The world now faces the next step in HIV management. We are in an era beyond treatment and viral suppression. The widespread roll out of antiretroviral treatment and good HIV testing programmes within pregnancy might substantially change vertical transmission rates globally. Lifelong treatment and innovations, such as those financed by the Global Fund, provide a pathway— indeed a lifeline—for s...

This article examines the possibilities for health care reform in the 111th Congress. It uses a simple model of policy making to analyze the failure of Congress to pass the Clinton health plan in 1993-1994. It concludes that the factors that created gridlock in the 103rd Congress are likely to have a similar impact in the present.

It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership an...

Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy...