Twenty-first century leadership for public health and HIV/STI prevention

Abstract

As we enter the second decade of the twenty-first century, the epidemic spread of HIV and other sexually transmitted infections (STI) presents severe and pervasive challenges for public health [1]. With more than 33 million people infected with HIV globally, and more than 45 million acquiring new STIs annually, the resultant morbidity and mortality associated with undiagnosed or untreated disease are major public health concerns in developed and developing country settings [2]. Accompanying this growing and substantial disease burden are concerns about the ability and capacity of existing public health systems to meet current and future needs. Among the many challenges facing HIV and STI prevention programs is the complex and evolving nature of the available interventions which need to be selected, targeted, combined, and implemented by a range of community, clinical, programmatic, and policy participants [3]. Unlike the clinical workforce that is well defined with clear accreditation systems, the boundaries of the HIV/STI prevention workforce are not always well defined. This absence of uniformity affects the strategic positioning and accountability of HIV/STI prevention programs at the national and local levels, as well as the coordination, consistency, and quality of HIV/STI prevention services [4].