Reaching global HIV/AIDS goals: What got us here, won't get us there.

In a Perspective, Wafaa El-Sadr and colleagues discuss tailored approaches to treatment and prevention of HIV infection

Framework for achievement of HIV epidemic control.

<p>Framework for achievement of HIV epidemic control.</p

Modeling the epidemiological impact and cost-effectiveness of a combined schoolgirl HPV vaccination and cervical cancer screening program among Chinese women

Human papillomavirus (HPV) infection is common in women and also the main cause of cervical cancer. Based on a dynamic compartmental model, we aimed to evaluate the population impact and cost-effectiveness of strategies that combined cervical cancer screening and HPV schoolgirl vaccination for Chinese women. The effectiveness of interventions was assessed by comparing modeled scenarios to the status quo, where a 3-y cervical cancer screening program remained at a 20% coverage and without a universal HPV vaccination program. Our study demonstrated that increasing screening coverage from 20% to 50% would reduce the high-risk HPV (HR-HPV) prevalence to 5.4%, whereas a universal schoolgirl vaccination program using the quadrivalent vaccine (qHPV) with a coverage of 50% would reduce the prevalence to 2.9% by 2069. Scaling-up the cervical screening coverage to 50% will prevent 16,012 (95% CI: 8,791 to 25,913) Disability-Adjusted Life-Years (DALYs) per year, with an incremental cost-effectiveness ratio (ICER) of US$10,958 (95$169 to $26,973)/DALY prevented. At the current qHPV price, vaccinating 50$ 83,043, 95% CI: $52,234 to$138,025) exceeds cost-effectiveness threshold (i.e., 3 times GDP per-capita of China: $30,792). The qHPV vaccine requires at least a 50% price reduction to be cost-effective. Vaccinating schoolgirls will result in a large population health benefit in the long term, but such a universal HPV vaccination program can only be cost-effective with a substantial price reduction

Global health systems: what will it take to deliver on the promise of health for all?

The health of communities around the world is influenced not only by their disease burden, but by local, regional, and global health systems, which have a profound impact on health promotion and the response to health threats. A focus on health system strengthening has been noted as critical to achieving the goals of global health enabling effective implementation of services and ensuring their ustainability. This chapter describes the various components of health systems and their role in ensuring the health of individuals and populations. It also highlights the interconnectedness of each of the health system “building blocks” including: clinical service delivery, governance and leadership, health financing, human resources for health, laboratory systems, commodities and procurement systems, health information systems (HIS), and community engagement