Corruption and health 5: why is it difficult to accelerate the end of the HIV/AIDS epidemic?

Abstract

Introduction: The quantity of resources mobilized to combat HIV/AIDS is unprecedented in the history of public health; however, the epidemic is not stopping due to inefficiencies, fraud, and corruption. Objective: To analyze why the epidemic persists despite scientific progress and the billion-dollar global mobilization of resources, and to develop recommendations and a roadmap for moving forward. Method: A literature review is conducted, and three cases are selected to illustrate the impact of corruption on the response against HIV/AIDS. Three executive experiences of the Author in international technical and financial assistance agencies are analyzed. A situation analysis is performed, and barriers and challenges are identified. Results: Eighteen recommendations are developed to transform the situation and achieve greater efficiency and impact, pointing out that unless ethical, moral, human, universal, or Christian values are restored, dehumanization, indifference, arrogance, greed, selfishness, and impudence replace the discernment between good and bad, right and wrong, just and unjust, what works and what does not work; therefore, a lack of honesty, responsibility, and integrity prevails among personnel responsible for institutions, health systems, and HIV/AIDS programs. Conclusions: The health of the poor and vulnerable population will not significantly improve, nor will the goals for HIV/AIDS prevention and treatment be met or the end of the epidemic accelerated, as long as individual, group, institutional, systemic, structural, political, and social conditions persist that favor and benefit from inefficiency, fraud, and corruption.