Global Institutions And The Hiv Aids Epidemic

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.

This book addresses conflicts and institutional changes of global health governance in the fight against HIV and AIDS.

This revised and updated edition of the pathbreaking report on the global AIDS epidemic outlines the strategic role that government must play in slowing the spread of HIV and mitigating the impact of AIDS. Drawing on the knowledge accumulated in the 17 years since the virus that causes AIDS was first identified, the report highlights policies that are most likely to be effective in managing the epidemic. These include early actions to minimize the spread of the virus, aiming preventive interventions at high risk groups, and evaluating measures that would assist households affected by AIDS according to the same standards applied to other health issues. This revised edition will a valuable resource for public health, policymakers, researchers, and anyone with an interest in this devastating global health crisis.

We began to research for this book in 2000, with the idea that we might contribute to the search for solutions to the global HIV/AIDS pandemic by c- bining perspectives from different disciplines. Much has happened in the interv- ing years. First, the severity of the HIV/AIDS pandemic in sub-Saharan Africa – and the threat it posed for many others regions of the world – led to a movement among several countries to correct the imbalance between producers and users of ph- maceutical products. This effort produced a clarification of the right of gove- ments to produce generic medicine under compulsory licenses and an amendment of the World Trade Organization’s TRIPS Agreement to allow exports of generic medicines from one WTO Member to another. In 2007, the amended rules were put into practice, with Canada authorizing the export of generic antiretroviral drugs to Rwanda. However, at the same time, global patent laws have been undermined due to regulatory capture, most notably in free trade agreements and through political pressure on countries like Thailand to not to exercise their right to issue compulsory licenses for pharmaceutical products. Second, the amount of money available for the treatment and prevention of HIV/AIDS has increased dramatically, with the establishment of the World Bank Multi-Country HIV/AIDS Program for Africa (MAP), the Global Fund to Fight AIDS, Tuberculosis and Malaria and the US President’s Emergency Plan for AIDS Relief (PEPFAR), among other funding initiatives.

The governance of the HIV/AIDS pandemic has come to represent a multi-faceted and complex operation in which the World Bank has set and sustained the global agenda for by the World Bank. The governance of HIV/ AIDS. Through economic incentive they have restructured the is a political foundations of countries in sub-Saharan Africa and the pursuit of change in state, project that seeks to embed liberal practice through individual, state, and societal community behaviour. At the heart of this practice is the drive to impose blueprint neoliberal market-based solutions on a personal-global issue. This book unravels how the Bank’s good governance agenda and commitment to participation, ownership and transparency manifests itself in practice, through the Multi-Country AIDS Program (MAP), and crucially how it is pushing an agenda that sees a shift in both global health interventions and state configuration in sub-Saharan Africa. The book considers the mechanisms used by the Bank – and the problems therein – to engage the state, civil society and the individual in responding to the HIV/AIDS crisis, and how these mechanisms have been exported to other global projects such as the Global Fund and UNAIDS. Harman argues in conclusion that not only has the Bank set the global agenda for HIV/AIDS, but underpinning this is a wider commitment to liberal governance reform through neoliberal incentive. Making an important contribution to our understanding of global governance and international politics, this book will be of interest to students and scholars of politics, international political economy, international relations, development studies and civil society.

This book examines the global governance of the HIV/AIDS epidemic, interrogating the role of this international system and global discourse on HIV/AIDS interventions. The geographical focus is Sub-Saharan Africa since the region has been at the forefront of these interventions. There is a need to understand the relationship between the international political environment and the impact of resulting policies on HIV/AIDS in the context of people’s lives. Hakan Seckinelgin points out a certain disjuncture between this governance structures and the way people experience the disease in their everyday lives. Although the structure allows people to emerge as policy relevant target groups and beneficiaries, the articulation of needs and design of policy interventions tends to reflect international priorities rather than people’s thinking on the problem. In other words, he argues that while the international interventions highlight the importance attributed to the HIV/AIDS problem, the nature of the system does not allow interventions to be far reaching and sustainable. Offering a critical contribution to the understanding of the problems in HIV/AIDS in Sub-Saharan Africa, International Politics of HIV/AIDS will be invaluable to students and researchers of health, international politics and development.

As we approach the 25th anniversary of the first recognition of HIV/AIDS in 1981, this book reflects on the international impact of the disease. It has persistently remained a global issue, with more than 50 million people worldwide estimated to have been infected since that date. This ambitious book, written by 165 authors from 30 countries, offers a multi-country comparative study that examines how the response to the common, global threat of HIV is shaped by the history, culture, institutions and health systems of the individual countries affected. Increasingly the shift of health systems has been from prevention only as the main containment strategy, to a strategy that includes scaling up HIV treatment, and care and prevention services, including antiretroviral therapy. Thus, all parts of the health system must be involved; policy makers, healthcare professionals and users of the services have been forced to think differently about how services are financed, how resources are allocated, how systems are structured and organized, how services are delivered to patients, and how the resulting activity is monitored and evaluated in order to improve the effectiveness, efficiency, equity and acceptability of the response. This book is unique in attempting to describe and assess a range of responses across the globe by situating them within the characteristics of each country and its health system. Most chapters combine a health policy expert with an HIV specialist, allowing both a 'top down' health system approach and a 'bottom up' HIV-specific perspective. There are thematic and analytical sections, which provide an overview and some suggestions for solutions to the most serious outstanding issues, and chapters which analyse specific country and organisational responses. There is no perfect health system, but the evidence provided here allows the sharing of knowledge, and a opportunity to assess the impact and reactions, to an epidemic that must be considered a long term issue.

The political impact of HIV/AIDS varies greatly and is difficult to map. States depend on how governments choose to manage the political implications of HIV and AIDS, both those stemming from the erosions of its own capacity as well as those that originate from their changing relationship on a national and international level. Across the developing world, HIV/AIDS is slowly killing adults in their most productive years, hollowing out state structures, deepening poverty and raising profound questions that touch on the organization of all aspects of social, economic and political life. With the epidemic showing scant signs of slowing down, this innovative volume assesses how HIV/AIDS affects governance and, conversely, how governance affects the course of the epidemic. In particular, the volume:

The devastating effects of HIV/AIDS have propelled a multiplicity of activities at global, national and local level. This book is based on in-depth studies of the major global institutions in health, the role of pharmaceutical corporations, the functions of NGOs, and national responses to HIV/AIDS in two key case studies: Brazil and South Africa.

For three decades post-apartheid, the HIV/AIDS epidemic from first acknowledgement to its management as a chronic disease, demanded unparalleled attention. This was nowhere more evident than in South Africa. This book explores how the state responded to its responsibilities to defend and protect (human) security. Linking this to the role of the state as sovereign protector and provider of security, it applies the findings to the broader re-interpretation of sovereign responsibility in the 21st Century. This book does not seek to absolve the South African state of its responsibility to respond. Moreover, it argues that although the state, the government, before, during, and after the transition to democracy, was aware of and acknowledged the threat - political, economic and social - posed by the epidemic, it nonetheless chose not to make the epidemic a priority policy issue. As a result, it argues that the South African HIV/AIDS case illustrates the tension inherent between a state’s ultimate sovereign responsibility to respond and its tactical dependence on external contributors to meet the demands of all of its constituents.