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By Tim Horn

Maximizing HIV, tuberculosis (TB), and viral hepatitis outcomes depends on the availability of state-of-the-art diagnostic and prognostic tools, engagement in expert and supportive care, and access to safe and effective drugs. Numerous technical barriers to these core components of health and survival exist, such as failures to maintain or improve healthcare infrastructure and capacity building, inadequate funding commitments, bureaucracy and corruption, and corporate rapacity, all of which are priorities for Treatment Action Group and its advocacy partners.

But it’s not simply about advancing good global health policies. It’s also about pushing for good global policies for health, notably those that take aim at the larger social, political, and economic conditions that exacerbate disparities and inequities among those living with, and at risk for, HIV, TB, and viral hepatitis. In this issue of TAGline, several TAG staff members call out some of the most critical social and structural challenges that we continue to face in ending these pandemics.

We begin with an edited transcript of Mike Frick’s thought-provoking presentation at the International AIDS Society TB2016 conference held in Durban in July. In “Science and Solidarity,” Frick demonstrates how human rights can be harnessed to advance TB research and the benefits of this research to all people with TB. While Frick argues that governments bear a great deal of responsibility for ensuring that scientific progress is upheld as a human right, Erica Lessem and the University of Chicago Law School’s Brian Citro add in “Who’s Responsible? Pharma’s Obligations Under the Right to Science” that the private sector—notably the drug industry—is also obligated to respect, protect, and fulfill public health needs.

In “Countering the Contagion of Racism Through Resistance,” Suraj Madoori sheds light on an often unacknowledged part of the HIV and TB movements: the history of Black activism and mobilization to construct the reality of these epidemics through data, organizing, and engaging with political structures to shift resources. The Tuskegee Syphilis experiment and the resulting health disparities and mistrust of biomedicine among African Americans is the focus of Kenyon Farrow’s “Beyond Tuskegee,” but with an emphasis on the need to reframe the consequences of history as opportunities to create educational, advocacy, and funding opportunities to address ongoing healthcare engagement challenges.

TAG’s new HCV Project Co-Directors Annette Gaudino and Bryn Gay explore two critical components of global efforts to end the viral hepatitis pandemics. In “Decriminalization is a Public Health Strategy,” Gaudino argues that the war on drugs and the resulting high rates of incarceration are the antithesis of effective strategies for combatting hepatitis C. Against the backdrop of the recent approval of the first single-tablet direct-acting antiviral regimen active against all HCV genotypes, Gay emphasizes the need for conscientious solidarity among countries of the global South, as well as across countries in the North and South, to make universal access to low-cost generic formulations a reality.

We conclude with Jeremiah Johnson’s “Toward Health Equity,” an appraisal of under-representation in the US’s response to the HIV epidemic, notably the absence of transgender women in surveillance and intervention data-collection efforts and the dearth of both transgender women and gay and bisexual men of color in positions of stakeholder leadership and high-level engagement.

The sum of these parts is clear: recognizing and addressing the root causes, longstanding inequalities, and power imbalances that contribute to health injustices is essential If we are to respond effectively to the disparities of these
life-threatening diseases.•

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