The National AIDS Trust (NAT) is a UK charity dedicated to transforming society's response to HIV. They have promoted effective HIV prevention, especially pre-exposure prophylaxis (PrEP). However, the National Health Service in England recently decided to discontinue work providing PrEP. This document discusses writing a commentary for the Journal of the International AIDS Society arguing that providing PrEP is important for preventing the rise of new HIV infections in the UK. Key stakeholders that must be considered include individuals at risk for HIV, healthcare providers, Public Health England, and Gilead Sciences, which produces the PrEP drug Truvada.

1. The fight for Pre-Exposure Prophylaxis in the United Kingdom.
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The Client: The National AIDS Trust (NAT) is the United
Kingdom's leading charity dedicated to transforming society's
response to HIV (NAT, 2016). Founded in 1987, NAT has spent
over 20 years promoting public health through effective HIV
prevention and early diagnosis of HIV infection, especially
when it comes to pre-exposure prophylaxis.
Problem Statement: What can be done to combat the recent
decision by the National Health Service (NHS) in England to
abandon its work to provide PrEP?
Stakeholders:
The National Health Service in England: Sets the priorities and
direction of the NHS and encourages/informs the national
debate to improve health and care (NHS, 2016). NHS England
recently decided to discontinue 18 months of work which
demonstrated the need, efficacy, and cost-effectiveness of PrEP.
Individuals at risk for HIV: The number and rate of new
diagnoses of HIV is continuing to rise in eastern Europe, and is
also rising sharply in central Europe (NAM, 2015)
Healthcare providers: As the incidence rates of HIV continue to
increase, health care providers are going to find it increasingly
more difficult to help these individuals without new treatments.
Public Health England: Has funded research to prove the
efficacy of PrEP.
Taxpayers: Many fear funding of further research into PrEP will
come out of their own pockets.
Gilead Sciences, Inc.: The pharmaceutical company responsible
for developing Truvada, a known PrEP drug.
Journal:

2. The Journal of the International AIDS Society (JIAS) was
founded in 2004 by the International AIDS Society as a
platform to disseminate essential HIV research with the mission
to contribute to evidence-based response to the HIV epidemic
and to support research capacity building in resource-limited
settings (JIAS, 2016).
JIAS has the following requirements for submitting commentary
articles (focused and opinionated articles on important and
timely issues). All information has been taking from the JIAS
Author Guidelines resource page:
Headings: Introduction, Discussion, Conclusions.
Work Limit: 2500 words.
Abstract Limit: 350 words.
Numbers of figures and tables: 1.
Additional Files: No.
Citation Style: All external sources of information should be
referenced within the text, tables and figures, and using
consecutive numbering in square brackets, e.g. [1], [3-5], [3,4].
Numbers of references are unlimited and should be formatted in
standard Vancouver style. Unpublished observations, personal
communications, and manuscripts currently under consideration
should be cited in the test in round brackets and not in the
reference list.
Link to Sample References:
http://www.nlm.nih.gov/bsd/uniform_requirements.html
Link to Author's Guide:
http://www.jiasociety.org/index.php/jias/about/submissions#onli
neSubmissions
Reference:
"About NHS England." NHS England. N.p., 2016. Web. 12 June
2016. <http://www.england.nhs.uk/about/>
"Journal History." Journal of the International AIDS Society.
The International AIDS Society. 2016. Web. 12 June 2016.
<http://www.jiasociety.org/index.php/jias/about/history>.
"Who We Are." NAT. National AIDS Trust Corp., 2016. Web.
12 June 2016. <http://www.nat.org.uk/About-us/Who-we-

