Measuring HIV programs' impacts will improve return on investment, 'drive better performance'

Noting that Bill Gates, co-chair of the Bill & Melinda Gates Foundation, in his annual letter "argued that it is essential to carefully measure progress in innovation and global health," Stefano Bertozzi, director of HIV at the Gates Foundation, writes in a SciDev.Net opinion piece, "This is because while measuring the quantity of interventions is important, we also need to determine which interventions -- and which approaches to them -- create the greatest long-term impact." For example, "[i]nstead of just counting the numbers of individuals beginning treatment, we need to evaluate treatment centers by how many people are successfully retained in care and consistently take their medications," he writes, adding, "An even stronger approach would be to monitor whether HIV replication is suppressed in each patient."

"As new performance measures are introduced, it is critical to understand which ones provide the best return on investment -- that is, yield the greatest gains in health at the lowest cost," Bertozzi continues, noting, "This is a new area of focus that has been recognized by others, including the U.S. Institute of Medicine in its recent evaluation of [PEPFAR]." He concludes, "By measuring the right things, we can better gauge the effectiveness of our HIV response, drive better performance and ultimately save more lives" (3/14).