Our Work With the Center for Strategic and International Studies (CSIS)
CIGH’s Sara Allinder previously served as Executive Director and Senior Fellow at the Global Health Policy Center (GHPC) at the Center for Strategic and International Studies (CSIS). She continues to be affiliated with GHPC as a non-resident Senior Associate. During her four years at CSIS, Sara led GHPC’s HIV portfolio and supported activities on nutrition, other infectious diseases, global health security, and women’s and family health. In addition to authoring or contributing to a number of publications, she moderated public events and was a frequent host of CSIS’s Take as Directed and AIDS 2020 podcasts.
Under Sara’s tenure, CSIS’s HIV portfolio focused on opportunities for continued U.S. leadership on global HIV; the importance of keeping HIV prevention, especially for adolescent girls and young women, a central priority; the need to address human rights and other vulnerabilities that affect HIV infection risk and service access; innovation in new technology, service delivery, and programs; hyperepidemics of HIV; and other critical issues affecting global and country-level HIV responses.
U.S. Global HIV Leadership
In May 2020, Sara published “Challenges to Continued U.S. Leadership Ahead of Global HIV’s Next Phase” with Maggie McCarten-Gibbs, CSIS GHPC HIV Program Manager. Concerted, well-financed, and targeted action is needed now to sustain progress against HIV, mitigate the threats posed by COVID-19, and get on track to end HIV as a public health threat by 2030. The policy brief explores the challenges facing progress toward the UNAIDS Fast Track goals and the leadership needed from the U.S. government to be successful in the HIV response’s next phase.
In 2017, Sara led an HIV Working Group to consider the landscape of global HIV and the legacy U.S. leadership and put forward thoughtful policy analysis for the incoming presidential administration and new congressional members and staff. Under Sara’s direction, the working group and several sub-groups produced a series of papers on the PEPFAR-Global Fund relationship, country ownership, and adolescent girls and young women, as well as country studies on Malawi, Thailand, and Cambodia. Sara authored several of the papers, including the chapeau piece, “Opportunities for U.S. Leadership at Its Moment of Reckoning on Global HIV,” which was published in September 2017.
On one of the first Take as Directed podcast episodes, released February 10, 2017, Sara hosted Ambassador Deborah Birx who reflected on PEPFAR’s achievements and priorities.
Hyper HIV Epidemics
In July 2018, Sara co-hosted a private discussion in Amsterdam during the AIDS 2018 conference on the issue of hyper-endemic HIV epidemics – those with more than 15 percent adult prevalence. Her co-hosts included Dr. Quarraisha Abdool Karim, the Centre for the AIDS Programme of Research in South Africa (CAPRISA); Tom LaSalvia, then at the End AIDS Coalition; Dr. Mark Dybul, Georgetown University Center for Global Health Practice and Impact; Dr. Mark Feinberg, the International AIDS Vaccine Initiative (IAVI); Mitchell Warren, AVAC; and Dawn Averitt, Women’s Research Initiative on HIV/AIDS. The discussion, which focused on South Africa’s KwaZulu-Natal province as a hyperepidemic example, highlighted the need for a radical change in approach to addressing these entrenched epidemics.
Sara launched a research project later in 2018 to delve into the situation in South Africa, understand why progress against HIV seems to be stuck, and highlight efforts to break the pattern. The research project included a February 2019 visit to South Africa with GHPC Senior Associate Janet Fleischman and culminated in several products, including an April 2019 commentary co-authored with Janet, “The World’s Largest HIV Epidemic in Crisis: HIV in South Africa”. Sara published a full report, “South Africa’s Future at the Brink: Emergency in the World’s Largest HIV Epidemic” in April 2020, along with an interactive online version, “The World’s Largest HIV Epidemic”. In addition, Sara, J. Stephen Morrison, and Andrew Schwartz discussed the ongoing challenges in South Africa in an AIDS 2020 podcast episode released on September 26, 2019, “South Africa’s Epidemic: Too Big to Fail?”.
