[e-drug] Can we document experiences with PEPFAR please? (4)

["Elizabeth Gardiner" <egardiner.sln2003@london.edu>]

E-DRUG: Can we document experiences with PEPFAR please? (4)
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I am impressed by the statement and EPN's willingness to take a strong stance. 
 
Recognising that as a consultant I may be part of the problem, I would be interested to hear viable solutions to the skills and capacities point EPN has raised: "In its current form, the implementation of PEPFAR promotes extensive use of US skills and capacities (personnel and institutions) to the detriment of available local expertise with greater understanding of the issues in their local contexts."
 
My understanding is that most developing countries have realised that they do not have the personnel needed to manage comprehensive HIV/AIDS programmes. Training up doctors and other personnel will take years, while the demand for ARVs is now. 
 
In this light, EPN's stance that "PEPFAR should actively identify and involve local experts resident in the partner countries for the effective implementation of activities" seems a little over-simplified. What should PEPFAR or anyone else do when there are insufficient numbers of doctors, nurses and managers to implement the programmes?

Elizabeth Gardiner
International Health Consultant
London
UK
egardiner.sln2003@london.edu