As the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) grows and matures, it is adopting an implementation science framework to improve the development and effectiveness of its program at all levels. PEPFAR’s plans for systematic application of an implementation science framework is outlined in an article in the Journal of Acquired Immune Deficiency Syndrome by Global AIDS Coordinator Dr. Eric Goosby and other colleagues, including Fogarty’s Rob Lyerla, currently detailed to the Office of the Global AIDS Coordinator.
Implementation science is the study of methods to improve the uptake, implementation and translation of research findings into routine and common practices, sometimes referred to as the “know-do” or “evidence-to-program” gap. PEPFAR, active in over 32 countries, is designed to implement programs that deliver locally appropriate and evidence-based HIV prevention, care and treatment in the developing world in order to save as many lives as possible. Evaluation of individual interventions of care and treatment are useful, but not sufficient when attempting to assess programs as complex as PEPFAR.
The authors describe an implementation science framework to be used that includes monitoring and evaluation, operations research and impact evaluation, which should provide a broader framework for a full assessment of both the effectiveness and efficiency of programs.
In the next phase of PEPFAR, emphasis will be placed on the delivery of knowledge about HIV/AIDS program implementation to the global community. An implementation science framework will permit identification of high-priority implementation questions and development of tools to provide the answers.