3. are.aspx>.
"UK Maintains the Largest HIV Epidemic in Western
Europe." HIV & AIDS Information. NAM Publications, 15 Dec.
2015. Web. 12 June 2016. <http://www.aidsmap.com/UK-
maintains-the-largest-HIV-epidemic-in-western-
Europe/page/3021724/>.
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· Assignment Description
Policy Analysis and Commentary
For this assignment, you will be required to write a brief
commentary to a journal of your choice discussing the pros and
cons of a particular health policy issue of interest to you and
offering a recommendation based on your research and analysis
about the particular issue. Choose a topic that will push you to
take strong positions. Select a topic that you CARE about.
Consider both intervention and prevention programs. Your
analysis should be accurate, timely, meaningful, and have an
impact factor. Ask the questions: 1) why should the person
reading this actually care about this issue?, 2) is a realistic
solution suggested?
The format will vary depending on the journal you decide to
submit the commentary to. In general the final document will
include a description of the problem, some statements about
different solution options that can be used to address the
problem, and a recommendation drawing on evidence that exists
in the literature related to your issue for the best way to solve
the problem.
The analysis must represent the interests of a specific client
(special interest group executive director, government official,
CEO, etc.) and your reading audience. The solution must be

4. realistic. The issue (problem) must be worthy of being placed
high on the public agenda. Your objective is to present a
problem and then you will offer several alternative choices for
addressing the problem after researching solution options. Your
goal is to come up with one preferred option through the
process of policy analysis. After presentation of the
alternatives, you will suggest a final recommendation.
There is no need to reinvent the wheel to develop your section
for policy options... rely on research. Borrow (cite original
source) language from current policy. Read the mission
statement of "your client". Find historical precedents. Locate
policies in the pipeline and adopt relevant language for your
proposal (citing resources, of course). “Real world” policy
proposals, pending and accepted legislation, and official plans
illustrate what could be accomplished. Generate a list of
legislation (if present) that passed and bills that died. Look for
already developed guidelines, regulations, or programs. Look
for new and developing alternatives currently in the
“pipeline”:identify policies in the pipeline (proposed, rejected,
accepted in other geographic areas). Consider areas for
compromise. Consider the possible consequences of action as
well as the possible consequences of inaction. Remember that
“do nothing” can be an alternative.
Think about your policy options and the positive and negative
aspects of each option according to criteria (cost, legal
issues, political feasibility, etc.) that your client would specify
as important. Dollars won't fix a problem ... but lack of dollars
can limit opportunity to fix a problem. Seeing the $$$
distribution indicates public priorities and placement on the
public agenda. Generally, you will find that funding and
awareness activities will increase if the subject rises on the
public agenda ... not the other way around. Money (by itself) is
NOT a solution. Increasing awareness (by itself) is NOT a
solution. The solution (policy) must help to resolve the issue
(problem).
The Final Product component of the Policy Proposal Project is

5. an individual effort. Your PPP Final Product will evolve while
you work independently on your concept. Change elements
(and wording) as you see a need for modification. The policy
proposal will be refined and modified through scheduled Step
assignments as the semester progresses. Policy creation is a
process. It requires time. Expect to research, revise, rethink,
compromise, and revise some more when preparing a policy
proposal. Rather than be concerned about your grade be
inspired to excellence. It takes a few times to revise a
publication-ready manuscript.
Adhering to all of the journal’s requirements for authors is
required. Try and keep references limited to recent journals.
The length of your final manuscript will vary but your final
product is to be 8 - 13 pages or a minimum of 1000 words
should be submitted for the final assignment unless the journal
you select requires less words for commentaries. If you need to
go over 13 pages, that is all right but make sure that the extra
pages are justified. Please do not go over 15 pages. You
decide on how much information (and how many pages) to
devote to each section. Focus on necessary content. You would
be surprised at how much you can cut out and how you can
tighten and solidify your writing. And remember, don't lose
sight of your client and the actual problem statement.
Acceptance for publication to the journal is not a requirement.
A main goal of this assignment is to provide the experience of
writing for a journal. Acceptance of your manuscript for
publication is a bonus. Follow up and revise your work if the
journal asks you to resubmit the article. If you need help with a
revision after the end of the semester, the professor will be
available to provide feedback. Please let me know when you
are published.
· Post a best effort, rough draft version to the DB.
REVISE: Expect detailed feedback and suggestions for
modifications because this process requires multiple revisions

