Threat to the Global AIDS Response and the Future of Global Health

Globally recognized infectious disease expert Salim Abdool Karim, MB, ChB, CAPRISA Professor for Global Health in the Department of Epidemiology at Columbia University Mailman School of Public Health, is an author on two Perspectives published this week in the New England Journal of Medicine. The piece titled “Threatening the Future of Global Health NIH Policy Changes on International Research Collaborations,” details a new policy that grants the NIH oversight responsibility for all sub-award recipients’ data and documentation to support research outcomes, sending a message to grantees that the NIH does not trust scientists in other countries to follow responsible research practices. Abdool Karim and colleagues make the point that granting NIH the right to examine these documents as part of its oversight responsibilities disrespects the scientific autonomy of international partners and may lead to a politicization of collaborations that are currently working well. They further believe that these excessive demands threaten to reverse progress and damage the reputation of NIH as a global health leader.

The second article, titled “Threatening the Global AIDS Response—Obstacles to PEPFAR’s Reauthorization,” describes the authors’ concerns that with PEPFAR’s authorization ending this month and without a solid plan for extending the program for the next 5 years, there are profound implications for the public health care infrastructure in the U.S. and globally. Additionally, without PEPFAR’s support for HIV treatment and prevention in more than 50 countries where AIDS remains a problem, there is little chance of reaching the global 2030 goal of ending HIV/AIDS as a Public Health Threat, a target of the Sustainable Development Goals of the United Nations. Abdool Karim also points out that some members of the U.S. Congress want to apply the “global gag rule” regarding abortion to the President’s Emergency Plan for AIDS Relief, further jeopardizing this essential global AIDS control program.

In addition to his professorship at Columbia Mailman School, Abdool Karim is Director of the Centre for the AIDS Program of Research in South Africa (CAPRISA), Pro Vice-Chancellor (Research) at the University of KwaZulu-Natal in Durban, South Africa, and adjunct professor of Medicine at Weill Medical College of Cornell University.

His contributions to microbicides for HIV prevention span two decades and culminated in the CAPRISA 004 tenofovir gel trial which provided proof-of-concept that antiretroviral drugs can prevent sexually transmitted HIV infection and herpes simplex virus type 2 in women. He is co-inventor on patents that have been used in several HIV vaccine candidates and his clinical research on TB-HIV treatment has shaped international guidelines on the clinical management of co-infected patients.

Abdool Karim is chair of the UNAIDS Scientific Expert Panel, Chair of the WHO's HIV and Hepatitis Scientific and Technical Advisory Group and a member of the WHO HIV-TB Task Force. He is an elected Fellow of the World Academy of Sciences, the African Academy of Sciences, the Academy of Science in South Africa, the Royal Society of South Africa and the American Academy of Microbiology. He is a Foreign Associate Member of the U.S. National Academy of Medicine and serves on the boards of NEJM, the Lancet-Global Health, Lancet-HIV, and the Journal of AIDS.