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In the mid-1990s, experts predicted that India would face the world's biggest AIDS epidemic by 2000. Though a crisis at this scale never fully materialized, global public health institutions, donors, and the Indian state initiated a massive effort to prevent it. HIV prevention programs channeled billions of dollars toward those groups designated as at-risk—sex workers and men who have sex with men. At Risk captures this unique moment in which these criminalized and marginalized groups reinvented their "at-risk" categorization and became central players in the crisis response. The AIDS crisis created a contradictory, conditional, and temporary opening for sex-worker and LGBTIQ activists to renegotiate citizenship and to make demands on the state. Working across India and Kenya, Gowri Vijayakumar provides a fine-grained account of the political struggles at the heart of the Indian AIDS response. These range from everyday articulations of sexual identity in activist organizations in Bangalore to new approaches to HIV prevention in Nairobi, where prevention strategies first introduced in India are adapted and circulate, as in the global AIDS field more broadly. Vijayakumar illuminates how the politics of gender, sexuality, and nationalism shape global crisis response. In so doing, she considers the precarious potential for social change in and after a crisis.
The disproportional loss of individuals to HIV/AIDS in their most productive years raises concerns over the welfare of surviving members of affected families and communities. One consequence of the rapid increase in adult mortality is the rise in the proportion of children who are orphaned. Sub-Saharan Africa, accounts for about 90 percent of these. Mainly due to the staggering toll of HIV/AIDS, research effort has focused on treatment and prevention. Children have received attention primarily in relation to 'mother to child transmission' and paediatric AIDS. These issues are important and compelling but fail to capture the whole story - the unprecedented surge in the number of children made vulnerable by HIV/AIDS. In this book we reflect on the plight of children classified as vulnerable, review interventions implemented to improve their welfare and grapple with the concept of vulnerability as it relates to human rights and the African child.
Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.
This report provides a comprehensive description of how AIDS community responses have been funded by international donors and in the process they have become key implementers of AIDS responses. However, the road map towards a more effective taking better advantage of the role that community responses
HIV/AIDS continues to take a tremendous toll on the populations of many countries, especially in sub-Saharan Africa. In some countries with high HIV prevalence rates, life expectancy has declined by more than a decade and in a few cases by more than two decades. Even in countries with HIV prevalence of around 5 percent (close to the average for sub-Saharan Africa), the epidemic can reverse gains in life expectancy and other health outcomes achieved over one or two decades. This volume highlights work conducted under the umbrella of a World Bank work program on “The Fiscal Dimension of HIV/AIDS,” including country studies on Botswana, South Africa, Swaziland, and Uganda. It covers four aspects of the fiscal dimensions of HIV/AIDS: First, it aims for a comprehensive analysis of the fiscal costs of HIV/AIDS, with a wider scope than a costing analysis focusing on only the policy response to HIV/AIDS. Second, it embeds the analysis of HIV/AIDS costs in a discussion of the fiscal context, and interprets these costs as a quasi-liability, not a debt de jure, but a political and fiscal commitment that binds fiscal resources in the future and cannot easily be changed, and very similar to a pension obligation or certain social grants or services. Third, it develops tools to assess the (fiscal dimensions of) trade-offs between HIV/AIDS policies and measures that take into account the persistence of these spending commitments. Fourth, most of the fiscal costs of HIV/AIDS are ultimately caused by new infections, and this study estimates the fiscal resources committed (or saved) by an additional (or prevented) HIV infection. Building on these estimates, the analysis here is able to assess the evolving fiscal burden of HIV/AIDS over time.
This manual is designed for health professionals working in high HIV and TB prevalence countries. It summarises the characteristics of both diseases and their interactions. It concentrates particularly on the problems of diagnosis and management both in adults and children and summarises the other HIV related illnesses the clinician might encounter.
"Entitled Together we will end AIDS, the new UNAIDS report contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. It highlights new scientific opportunities and social progress which are bringing the world closer to UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. The report also gives an overview of international and domestic HIV investments and the need for greater value for money and sustainability. Calling for global solidarity and shared responsibility, the UNAIDS report contains commentaries from global and community leaders as well as people living with and affected by HIV."--HTML home page.