In Addressing HIV, the U.S. Has a Lot to Learn From Namibia

The health problems of millions of Americans are directly related to patients' failure to follow doctors’ orders. Community health workers are increasingly successful in New York and other American cities – not to substitute for doctors, but to help patients stick to their treatment plans.

Two columns on how Iran averted a major AIDS epidemic through needle exchange programs; a conservative theocracy is successfully treating drug abuse as if it were Amsterdam.

One-pill-a-day generic AIDS drugs for poor countries are hard to make because each ingredient is patented by a different pharmaceutical company. The Patent Pool provides a way for companies to donate their intellectual property safely.

To educate and prepare new mothers, Centering Pregnancy and Centering Parenting sites in the United States offer community-based patient-centered care in low-income areas. Centering offers interactive learning, check-ups, and social support, so that women can take charge of their health.

Latin American women in San Francisco have suffered from post-partum depression, social isolation, and chronic stress at the time of their pregnancies. Run by midwives, the Centering Pregnancy program at the San Francisco General Hospital provides patient-centered care, an environment to speak in Spanish, and a nurturing community for women’s group appointments. The results boast fewer c-sections and pre-term births, and an improvement in emotional support and overall prenatal health.

Post-traumatic stress has dire consequences for U.S. veterans, including an increase in suicide, and not all therapeutic treatments for the disorder have succeeded. To treat and potentially cure the effects of PTSD, the Center for Mind-Body Awareness offers veterans Buddhist-inspired meditation, and mindfulness, as well as skills to develop creative expression.

For decades, AIDS has taken the lives of millions of people and infected millions more worldwide. The key to reducing the effect of AIDS, and even potentially curing it, involves treating patients as early as possible after being diagnosed with HIV, before the disease damages organs. San Francisco General Hospital developed the RAPID program for this purpose, with the goal of “Getting to Zero” the number of new infections and deaths.

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

Two columns on how Iran is treating its massive epidemic of injecting drug use by tackling it as a health problem, effectively lowering H.I.V. rates among drug users using an approach to drugs known as harm reduction.

In a mountainous region of Lesotho, a man named Tsepo Kotelo visits 20 villages every week on his new motorcycle to provide health care to local villagers. The Elton John AIDS Foundation gifted the motorcycles to Kotelo and his colleagues, allowing them to increase the number of patients they visit by 600 percent. An organization called Riders for Health helps maintain the bikes, ensuring that remote villages will continue to receive medical care.