Introduction
This essay will be focussed on evaluating the policy – Towards Zero – An action plan towards ending HIV transmission, AIDS and HIV-related deaths in England – 2022 to 2025 by using the Nancy Kass Framework. The prevalence of HIV or AIDs has been increasing on a worldwide basis (Gov 2023). According to the recent statistics, 106,890 people were living with HIV in 2019 and 95,900 people are living with HIV in England since 2021 (Suthar et al. 2021). The essay will include a brief of the policy first, followed by other assessment criteria.
The policy is about ending the transmission of HIV or AIDs, which causes a huge number of deaths per year in England. However, there has been a massive reduction in the number of deaths and this trend has to be continued. Therefore the policy intends to complete four specific objectives.
The objectives are focused on increasing equitable access and uptake of HIV prevention programmes, scale up HIV testing in line with the national guidelines, and optimize rapid access to treatment as well as retention in care followed by finally improving the life quality for people living with HIV followed by addressing stigma.
The policy based findings were good since it will lead to a reduction in the HIV transmission reduction. The essay will further evaluate the policy with Kass ethics framework and discuss whether every policy guideline was met according to the ethics framework or not. Finally, the essay will be summarized with its main findings in a conclusion section.
Policy Explanation
The HIV prevention programme based policy spanning from 2021 to 2024 has been developed by the Office for Health Improvement and Disparities (OHID). The policy intends to increase the awareness, uptake and accessibility in order to reduce disparity in HIV prevention efforts made in England. The policy further intends to use a multi-faceted approach by using HIV prevention campaigns, scaling up HIV PrEP and optimising rapid treatment as well as care services (Gov 2023). The policy finally intends to make campaigns, biomedical interventions, distribute condoms and develop innovative methods to increase their reach towards diverse demographics. Thus, the intentions of the policy are mainly related to reducing HIV transmission, increase awareness and address the mitigation of HIV related stigma by awareness and education campaigns.
The implementation of this policy involves a massive investment of more than £3.5 million. The policy supports PrEP through financial investment, evaluation, and monitoring of frameworks. However, the policy implementation is subjected to several conditions and challenges, which affect its preferences. Preferences include a specific focus on using evidence based approaches, local authority associations, and the development of unique models. On the other hand, conditions involve setting specific standards of testing rates, evaluation and monitoring the innovation effectiveness in care delivery.
However, there are several challenges of implementing this policy. These challenges include testing rate disparities based on demographics. Addressing stigma within healthcare settings, especially among the dark people (Africans) is also another challenge. In 2019, this policy has covered 65% of the HIV testing and therefore can be stated to be a significantly popular as well as effective in addressing the gaps. However, this policy also has some strengths as well as weaknesses (Gov 2023).
The strengths lie in the comprehensive approach in covering testing, treatment, prevention and well-being. A specific focus on evidence based strategies, innovative approaches and collaboration adds to the strength of the policy. Furthermore, the policy has been evaluated using the Nancy Kass ethics framework in the following section.
Ethical Framework
The purpose of an ethical framework is to assess whether the policy and its guidelines align with ethical values and principles. Evaluating public health policies is importance since it helps an individual to understand the efficacy, effectiveness and intervention equity aimed at the improvement of population health (Mastroianni et al. 2019). Moreover, effectiveness assessment includes impact on health outcomes, identification of best practices and challenges associated with the policy. Equity and social justice were observed to be associated with the policy and therefore it has to be evaluated too in order to understand the impact of the policy on reducing disparity. The selected framework for this public health policy evaluation is Nancy Kass framework (Morain et al. 2019). The framework was selected to evaluate the policy since it includes social value, scientific validity, fair subject selection, favourable risk benefit ratio, independent review and informed consent based assessment for policies. Therefore, the selection of this framework for the current policy assessment can be stated to be justified.
