such adaptation processes and also provide support for advocacy, policy development, training, resource mobilisation, and monitoring and assessment of HIV/AIDS programmes. WHO acknowledges the need to package its products effectively and is reviewing its website to ensure that HIV/AIDS guidelines and other tools, policy documents, and information products are more accessible. We believe that statistics and technical guidance from WHO and UNAIDS have been important for the global scale-up of HIV prevention, treatment, care, and support. Nevertheless, the HIV/AIDS field is too large and dynamic for any one organisation to claim a monopoly over information or guidance, and we welcome new contributions to it. See Series page 2001
*Kevin M De Cock, Purnima Mane [email protected] Director, Department of HIV/AIDS, WHO, CH-1211 Geneva, Switzerland (KMDC); Director, Policy, Evidence and Partnerships, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland (PM) 1 2
3
4
e-mail submissions to [email protected]
1960
Billingham D. Does the world need another AIDS authority? Lancet 2006; 368: 1639–40. WHO. Antiretroviral therapy for HIV infection in adults and adolescents in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006. WHO. Antiretroviral therapy for HIV infection in infants and children in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva: World Health Organization, 2006.
5
WHO. Guidelines on co-trimoxazole prophylaxis for HIV-related infections among children, adolescents and adults in resourcelimited settings: recommendations for a public health approach. Geneva: World Health Organization, 2006.
Author’s reply Angela Obasi and David Tovey write that Delon Human “is not part of the BMJ Knowledge team and does not speak on their behalf”. I apologise for failing to appreciate this. In email interviews with me, Human gave the impression that he did have an association with the project and at no point was it made clear to me that he did not. However, in my World Report I clearly attributed all of Human’s views and quotes to him personally. Obasi and Tovey also write that my report gave a “grave misrepresentation” of Tovey’s views. However, I have an email from Tovey in which he remarks that the way “WHO and other groups” collate their evidence “leaves them open to criticism” and thereafter discusses the strength of his project’s evidencegathering. I did not state any more or less than this in my report. I never stated that Tovey himself had personally criticised WHO or UNAIDS. Obasi and Tovey state that their reviews were never meant to be guidelines in themselves but to influence future guidelines. This is quite true and my original copy reflected this fact. Unfortunately, editing within the news agency for which I work, and prior to submission to The Lancet, altered the sense of the piece. For this I can only apologise. Obasi and Tovey also state that I suggested that they support a call for a new single HIV/AIDS authority. I did not mean to imply a single authority in the organisational sense, but a single source of authoritative information. This could have been made slightly clearer in my report and The Lancet’s choice of headline was unfortunate in this regard. I understand why Kevin De Cock and Purnima Mane might be feeling
aggrieved at the criticism directed towards WHO and UNAIDS. These criticisms were not my own view however, and were directly attributed to Delon Human. It is clear that my report could have been more balanced. This was difficult, however, given the strict word-limit imposed. I received quotes from the BMJ team on why they thought their method was superior, and included them in my draft. They were then (with hindsight regrettably) edited out. I hope that WHO and UNAIDS do not feel undermined by my report. It was never my intention nor, I believe, that of Human, to criticise unnecessarily the work of the organisations. The intention was rather to highlight areas where they could improve their effectiveness, and I am proud that I felt able to raise these issues.
Dan Billingham [email protected] Kastnergasse 9/22, A-1170 Vienna, Austria
Centers for Disease Control and Prevention and authorship We write to clarify the circumstances referred to in the Editorial “Reviving reproductive health” (Nov 4, p 1549)1 regarding the US Centers for Disease Control and Prevention (CDC) review of the article “Global control of sexually transmitted infections”.2 With every article submitted for scientific clearance, CDC follows a rigorous peer-review process to ensure that scientific communications authored or coauthored by our scientists make clear distinctions between science and opinion. We do this so that recommendations about health protection and disease prevention are based on scientific evidence. Our peer review of this article concluded that the line between science and opinion was blurred. We recommended that the opinion be www.thelancet.com Vol 368 December 2, 2006