July 20, 2016

What Got Us Here, Won’t Get Us There

Written by Nina Hasen, HIV and TB Director, Population Services International (PSI)

This post originally appeared on PSI Impact. Reposted with permission.

We’re going to hear a lot of debate about the HIV response as we converge at AIDS 2016 in Durban. Should we keep scaling treatment or focus more on prevention? Should we focus resources on the biggest epidemics for the biggest impact, or work for more equity across the globe?

And we’ll hear a lot of questions. How do we do a better job reaching the people most affected by the epidemic, whether they are girls and young women, sexually active men, sex workers or people who inject drugs?

There’s a problem with this scenario. These questions are the same ones we’ve been asking for almost 16 years, but the world is rapidly changing. Some facts to consider:

Number of internet users in Kenya in 2000: 220,000

Number of internet users in Kenya in 2016: 19,600,000

Percent of adults with a cell phone in South Africa 2002: 33%

Percent of adults with a cell phone in South Africa 2014: 89%

Rural versus urban in Tanzania in 2000: 78/22

Rural versus urban in Tanzania in 2016: 68/32

I have a friend who works for a young, very successful marketing company. Plastered all over this company’s offices is the phrase “what got us here, won’t get us there.” This company understands that whatever they did to get to the success they are experiencing today probably won’t be what makes them successful tomorrow. The world is changing too quickly for that. So they’ve infused their corporate culture with the expectation that they change, too. And everyone who works for them understands, “if I want to succeed I have to challenge my assumptions every day.”

At PSI, we’re changing our thinking about the HIV epidemic, too. We know what made us successful in the past — distributing billions of condoms, testing millions of people, providing millions of male circumcisions — won’t be what gets us to impact in the future.

We think this assumption — that what got us here, won’t get us there — is one the HIV community should adopt along with us. Instead of debating “treatment versus prevention,” let’s ask new questions, like “What is the role of the private sector in bringing new people to HIV services?” Instead of debating “impact versus equity,” let’s ask “How can we use technology and creativity to build smarter, more efficient HIV services for everyone, everywhere?”

Back in 2000, we could barely imagine a world where 1 million people in developing countries would be on treatment and now that number tops 17 million. It’s time for new, bigger leaps of imagination to take us forward. Leap with us. Let’s get there.