Back to Africa

I'm finally here. Bum in seat. On Tarmac at Heathrow. It is incredibly exciting to think that I have a place on the DTM&H, and one in Africa at that.

At present all I can think of is sleep, hoping I can get some Injera and veggies when I land in Addis, and that I'm not too tired when I finally get to Kilimanjaro tomorrow.

I've spent 5 weeks at 56 Dean Street and Chelsea and Westminster and loved every second.

We have had lively debates at work about PrEP, criminalisation and prevention strategies. PrEP is probably going to be one of the most significant public health interventions of all time for for this planet.

How we have progressed from a time when we feared the virus and there was little one could do, to when in the UK at least, we have several established clinics for the "older person" living with HIV as a manageable chronic condition. Most
of sub-Saharan Africa however has a shockingly high prevalence of HIV and relatively few treatment options.

One thing is for certain - we have got two, very different epidemics in Africa vs the "developed" world, and a "one size fits all" solution just won't work without taking these differences into account.

"Social medicine", or better put, "why certain people get ill from certain things", is going to be vital, and I believe that physicians must take on the role of asking those uncomfortable questions that make us feel awkward, and out of our comfort zones, if we are to truly understand and focus our efforts on succeeding where so many other prevention campaigns have failed.