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Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Globally, action to prevent HIV spread is inadequate. Over 16,000 new infections occur every day. Yet we are not helpless in the face of disaster, as shown by the rich prevention experience analyzed in this valuable new compendium. “Best pr- tice” exists—a set of tried and tested ways of slowing the spread of HIV, of persuading and enabling people to protect themselves and others from the virus. Individually, features of best practice can be found almost everywhere. The tragedy, on a world scale, is that prevention is spotty, not comprehensive; the measures are not being applied on anywhere near the scale needed, or with the right focus or synergy. The national response may concentrate solely on sex workers, for example. Elsewhere, efforts may go into school education for the young, but ignore the risks and vulnerability of men who have sex with men. Action may be patchy geographically. AIDS prevention may not benefit from adequate commitment from all parts and sectors of society, compromising the sustainability of the response. In some countries matters are still worse—there is still hardly any action at all against AIDS and scarcely any effort to make HIV visible. It is no wonder that the epidemic is still emerging and in some places is altogether out of control.
This is not another book about how AIDS is out of control in Africa and Third World nations, or one complaining about the inadequacy of secured funds to fight the pandemic. The author looks objectively at countries that have succeeded in reducing HIV infection rates...along with a worrisome flip side to the progress. The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs—stressing increased monogamy and delayed sexual activity for young people—have made the greatest headway in fighting or preventing the disease's spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results. As National Review journalist Rod Dreher put it, Rather than pay for clinics, gadgets and medical procedures—especially in the important earlier years of its response to the epidemic—Uganda mobilized human resources. In a New York Times interview, Green cited evidence that partner reduction, promoted as mutual faithfulness, is the single most effective way of reducing the spread of AIDS. That deceptively simple solution is not merely about medical advances or condom use. It is about the ABC model: Abstain, Be faithful, and use Condoms if A and B are impossible. Yet deeply rooted Western biases have obstructed the effectiveness of AIDS prevention. Many Western scientists have attacked the ABC approach as impossible and moralistic. Some Western activists and HIV carriers have been outraged, thinking the approach passes moral judgment on their behaviors. But there is also a troubling suspicion among a growing number of scientists who support the ABC model that certain opponents may simply be AIDS profiteers, more interested in protecting their incomes than battling the disease. This book is a bellwether in the escalating controversy, offering persuasive evidence in support of the ABC approach and exposing the fallacies and motivations of its opponents.
AIDS in the World, Vol. 1, published in 1992, was the first full analysis of mankind's global confrontation with this disease. The AIDS scene, however, has been changing so rapidly that the need for a second volume was felt much earlier than expected. In AIDS in the World II, the authors extend the international comparisons from 38 countries to the entire world, and show that the AIDS pandemic has become increasingly fragmented within the world population. They present data that takes the discussion beyond the current understanding of the vulnerability of nations and communities to the worldwide spread of HIV, engaging in a detailed exploration of the social strategies that have enabled individuals to avoid infection. Mann and Tarantola chart a course into the future based on an incisive investigation of the global pandemic and response, the crucial lessons learned from the first decade, and their expert understanding of the scientific and social dimensions of the HIV challenge. The authors explain how the variety of reactions to the pandemic has contributed to a more advanced awareness of our vulnerability to HIV/AIDS, and offer a blueprint for an expanded global prevention effort. Intended to serve the information needs of all professionals involved in AIDS research and care, this volume's accessibility and clarity of writing make it highly suitable for the general reader as well.
This is not another book about how AIDS is out of control in Africa and Third World nations, or one complaining about the inadequacy of secured funds to fight the pandemic. The author looks objectively at countries that have succeeded in reducing HIV infection rates...along with a worrisome flip side to the progress. The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs—stressing increased monogamy and delayed sexual activity for young people—have made the greatest headway in fighting or preventing the disease's spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results. As National Review journalist Rod Dreher put it, Rather than pay for clinics, gadgets and medical procedures—especially in the important earlier years of its response to the epidemic—Uganda mobilized human resources. In a New York Times interview, Green cited evidence that partner reduction, promoted as mutual faithfulness, is the single most effective way of reducing the spread of AIDS. That deceptively simple solution is not merely about medical advances or condom use. It is about the ABC model: Abstain, Be faithful, and use Condoms if A and B are impossible. Yet deeply rooted Western biases have obstructed the effectiveness of AIDS prevention. Many Western scientists have attacked the ABC approach as impossible and moralistic. Some Western activists and HIV carriers have been outraged, thinking the approach passes moral judgment on their behaviors. But there is also a troubling suspicion among a growing number of scientists who support the ABC model that certain opponents may simply be AIDS profiteers, more interested in protecting their incomes than battling the disease. This book is a bellwether in the escalating controversy, offering persuasive evidence in support of the ABC approach and exposing the fallacies and motivations of its opponents.
Ideological blinders have led to millions of preventable AIDS deaths in Africa. Dr. Edward C. Green, former director of the Harvard AIDS Prevention Project, describes how Western AIDS “experts” stubbornly pursued ineffective remedies and sabotaged the most successful AIDS prevention program on that ravaged continent. Drawing on 30 years of conducting research in Africa, Southeast Asia, and other parts of the world in international health, Green offers a set of evidence-based and experience-rich solutions to the AIDS crisis. He calls for new emphasis on promoting sexual fidelity, the only strategy shown by research to work. Controversial but important findings for health researchers, international development specialists, and policy makers.