In the 18 years since the first cases of the acquired immunodeficiency syndrome (AIDS) were reported by the Centers for Disease Control and Prevention (CDC), the epidemic has undergone profound transformations, and so, too, has the sociomedical context within which public health policy is fashioned and implemented. The early years of neglect and panic were also characterized by relative therapeutic impotence and deep uncertainty about the epidemiological course the new threat would take. In the United States and in other economically advanced nations, the threat of contracting the human immunodeficiency virus (HIV) has abated. The incidence of infection has declined, and the prevalence of infection has stabilized and, in some instances, begun to fall. The pattern of HIV spread, where it has continued, has been dramatically circumscribed to marginalized populations.1 The panic of the mid-1980s has passed, and in many nations, AIDS has lost its salience as a public issue. A sense of therapeutic impotence no longer prevails, and a new mood of triumphalism has taken hold. How have these crucial changes affected AIDS policies in America? (Introduction).
This volume is jointly written by four authors at the University of Utah with expertise in bioethics, health law, and infectious disease. In collaboration they attempt to develop a normative framework sensitive to situations of disease transmission- situations in which the patient is not only a victim but a vector; i.e. vulnerable to disease but also a threat to others.
Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for “resource-poor” hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science. Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money—as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.
Dawning Answers looks at the global HIV/AIDS epidemic through the lens of its evolvoing influence on public health theory and practice. Losses from the epidemic have been devastating, but the many lesson learned have positively influenced other domains of public health and will continue to generate new approaches to health assessment, policy development and assurance. Students and teachers of public health and preventive medicine will find in this singular volume useful analyses from the various disciplines comprising public health
It has now been 25 years since the apocryphal report in the CDC Morbidity and Mortality Weekly Report dated June 5, 1981 entitled, “Pneumocystis Pneumonia - Los Angeles”, which announced what was to become HIV/AIDS. HIV has now affected virtually all countries that have looked for it and has had a devastating impact on the public health and medical care infrastructure around the world. HIV/AIDS has also disproportionately affected nations with the least capacity to confront it, especially the developing world nations in Sub-Saharan Africa, South and Southeast Asia, and the emerging republics of Eastern and Central Asia. The pandemic, unlike any other disease of our time, has had profound impacts on the practice of public health itself: bringing affected communities into decision making; demanding North-South partnerships and collaborations; and changing the basic conduct of clinical and prevention trials research. While much has been written in scholarly publications for medical, epidemiologic and disease control specialists, there is no comprehensive review of the public health impact and response to HIV/AIDS in the developing world. This edited volume seeks to systematically describe the emergence and form of the epidemics (epidemiology), the social, community and political response, and the various measures to confront and control the epidemic, with varying levels of success. Of particular importance are strategies that appear to have been useful in ameliorating the epidemic, while contrasting the situation in a neighboring country or region where contrasting prevention or care initiatives have had a deleterious outcome. Common to all responses has been the international multi-sectoral response represented by the Global Fund for HIV/AIDS, Malaria and Tuberculosis, the President's Emergency Plan for AIDS Relief, and the Gates Foundation, among others, to promote HIV pharmacologic therapy in resource-poor settings. The chapter authors will explore the political challenges in meeting HIV/AIDS prevention and care in concert with the public health realities in specific country and regional context.
Named an Outstanding Academic Title for 2009 byChoice! "[A] set of almost 70 essays, all well informed and many with attitude." Harold Shapiro, PhD Professor Emeritus and Professor of Economics and Public Affairs Princeton University, Former Chair, National Bioethics Advisory Board "This most noteworthy and authoritative collection of 67 essays...represents 'the Penn way of doing bioethics' ....The Penn Center is widely known for multidisciplinary scholarship that emphasizes empirical inquiry on bioethical issues coupled with practical application(s)....The book provides excellent coverage of...both classical topics (e.g., informed consent, infertility, eugenics) and emerging issues (e.g., cloning, nonprofessional caregiving, privacy of thought in the age of brain imaging). The contributors, including the three editors, are either well-established or emerging scholars. Each essay offers historical background, an overview of relevant issues, a conclusion, and a list of references....Summing Up: Highly recommended."--Choice: Current Reviews for Academic Libraries "This well-written book addresses a wide-ranging assortment of traditional bioethics issues that persist in the field as well as contemporary bioethics concerns that have evolved with new technologies and medical advances. This is a great resource for scholars in bioethics as well as various other relevant disciplines concerned with bioethical issues." Score: 96, 4 stars--Doody's Medical Reviews The Center for Bioethics at the University of Pennsylvania is the internationally recognized leader in bioethical education and research. Its interdisciplinary faculty is drawn from the fields of medicine, law, nursing, education, philosophy, psychology, and religious studies. Arthur L. Caplan, the Center's founding director, is recognized as one of the most influential experts in bioethics. He has authored numerous books and articles, and served as the Chair of the Advisory Committee to the United Nations on human cloning. The Penn Center's leading fellows, Autumn Fiester and Vardit Ravitsky, have combined their expertise with Dr. Caplan and over 80 other contributors to create The Penn Center Guide to Bioethics--the foremost authority on both traditional and cutting-edge bioethical issues. The Penn Guide navigates uncharted ethical terrains, undoubtedly shaping both academic and public discourses on the challenging controversies generated by new technologies, theories, and medical advances. This volume represents the Penn Center's distinct, pioneering approach to bioethics, one that emphasizes empirical treatment of bioethical issues, and the integration of bioethical scholarship with practical application. Learn what the Penn Center has to say about: Neuroethics and brain imaging: Is my mind mine? Choosing future people: reproductive technologies and identity Eugenics and survival of the fittest in the modern world Bioethics and national security Vaccination, abortion, nanotechnology, organ transplantation, end-of-life issues, and more The Penn Guide will be the definitive text for policy makers, health practitioners, researchers, and students. This book will also inform the general public, patients, and family members as they seek answers to the bioethical issues of the day.
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 occurrence of HIV/AIDS has dramatically affected every aspect of justice systems worldwide. Legal, law enforcement and custody issues abound. This volume provides a comprehensive overview of these issues as well as strategies and solutions.
An international team of specialists in politics, policy, and activism provide an indispensable guide to the persistent challenges and emerging issues posed by the global HIV/AIDS epidemic, now in its fourth decade. The HIV/AIDS epidemic is at a critical turning point. Compelling new findings herald the potential to eventually grind the epidemic to a halt through a combination of expanded treatment coverage and new biomedical approaches to prevention. At the same time, the severe global economic downturns have negatively affected wealthy donor nations that have provided the funds and technical support for programs in the developing world. It is against this backdrop that this landmark three-volume set was developed. It provides a broad overview of the critical political issues surrounding HIV/AIDS, inspects key areas of policy and policymaking, and spotlights the most important forms of activism and community mobilization. The volumes reflect an eclectic and wide-ranging set of issues written by an international team comprising dozens of authors from nations including the United States, the United Kingdom, Ghana, South Africa, Brazil, Cambodia, Norway, and Qatar. The international contributors represent a variety of disciplines and bring with them a range of styles and methodological approaches appropriate to their specific topics and disciplines. An important addition to academic and public libraries, this expansive work will benefit students and other readers interested in politics, policymaking, public health, activism, and community mobilization, both in the United States and globally.
This book explores the possibilities and difficulties of living with HIV and ARVs, or antiretroviral treatment, today. It draws on HIV-positive people's stories from both the UK and the South African epidemics and offers a deep understanding of the continuing difficulties of living with HIV and the effective strategies for coping that have evolved.