In October 2019, Sara and Maggie McCarten-Gibbs published “The Evolution and Future of HIV Prevention Technology: An HIV Policy Primer.” Over the last almost four decades, many prevention strategies and tools have been utilized to try to stymie the spread of HIV, with moderate success. The arsenal of prevention tools and approaches used over that period has enabled many gains; however, prevention programs have faced a variety of structural barriers even as new tools have come to market, including inadequate financing, regulatory and guideline obstacles, and inefficient delivery of health services. The brief explores these issues as well as the current opportunity to address critical implementation challenges for prevention tools with several novel HIV prevention tools at different stages of development.
Sara and Maggie launched the brief at a public session at CSIS on October 22, 2019, on “Improving Access to Innovative HIV Technology”, which featured a fireside chat with Deborah Waterhouse, CEO of ViiV Healthcare. Sara moderated a panel discussion with Ambassador Deborah Birx; Charles Lyons, President and CEO, Elizabeth Glaser Pediatric AIDS Foundation; and Mitchell Warren. Sara also hosted a AIDS 2020 podcast episode with Deborah Waterhouse on “Innovative Technologies to End HIV”, released on December 19, 2019.
In a Take as Directed podcast episode, released on May 3, 2018, Sara spoke with IAVI’s Mark Feinberg about “Pursuing a Vaccine for HIV”.
Human rights have been part and parcel of the global response to the HIV/AIDS pandemic since the illness was discovered in 1981. Due to stigma and discrimination faced by those infected or affected by the virus in the earliest days and the high burden of the disease on often-marginalized populations, it has never been possible to speak about addressing HIV/AIDS without also discussing the human rights issues that help fuel the spread of the disease 40 years on. Sara has highlighted human rights as critical to the success of the global HIV response in several commentaries and papers. Most recently, her piece, “Addressing Human Rights Is Inherent to Success against HIV Worldwide”, was featured in the September 2019 CSIS compendium, “Human Rights in a Shifting Landscape: Recommendations for Congress” led by Amy K. Lehr, Director of the CSIS Human Rights Initiative. Sara’s commentaries on human rights and HIV include “Addressing Human Rights Is Central to U.S. Leadership on Global HIV”, published November 30, 2018, and “End of AIDS Requires Addressing LGBTI Safety, published June 29, 2016.
Global Health Program Integration
Integration of global health programs as a concept and programmatic approach has been building momentum over the last 10 years. While large-scale integration of HIV with other health areas has yet to be proven as a successful endeavor in donor-funded programs, there is growing interest in demonstrating the efficiency and effectiveness of combining resources and capacity for greater impact. The idea has gained steam as worldwide resources for global health have waned since 2015 and demands for more patient-centered care have grown. Sara explored the idea of global health integration in several projects at CSIS, including a nutrition-focused research trip to Uganda, which culminated in “Improving Nutrition in East Africa’s Bread Basket: U.S. Government Nutrition Investments in Uganda”, published in October 2018.
In addition, she was a member of the secretariat for the CSIS Women’s and Family Health Task Force, which put forward a recommendation for a mid-level U.S. government initiative targeting an important population: adolescent girls and young women (ages 10–24) – not a single disease or global health challenge – in 13 countries. “The proposed approach takes full advantage of global health and related development investments in each country to target the special needs of adolescent girls and young women. That means systematically leveraging the DREAMS partnership (active in six of the target countries); its platforms offer exceptional opportunities for incorporating the initiative’s core health and development activities. It means tapping existing health investments in family planning and reproductive health; maternal, newborn, and child health; immunizations; and nutrition. It means taking full advantage of PEPFAR’s major capacities; investments in primary and secondary education; evolving work in food security; and programs to strengthen women’s empowerment, address gender-based violence, and prevent child marriage.” Sara was lead writer for the nutrition and governance sections of the final report, “HER HEALTH, HER LIFETIME, OUR WORLD, Unlocking the Potential of Adolescent Girls and Young Women,” published in March 2017.