#TIPHChat Question 4

[Emily]

Has this book challenged your viewpoints on HIV/AIDS, international aid, or public health in general?

[Jite]

This book has definitely challenged my view of how I see my work. I have an NGO background, so I’m one of those that Pisani says do boutique, specialized programs for a special relative few whilst the real health issues rage through the majority. It wasn’t easy to read that but upon reflection, I have to admit she is not entirely wrong. It is true that ideally more systemic health programs should bear the burden of health so that everyone has access to an effective basic minimum quality and standard of service. I look back on the projects I’ve worked in over the past few years and think of the long term impact. Yes, maybe my project had the desired outcome but to what extent did it contribute to systemic change. How are the population level statistics still as bad years later as they were before our intervention in a few communities? I think in my sector, we always pay lip service to sustainability through government partnership but this book made me realize how important that agency by the government or health management systems actually is. But I’m left with the question of how do you advocate for these systems to have that agency or political will or initiative when they’ve gotten by without it for years.