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An estimated forty million people carry the human immunodeficiency virus (HIV), and five million more become newly infected annually. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected individuals live in the poorest regions of the world, where ART is virtually nonexistent. The consequent death toll in these regionsâ€"especially sub-Saharan Africaâ€"is begetting economic and social collapse. To inform the multiple efforts underway to deploy antiretroviral drugs in resource-poor settings, the Institute of Medicine committee was asked to conduct an independent review and assessment of rapid scale-up ART programs. It was also asked to identify the components of effective implementation programs. At the heart of the committee's report lie five imperatives: Immediately introduce and scale up ART programs in resource-poor settings. Devise strategies to ensure high levels of patient adherence to complicated treatment regimens. Rapidly address human-resource shortages to avoid the failure of program implementation. Continuously monitor and evaluate the programs to form the most effective guidelines and treatment regimens for each population. Prepare to sustain ART for decades.
This Open Access volume provides in-depth analysis of the wide range of ethical issues associated with drug-resistant infectious diseases. Antimicrobial resistance (AMR) is widely recognized to be one of the greatest threats to global public health in coming decades; and it has thus become a major topic of discussion among leading bioethicists and scholars from related disciplines including economics, epidemiology, law, and political theory. Topics covered in this volume include responsible use of antimicrobials; control of multi-resistant hospital-acquired infections; privacy and data collection; antibiotic use in childhood and at the end of life; agricultural and veterinary sources of resistance; resistant HIV, tuberculosis, and malaria; mandatory treatment; and trade-offs between current and future generations. As the first book focused on ethical issues associated with drug resistance, it makes a timely contribution to debates regarding practice and policy that are of crucial importance to global public health in the 21st century.
AIDS on the Agenda is written for policymakers, managers, and program staff in development and humanitarian agencies, to promote debate about the challenges that confront them in a world which has been changed for ever by the pandemic of AIDS. The book considers three possible responses to the problem: * Do nothing. * Try to specialize in direct AIDS work. * Adapt core programs and internal systems to respond to the impact of AIDS. The author argues for the third approach as the essential initial response. She shows how mainstream work in a wide range of sectors e" including food security, livelihoods support, education, health promotion, and emergency provision of water and sanitation e" can be modified to reduce susceptibility to HIV infection and vulnerability to the impacts of AIDS. She also offers practical advice on modifying personnel and financial systems to protect the interests of staff and the viability of organizations when operating in AIDS-prone contexts. The text is based on case studies drawn from the experiences of three agencies (ActionAid, Oxfam International, and Save the Children UK) and their partners; and on insights contributed by a wide range of other organizations. The problems inherent in the e~mainstreaminge(tm) approach are dealt with frankly and constructively. The comprehensive Resources section offers user-friendly guidance on the following topics: * Researching and predicting the internal impacts of AIDS * Assessing the impacts of AIDS education and awareness-raising * Drafting a workplace policy * Monitoring the impact of AIDS and of internal mainstreaming * Training for mainstreaming AIDS in development and humanitarian work * Undertaking community research for mainstreaming AIDS in development and humanitarian work * Adapting organizational systems
Advocacy and investment on behalf of children affected by AIDS have had an impact, and the goal of eliminating mother-to-child transmission of HIV appears within reach. But for every problem solved or advance made, new challenges and constraints have arisen. This Children and AIDS: Fifth Stocktaking Report examines current data, trends and the progress that s been made - pointing out disparities in access, coverage and outcomes - and calls for concrete actions to benefit the millions of children, women and families worldwide who bear the burden of the epidemic.