It has been over 30 years since the first cases of “Slim” started appearing in men and women from the villages dispersed near the border of Uganda and Tanzania. Since then, the world has made progress- “Slim” was recognized as the Human Immunodeficiency Virus, the progression of HIV to AIDS was more clearly understood, the science behind HIV transmission dispelled xenophobic notions (for the most part), antiretroviral therapy was discovered and is improving, researchers have demonstrated a functional cure via stem cell transplant, and the results of a recent multinational trial presented at the 2011 Intl. AIDS Society Conference have finally confirmed the highly effective duality of treatment as prevention. The statistics reflect these advances- nearly 50% of ARV eligible people now have access to treatment, in 2010 there were only 1.8 million AIDS-related deaths as compared to 2.2 million in 2005, and there has been a 15% reduction in new infections per year over the last decade, with 22 African countries now reporting incidence rates which are 25% lower than in 2001 (UNAIDS World AIDS Day Report 2011).
In the global health arena, the 21stcentury has seen an unprecedented growth in the role of the non-governmental organization (NGO). High school, undergraduate and graduate students in the U.S. are increasingly volunteering and researching with international NGOs, particularly in developing countries, with some students even having created their own U.S. based NGOs which primarily function abroad.
Most international health NGOs tend to focus on very particular problems and diseases that are neglected or under-addressed by the larger health system. In this way, NGOs are serving as patchwork solutions to underlying problems with healthcare infrastructure. I have personally worked for several US-based and international NGOs providing services in Africa, India, and Latin America and continue to be struck by the dichotomy between NGOs and the local government with regards to development initiatives.