Applying the Ethical Framework to the Chosen Policy
The selected Nancy Kass framework has 6 specific steps –
1. What are the public health goals of the proposed program?
Answer – The goals have been observed to reduce morbidity and mortality. Early detection and treatment are associated with direct reduction of mortality associated with HIV as well as morbidity. If the disease is diagnosed at early stage, life span can be increased and immediately mortality can be reduced. Optimizing treatment access further reduces disparity in access to healthcare sectors (Bhaskaran et al. 2021). People from all sections from the society will get access to every healthcare service at an early stage. Finally, providing holistic support and ensuring well-being of the people can be stated to be beneficial in reducing morbidity and mortality associated with the disease.
2. How effective is the program in achieving its stated goals?
Answer – The program aims at achieving 90% testing rates in order to reduce HIV transmission. A specific focus on investing in HIV PrEP as well as improving access for specific populations is also a necessary step. Efforts for reduction for missed testing opportunities in high prevalence regions were aimed to address later HIV diagnosis (Otto et al. 2021). The program has been observed to be effective in increasing access to treatment.
3. What are the known or potential burdens of the program?
Answer – The potential burdens regarding privacy and confidentiality risk reduction includes testing data security, autonomy and liberty risks are associated with consent issues and justice risks are related to disparities in testing. Stigmatization is also a major burden of the program since it might face challenges in addressing discrimination of groups to participate in the program (Hiv 2020). Informed consent is a specific mitigation strategies to ensure testing and notification of partners on what test is to be conducted to reduce HIV transmission.
4. Can burdens be minimized? Are there alternative approaches?
Answer – The burdens can be minimised by increasing the reach of policy to a larger section of the society.
5. Is the program implemented fairly?
Answer – The programs has been implemented fairly. None of the groups face any burden and the program will decrease inequalities by reducing disparity. The program should be universal in reducing the prevalence of HIV on a worldwide basis and not only on England (van Sighem and van der Valk 2022). The programs will be better implemented if restrictive measures are proposed.
6. How can the benefits and burdens of a program be fairly balanced?
Answer – A balance will be automatically obtained where a higher burden associated with the program will produce higher benefits for the associated public.
Discussion
Through the utilization of independent assessments, stakeholder participation, and solutions based on evidence, the National HIV Prevention Programme shows its dedication to ethical considerations. The focus on improving partner notification, reducing late diagnosis probabilities, increasing testing rates, maximizing PrEP availability, and boosting the quality of life for HIV-positive individuals is consistent with the moral principles of beneficence, equality, and autonomy respect (Nichols and van der Valk 2021).
The paper outlines mitigation techniques and attracts attention to possible risks, including privacy problems and discrepancies in testing, in order to determine if the implementation has produced more benefit than damage. The program’s success in the context of any unintentional effects is left up for interpretation; as such harms are not specifically mentioned.
The overall success of the policy must be ascertained by carefully analyzing any unanticipated repercussions and how they affect people’s quality of life (Hanum et al. 2020). If the unintended consequences be substantial and compromise the objectives of the program, a policy change could be necessary.
It is imperative that policy changes are guided by ongoing monitoring, assessment, and stakeholder input in order to uphold ethical norms and maintain a fair balance between benefits and harms throughout time. In order to preserve the program’s ethical integrity and accomplish its fundamental objective of reducing novel HIV transmissions and enhancing public health outcomes, a dedication to continuous evaluation and improvement is essential.
Conclusion
On a concluding note, it can be stated that this article utilized the Nancy Kass Framework to assess the National HIV Prevention Programme in England. “Towards Zero,” , which is the strategy to reduce HIV transmission. The policy concentrates on the important objective of preventing HIV infection and deaths from AIDS. This policy also lays forth certain goals with an emphasis on treatment, prevention, testing, and enhancing the quality of life for HIV-positive individuals. The program’s conformity with the ethical precepts of beneficence, fairness, and respect for autonomy is highlighted by the ethical evaluation conducted using the Kass framework. The comprehensive approach and evidence-based tactics employed by the policy are noteworthy; nevertheless, ongoing focus is necessary to address possible difficulties related to privacy, autonomy, and justice. Reducing inequities, reducing stigma, and ensuring ongoing ethical review should be given top priority in future modifications in order to preserve the program’s effectiveness and ethical integrity.These aspects are crucial in the broader context of healthcare assignment discussions, particularly in understanding ethical policymaking and public health strategies.
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References
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