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Offers a critical analysis of the global governance of the HIV/AIDS epidemic. This book interrogates the role of the international system and provides a comparative regional analysis looking at the global debate from a holistic perspective. It is of interest to students and researchers of health, international politics and development.
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.
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Peter Piot, founding executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), recounts his experience as a clinician, scientist, and activist fighting the disease from its earliest manifestation to today. The AIDS pandemic was not only catastrophic to the health of millions worldwide but also fractured international relations, global access to new technologies, and public health policies in nations across the globe. As he struggled to get ahead of the disease, Piot found science does little good when it operates independently of politics and economics, and politics is worthless if it rejects scientific evidence and respect for human rights. Piot describes how the epidemic altered global attitudes toward sexuality, the character of the doctor-patient relationship, the influence of civil society in international relations, and traditional partisan divides. AIDS thrust health into national and international politics where, he argues, it rightly belongs. The global reaction to AIDS over the past decade is the positive result of this partnership, showing what can be achieved when science, politics, and policy converge on the ground. Yet it remains a fragile achievement, and Piot warns against complacency and the consequences of reduced investments. He refuses to accept a world in which high levels of HIV infection are the norm. Instead, he explains how to continue to reduce the incidence of the disease to minute levels through both prevention and treatment, until a vaccine is discovered.
AIDS, Sex, and Culture is a revealing examination of the impact the AIDS epidemic in Africa has had on women, based on the author's own extensive ethnographic research. based on the author's own story growing up in South Africa looks at the impact of social conservatism in the US on AIDS prevention programs discussion of the experiences of women in areas ranging from Durban in KwaZulu Natal to rural settlements in Namibia and Botswana includes a chapter written by Sibongile Mkhize at the University of KwaZulu Natal who tells the story of her own family’s struggle with AIDS
Brazil’s public policy response to the AIDS epidemic preceded those of many developing countries. During my tenure as President, in 1996, Brazil adopted a law guaranteeing free and universal access to AIDS treatment for all people living with HIV/AIDS. Brazil became the first developing country to provide publicly-financed AIDS treatment for all people living with HIV/AIDS. We now have one of the world’s most successful AIDS programs that is considered a model for other dev- oping countries. Today, 185,000 people receive life-saving AIDS cocktails in Brazil, and thousands of lives have been saved. But this was not an easy battle. There were many challenges along the way. Twenty years ago, Brazil’s achie- ments today might have seemed impossible. During the 1980s, in Brazil, as elsewhere, there was overwhelming stigma associated with AIDS; people living with HIV often lost their jobs and died quickly before the advent of life-saving antiretroviral drugs. Brazil’s AIDS movement was extraordinarily important in promoting progressive AIDS policies; associations of people living with HIV were the first to denounce pervasive AIDS-related discri- nation and called public attention to the importance of AIDS. Activists protested in the streets for over a decade, engaged the media, and framed AIDS as a human rights issue.
From their posts at the center of the pandemic - in the laboratory, the academy, clinics, and community based organizations - experts such as Evelynn Hammonds, Risa Denenberg, Michelle Murrain, and Paul Farmer criticize blind spots in the recognition and treatment of HIV in women and articulate accessible and practical solutions to specific areas of difficulty.
In this collection of essays, Lawrence O. Gostin, an internationally recognized scholar of AIDS law and policy, confronts the most pressing and controversial issues surrounding AIDS in America and around the world. He shows how HIV/AIDS affects the entire population--infected and uninfected--by influencing our social norms, our economy, and our country's role as a world leader. Now in the third decade of this pandemic, the nation and the world still fail to respond to the needs of persons living with HIV/AIDS and continue to tolerate injustice in their treatment, Gostin argues. AIDS, both in the United States and globally, deeply affects poor and marginalized populations, and many U.S. policies are based on conservative moral values rather than public health and social justice concerns. Gostin tackles the hard social, legal, political, and ethical issues of the HIV/AIDS pandemic: privacy and discrimination, travel and immigration, clinical trials and drug pricing, exclusion of HIV-infected health care workers, testing and treatment of pregnant women and infants, and needle-exchange programs. This book provides an inside account of AIDS policy debates together with incisive commentary. It is indispensable reading for advocates, scholars, health professionals, lawyers, and the concerned public.
Written by a leading expert in the field, this book provides a clear and incisive analysis of the different perspectives of the global response to HIV/AIDS, and the role of the different global institutions involved. The text highlights HIV/AIDS as an exceptional global epidemic in terms of the severity of its impact as a humanitarian tragedy of unprecedented proportion, its multi-dimensional characteristics, and its continuous evolution over more than two decades. The careful analysis in this volume critically reviews key issues in the global response, including: HIV/AIDS as a development challenge North-South power relationships and tensions international and regional partnerships between donor governments and recipient countries governance of global institutions and impact on the capacity of developing countries to respond effectively to the epidemic prevention versus treatment as options in HIV/AIDS services how to make the money work in support of effective AIDS financing. Providing a comprehensive but easy to read and compact overview of history, trends and impacts of HIV/AIDS and the global efforts to respond effectively this book is essential reading for all students of international relations, health studies and international organizations.
Why have governments responded to the HIV/AIDS pandemic in such different ways? During the past quarter century, international agencies and donors have disseminated vast resources and a set of best practice recommendations to policymakers around the globe. Yet the governments of developing countries in sub-Saharan Africa, Asia, Latin America, and the Caribbean continue to implement widely varying policies. Boundaries of Contagion is the first systematic, comparative analysis of the politics of HIV/AIDS. The book explores the political challenges of responding to a stigmatized condition, and identifies ethnic boundaries--the formal and informal institutions that divide societies--as a central influence on politics and policymaking. Evan Lieberman examines the ways in which risk and social competition get mapped onto well-institutionalized patterns of ethnic politics. Where strong ethnic boundaries fragment societies into groups, the politics of AIDS are more likely to involve blame and shame-avoidance tactics against segments of the population. In turn, government leaders of such countries respond far less aggressively to the epidemic. Lieberman's case studies of Brazil, South Africa, and India--three developing countries that face significant AIDS epidemics--are complemented by statistical analyses of the policy responses of Indian states and over seventy developing countries. The studies conclude that varied patterns of ethnic competition shape how governments respond to this devastating problem. The author considers the implications for governments and donors, and the increasing tendency to identify social problems in ethnic terms.