6. as you refine your thinking.
· The PPP Step assignments are supposed to reflect a
progressive learning process.
· Do not expect "correct" on the first attempts.
PARTICIPATION: Peer comments are required. You can
expect detailed feedback and suggestions for modifications.
· The PPP Step assignments are intended to be a learning
process and I am looking for a good faith effort. Learn from
each other as changes are made on the subsequent PPP Step
assignments. I hope you gain insights BECAUSE of the need
for revisions and corrections. Review each others work and my
comments on the PPP Step assignments. Ongoing revisions,
modifications, and changes are encouraged. Look for new
posts to the most recent Step assignments. Add your thoughts
... and expect to see my thoughts.
"The only thing" that you want to post is what you are asked to
complete: client, revised problem statement, a few stakeholders,
and your journal selection.
Answer the following questions for PPP Step 2:
1. Modify and revise (if necessary): Who is your client?
2. Improve the wording (as needed) of your problem statement.
3. Identify some of the key stakeholders whose positions and
concerns must be understood before a well-informed decision
can be made. Consider the politics and who has the power.
Be specific and list 4 to 6 significant stakeholders (individuals,
interest groups, etc.).
· Note: The List of Stakeholders should contain at least one
descriptive sentence for each of those stakeholders.
4. Select a peer-reviewed journal.
· Name the journal and provide a very brief description of its
purpose.
· Include a brief summary of the selected journal's basic
requirements for publication (word length, format, etc.). Also,
include the citation style required by the journal and a link to
the citation style if the journal has it’s own approach to

7. citations.
· Include a link to the Author's Guide.
1
Healthcare Policy Analysis 1
SMPP 6290
Policy Proposal Project
Samples: Client & Problem Statement
Client: Virginia Academy of Family Physicians
Problem Statement:
As more EHR applications become applicable on mobile devices
and data
exchange is encouraged how will our hospitals protect patient
information?
Client: New Jersey Association of Mental Health and Addiction
Agencies
Problem Statement: What is in the best interest of the mental
health consumers
with regard to access for services and wait time?
CLIENT: The Truth About Gardasil.org
PROBLEM STATEMENT: Does a public health necessity exist
to justify the HPV

8. vaccine be mandated?
The Client-West Virginia Rural Health Association
Problem Statement: What can be done to increase rural West
Virginia patients‘
access to specialty healthcare?
Client: Massachusetts Correctional Legal Services, a legal
advocacy group
whose priority is medical and mental healthcare in the state and
county prison
system
Problem Statement: Should end of life care for prisoners model
that of the
larger community, affording patients the right to die “at home”
in dignity, free of
pain, and with the freedom of knowing that the natural dying
process will not be
interfered with when death is deemed imminent?
Client: The American Society of Transplantation (AST)
Problem Statement: Should living organ donors (both current
and prospective
donors) obtain comprehensive and affordable health care
coverage protecting a
donor from insurance discrimination?
CLIENT: Maryland Public Secondary Schools Athletic
Association Concussion
Task Force
PROBLEM STATEMENT: Does return to play authorization by
unlicensed
healthcare providers place student-athletes at risk?
Client: American Ambulance Association
Problem Statement: How can we see continuous improvement in

9. the paramedic
skills that will be needed for healthcare needs in the future?
Client: NAMI (National Alliance on Mental Illness)
2
Problem Statement: What can be done to decrease the negative
stigma
regarding mental health illness in the military?
Client: California Emergency Physicians Medical Group
Problem statement: What steps can be taken to reduce over
crowding in
hospital emergency departments?
Client: Massachusetts Pharmaceutical Association
Problem Statement: Should we utilize pharmacists to reduce
healthcare
expenditures through employer-based offerings?