The Economics Of The Global Response To Hiv Aids

The book addresses the impact of HIV/AIDS across different countries, the global response to HIV/AIDS, and cost-effectiveness of HIV/AIDS-related interventions.

This paper analyzes the macroeconomics of HIV/AIDS. The paper highlights that the mortality and morbidity associated with AIDS make it unlike most other types of sickness and disease. The paper describes the most common approaches used in accounting for growth in the context of an HIV/AIDS epidemic. The impact of HIV/AIDS on education and the accumulation of human capital is discussed. The paper also discusses the impact of HIV/AIDS on the public sector, and elaborates certain demographic events specific to the HIV/AIDS pandemic.

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.

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.

Nearly thirty years since HIV/AIDS was first identified, confusion over effective mechanisms of controlling and eradicating the illness remain prevalent. This book highlights the need for comprehensive approaches to governance, as responses to HIV/AIDS become increasingly focused upon the health aspect of the epidemic, and financial commitments become subject to aid fatigue. This book examines the roles and influence of multiple actors and initiatives that have come to constitute the global response to the epidemic. It considers how these actors and structures of governance enhance, or limit, participation and accountability; and the impact this is having upon effective HIV/AIDS responses across the world. The book addresses participation and accountability as key elements of governance in four thematic areas: the role of the state and democratic governance; non-state actors and mechanisms of political governance; public-private partnerships and economic governance; and multilateral institutions and global governance. Drawing on the insights of public health specialists; political scientists; economists; lawyers; those working with community groups, and within international organisations, it offers valuable perspectives on the governance of HIV/AIDS. Aimed at both academics and practitioners throughout the world, this book contributes to the academic debate surrounding global governance, health and development economics, and the work of multiple international organisations and civil society organisations.

HIV is the leading cause of premature death in Thailand. Since the first case of AIDS was reported in 1984 more than one million Thais have been infected. The social, human and economic costs of this burden are enormous. The Thai government has shown a strong commitment to providing care and support to persons living with HIV/AIDS by launching the National Access to Care Program (NAPHA) in 2003, which provides for publicly financed antiretroviral therapy (ART) to all HIV-infected people. This book documents through interviews how ART has radically changed the lives of those living with HIV. In the words of an HIV positive 29-year old man, ART is a "miracle." The book then develops an innovative analytical framework and uses it to show how the future sustainability and cost-effectiveness of this ambitious program depend critically on Thai government choices of AIDS treatment policy, HIV prevention policy and AIDS drug pricing. For the most likely assumptions, the book estimates that ART will save years of healthy life at a cost of between $700 and $2,400 per year. Successful AIDS treatment accumulates ever-increasing numbers of patients who need subsidized ART. Despite the magnitude of the resulting fiscal burden, the authors judge this expenditure to be a worthwhile public health investment for Thailand, However, they show that the future sustainability of the program will hinge critically on how well the government manages the quality of ART service delivery, on whether it is able to sustain its past successes in HIV prevention and on its negotiations with multinational pharmaceutical manufacturers on the prices of new AIDS drugs.

Why has the response to HIV/AIDS been unique? How did civil society organizations gain access to global decision-making forums to demand exceptional attention and resources for HIV/AIDS? This book seeks to answer these questions, among others, through a critical international relations approach that enquires into the role of civil society in global health governance. It documents how civil society forged the initial response to HIV/AIDS within a rights-based paradigm, and built international networks. It analyses why civil society was able to gain the right to participate in global health institutions and assesses what influence civil society representatives have within these institutions, particularly focusing on outcomes related to institutional legitimacy and downward accountability. It then discusses changes in the broader political economy of global health and how HIV/AIDS organizations have, or have not, adapted to these shifts. Finally the book tells the story of the many struggles civil society organizations have engaged in to advance a rights-based response to HIV/AIDS, the transformations achieved and the resistance experienced.

Across Africa, people in whom significant resources have been invested are dying prematurely from AIDS that continues to pose serious challenges to the ability of African States to maintain efficient public institutions and deliver sound policies and promote the rule of law. HIV infection patterns are continually changing; economic realities are making treatment adherence difficult and resistance to current drugs are beginning to emerge. These challenges can be faced and surmounted through better appreciation of the country-specific epidemic, use of better data for national response good governance and stronger political commitments at all levels of society. Therefore, comprehensive and enhanced response to AIDS must be at the centre of development strategies. This retrospective report presents key messages and policy recommendations formulated with a crucial role of the views of people affected and infected by AIDS.

HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.