The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.
The relative lack of information on determinants of disease, disability, and death at major stages of a woman's lifespan and the excess morbidity and premature mortality that this engenders has important adverse social and economic ramifications, not only for Sub-Saharan Africa, but also for other regions of the world as well. Women bear much of the weight of world production in both traditional and modern industries. In Sub-Saharan Africa, for example, women contribute approximately 60 to 80 percent of agricultural labor. Worldwide, it is estimated that women are the sole supporters in 18 to 30 percent of all families, and that their financial contribution in the remainder of families is substantial and often crucial. This book provides a solid documentary base that can be used to develop an agenda to guide research and health policy formulation on female health--both for Sub-Saharan Africa and for other regions of the developing world. This book could also help facilitate ongoing, collaboration between African researchers on women's health and their U.S. colleagues. Chapters cover such topics as demographics, nutritional status, obstetric morbidity and mortality, mental health problems, and sexually transmitted diseases, including HIV.
This book emphasizes the factors in the spread and control of AIDS that have received less attention in the literature. It suggests that a collaborative action program involving traditional healers is necessary if we wish to impact the spread of AIDS and other STDs in Africa.
Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Reproductive tract infections (RTis) have become a silent epidemic that is devastating women's lives. Each year, thousands of women die needlessly from the consequences of these infections, including cervical cancer, ectopic pregnancy, acute and chronic infections of the uterus and the fallopian tubes, and puerperal infections. For many women, this happens because they receive medical attention too late, if at all. The terrible irony of this tragedy is that early diagnosis of and treatment for many RTis do not require high-technology health care. For the hundreds of millions of women with chronic RTis acquired from their sexual partners, life can become a living hell. Infection is a major cause of infertility, and it leads to scorn and rejection in many countries. These women may experience constant pain, have festering lesions of the genital tract, be at enhanced risk of second ary diseases, and endure social ostracism. The problems associated with RT!s have grown even greater in the past decade with the emergence of human immunodeficiency virus (HIV) and AIDS. Preexisting sexually transmitted disease, particularly when associated with genital tract ulcers, raises women's vulnerability to the transmission of HIV 3-5 fold.
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
In this groundbreaking narrative, longtime Washington Post reporter Craig Timberg and award-winning AIDS researcher Daniel Halperin tell the surprising story of how Western colonial powers unwittingly sparked the AIDS epidemic and then fanned its rise. Drawing on remarkable new science, Tinderbox overturns the conventional wisdom on the origins of this deadly pandemic and the best ways to fight it today. Recent genetic studies have traced the birth of HIV to the forbidding equatorial forests of Cameroon, where chimpanzees carried the virus for millennia without causing a major outbreak in humans. During the Scramble for Africa, colonial companies blazed new routes through the jungle in search of rubber and other riches, sending African porters into remote regions rarely traveled before. It was here that humans first contracted the strain of HIV that would eventually cause 99 percent of AIDS deaths around the world. Western powers were key actors in turning a localized outbreak into a sprawling epidemic as bustling new trade routes, modern colonial cities, and the rise of prostitution sped the virus across Africa. Christian missionaries campaigned to suppress polygamy, but left in its place fractured sexual cultures that proved uncommonly vulnerable to HIV. Equally devastating was the gradual loss of the African ritual of male circumcision, which recent studies have shown offers significant protection against infection. Timberg and Halperin argue that the same Western hubris that marked the colonial era has hamstrung the effort to fight HIV. From the United Nations AIDS program to the Bush administration's historic relief campaign, global health officials have favored well-meaning Western approaches--abstinence campaigns, condom promotion, HIV testing--that have proven ineffective in slowing the epidemic in Africa. Meanwhile they have overlooked homegrown African initiatives aimed squarely at the behaviors spreading the virus. In a riveting narrative that stretches from colonial Leopoldville to 1980s San Francisco to South Africa today, Tinderbox reveals how human hands unleashed this epidemic and can now overcome it, if only we learn the lessons of the past.
