Science Policy News
Speaking Out and Reaching Out on
Global Health Policy—
The Case of HIV/AIDS
For this month’s column, I’m pleased to introduce guest columnist
Roger Hoerl of GE, who will lay out his ideas for how statisticians can
and should make contributions to health policy. If you would like to be
considered as a guest columnist, please contact Steve Pierson, pierson@
amstat.org with your idea and a detailed outline.
HIV. In fact, AIDS is currently the leading
cause of death for U.S. African-American
women between the ages of 25 and 34.
cated within countries? How should deci-
What does this have to do with the ASA
sions be made about balancing funding for
or statisticians? To answer that question, let
AIDS relief with funding to fight malaria,
me review a few figures. According to the
dysentery, or other preventable diseases?
latest UNAIDS estimate, the number of
Surely, accurate data on the extent of HIV
people currently living with HIV globally is
infection is critical to sound decisionmak-
33.2 million, with an “uncertainty interval”
ing and public policy.
(not a formal statistical confidence interval)
There are a number of other AIDS pol-
of 30.6–36.1 million. However, the esti-
icy issues being hotly debated in the pub-
Roger W. Hoerl, GE Global Research
mate from the 2006 report was 39.5 mil-
lic arena for which our objective, scientific
lion infected, with an uncertainty interval
input could provide guidance. For brevity,
of 34.7–47.1 million. The 2007 point esti-
I will list only a few.
mate was outside the uncertainty interval of
Estimating the impact on HIV
T
hroughout the years, numerous ASA the previous year, with the significant drop
infection of providing/not providing
leaders have called for expanded in infections not being explained by deaths
needle exchange programs for
efforts by the ASA and individual versus new infections. The 2007 uncertain-
intravenous drug users
statisticians for making a greater impact on ty interval also does not include the 2006
public policy (See the links at www.amstat. point estimate. This awkward situation
Estimating the impact on HIV
org/scipolicy). One of the most critical areas suggests a methodology issue. My point is
infection of distributing/not
for such influence is global heath. not to be critical of UNAIDS, but rather
distributing condoms in prisons
While tremendous advances are being to highlight the difficulty in estimating the
Providing scientific evidence
made in medical technology, millions of number of people living with HIV.
of the relative effectiveness of
people continue to die from preventable One might ask if the accuracy of these different prevention strategies,
diseases each year. Governments and non- estimates matters. The U.S. House recently
including abstinence promotion,
government organizations (NGOs) are pro- passed a bill to reauthorize the President’s
condom distribution, and various
viding billions of dollars to address these Emergency Plan for AIDS Relief with $50
educational programs
issues, and while some progress is being billion over the next five years. Organizations
While ASA members are already active
made, millions continue to die unnecessari- such as the Gates Foundation; the World
in these areas, especially in the clinical tri-
ly. For example, about 2 million people died Health Organization; and the Global Fund
als of new anti-retroviral (ARV) drugs or
of AIDS-related illnesses last year, leaving to Fight AIDS, Tuberculosis, and Malaria
potential HIV vaccines, I believe we can
behind millions of AIDS orphans. While also apportion billions of dollars to AIDS
speak out and reach out more.
Africa remains the epicenter of the AIDS relief. How can such significant funds be
I became involved in AIDS policy issues
pandemic, millions in China, India, Russia, allocated between countries to have the
during a six-month sabbatical from GE
and even the United States are infected with greatest impact? How should they be allo-
Global Research in 2007 that I used to study
JULY 2008 AMSTAT NEWS 31
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