In One Simple Tool, Hope for H.I.V. Prevention

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.

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.

PrePex, a new nonsurgical circumcision tool, could revolutionize the prevention of H.I.V. and AIDS in sub-Saharan Africa. Cheap and easy to assemble, the device has proven successful in several randomized trials.

Two Iranian brothers worked as doctors to reform how Iran tackles HIV, moving the country toward the harm reduction approach. By providing clean needles and methadone, the doctors were able to lower infection rates, even in prisons.

The Jaipur Limb organization based in India has developed prostheses at low cost, and services are free for the poor. The organization’s efforts have recently spread to other countries with impoverished people. Jaipur Limb reaches patients through branch clinics, traveling workshops, and limb camps in cities around the world.

A prosthetist from Texas visiting Jaipur Limb workshops in Honduras saw problems with their low-cost prosthetics - the issue wasn't the design of the leg, but the technicians at the Honduras workshops were people completely new to prosthetics who were given just eight weeks of training. Thanks to his research, Jaipur established a research and development unit to improve the limb.

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.