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Offline: AIDS is not zero sum
Comment
Offline: AIDS is not zero sum
LSHTM
How do you take over an organisation at its historical peak? With great and unenviable difficulty. The London School of Hygiene and Tropical Medicine is seeking a new Director. Andy Haines is stepping down after an outstanding decade of leadership. The School is one of the world’s premier institutions in global health—and certainly the UK’s greatest. It is now at a critical juncture. It is a much debated question as to whether the School can continue to exist as an independent institution or whether it must connect itself to a similarly great and geographically close university. Global predicaments in health demand multidisciplinary solutions. How should the School widen its disciplinary base? There is an emerging clutch of strong and surprising internal and external candidates, in the UK and overseas. This appointment matters.
Corbis
*
Reuters
The printed journal includes an image merely for illustration
In 1910 Abraham Flexner published his utterly iconoclastic report on medical education in the US and Canada. The impact was astonishing and reverberated in medical schools across the world. He made the case for science as an axial part of the medical curriculum. And he killed the apprenticeship model of medical training, replacing it with an academic foundation. These twin reforms cut a path to the creation of the modern academic medical centre, which itself ushered in a flourishing new era of scientific discovery. It is appropriate then that there will be a 21st century Flexner report in this centenary year. A commission chaired by Julio Frenk and Lincoln Chen is examining the future of health professional education. It is due to report its findings later this year. They have big shoes to fill. But the predicaments facing professional education this century are no less serious than those which troubled Flexner one hundred years ago. Something equally radical is needed. *
Corbis
At a meeting recently about the future of the AIDS epidemic—to plan a report that we hope to publish later this year—a sharp division emerged among HIV scientists about whether the AIDS community should be optimistic or pessimistic about its prospects. The optimists wanted to present a “can-do” picture: the money invested into AIDS has been worthwhile 624
and without it there would have been a human catastrophe. The pessimists preferred to err on the side of anxiety: needs are increasing, funding is threatened, political will is weak. Which is the best approach to win greater public support for increased financing of AIDS programmes? Disagreement. There was also general depression that some in global health see AIDS as suddenly unfashionable. HIV may have had its day. Now it’s the turn of maternal, newborn, and child health—or climate change. It’s certainly right, at a moment of economic instability, to be cautious and concerned about the future of AIDS support. But the unprecedented international response to AIDS—and the benefits that response has delivered to global health overall—should not be minimised by those who do not work in AIDS. Just as the AIDS community needs to jettison its attachment to exceptionalism, so the wider world of global health needs to embrace AIDS as an ally in efforts to secure a stronger place for itself on the development agenda. It’s not either/or. It’s not zero sum. * The Paul Bowles revival, part 2. He wrote four novels. The last, Up Above The World (1966), he called “an entertainment” (it was a psychological murder mystery). Still, there are illuminating clues to Bowles’ own attitudes to life to be found here. He lived as free of commitment as possible in order to have the maximum liberty to act on sudden decisions. He always sought to observe and react to his surroundings as though he were seeing everything for the first time. And, as a long-time resident and student of Morocco, he resisted universalist ideas of development and progress imposed on parts of the world by the West. As one of his characters in Up Above The World remarks, “but what does the term ‘human rights’ mean? The American idea is based completely on the fact that Americans have always had more than their share… Put them in the same position as the rest of the people in the world, and they’ll understand soon enough that what they’ve had so far have been only privileges, not rights.” Richard Horton, The Lancet, London NW1 7BY, UK www.thelancet.com Vol 375 February 20, 2010
Offline: AIDS is not zero sum
LSHTM
How do you take over an organisation at its historical peak? With great and unenviable difficulty. The London School of Hygiene and Tropical Medicine is seeking a new Director. Andy Haines is stepping down after an outstanding decade of leadership. The School is one of the world’s premier institutions in global health—and certainly the UK’s greatest. It is now at a critical juncture. It is a much debated question as to whether the School can continue to exist as an independent institution or whether it must connect itself to a similarly great and geographically close university. Global predicaments in health demand multidisciplinary solutions. How should the School widen its disciplinary base? There is an emerging clutch of strong and surprising internal and external candidates, in the UK and overseas. This appointment matters.
Corbis
*
Reuters
The printed journal includes an image merely for illustration
In 1910 Abraham Flexner published his utterly iconoclastic report on medical education in the US and Canada. The impact was astonishing and reverberated in medical schools across the world. He made the case for science as an axial part of the medical curriculum. And he killed the apprenticeship model of medical training, replacing it with an academic foundation. These twin reforms cut a path to the creation of the modern academic medical centre, which itself ushered in a flourishing new era of scientific discovery. It is appropriate then that there will be a 21st century Flexner report in this centenary year. A commission chaired by Julio Frenk and Lincoln Chen is examining the future of health professional education. It is due to report its findings later this year. They have big shoes to fill. But the predicaments facing professional education this century are no less serious than those which troubled Flexner one hundred years ago. Something equally radical is needed. *
Corbis
At a meeting recently about the future of the AIDS epidemic—to plan a report that we hope to publish later this year—a sharp division emerged among HIV scientists about whether the AIDS community should be optimistic or pessimistic about its prospects. The optimists wanted to present a “can-do” picture: the money invested into AIDS has been worthwhile 624
and without it there would have been a human catastrophe. The pessimists preferred to err on the side of anxiety: needs are increasing, funding is threatened, political will is weak. Which is the best approach to win greater public support for increased financing of AIDS programmes? Disagreement. There was also general depression that some in global health see AIDS as suddenly unfashionable. HIV may have had its day. Now it’s the turn of maternal, newborn, and child health—or climate change. It’s certainly right, at a moment of economic instability, to be cautious and concerned about the future of AIDS support. But the unprecedented international response to AIDS—and the benefits that response has delivered to global health overall—should not be minimised by those who do not work in AIDS. Just as the AIDS community needs to jettison its attachment to exceptionalism, so the wider world of global health needs to embrace AIDS as an ally in efforts to secure a stronger place for itself on the development agenda. It’s not either/or. It’s not zero sum. * The Paul Bowles revival, part 2. He wrote four novels. The last, Up Above The World (1966), he called “an entertainment” (it was a psychological murder mystery). Still, there are illuminating clues to Bowles’ own attitudes to life to be found here. He lived as free of commitment as possible in order to have the maximum liberty to act on sudden decisions. He always sought to observe and react to his surroundings as though he were seeing everything for the first time. And, as a long-time resident and student of Morocco, he resisted universalist ideas of development and progress imposed on parts of the world by the West. As one of his characters in Up Above The World remarks, “but what does the term ‘human rights’ mean? The American idea is based completely on the fact that Americans have always had more than their share… Put them in the same position as the rest of the people in the world, and they’ll understand soon enough that what they’ve had so far have been only privileges, not rights.” Richard Horton, The Lancet, London NW1 7BY, UK www.thelancet.com Vol 375 February 20, 2010