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HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
AIDS AND SOCIETY. 1991 Jan-Feb; 2(2):1, 6, 12-3.The political constraints slowing the battle against AIDS in Africa are getting AIDS on the public agenda, integrating the international community into the AIDS policy-making agenda and cultural barriers in national AIDS strategies. Policy making in most Africa is bureaucratic rather than democratic, so whether AIDS is a government priority depends largely on perception of AIDS risk by the leaders. In Zambia and Uganda, AIDS is a concern because it affects the ethnic group or family in power, while in Tanzania and Kenya, AIDS is associated with minority or "high risk" groups. The domination of AIDS agenda setting within nations in Africa by international donors and non-governmental organizations is a problem, made more severely severed by sensitivity of Africans who perceive research as a foreign effort to prove that AIDS originated there. Foreign domination is also detrimental because it prevents localities from becoming committed to AIDS interventions. Cultural barriers against effective interventions are similar to those in Western countries: AIDS is seen as a disease of shame affecting immoral people. In addition, the prevalent concept of fatalism defeats the Western insistence on intervention and strategies. Furthermore, women who are largely dependent on men cannot insist on preventive behavior, not do they have organizations in place to protect their rights. Finally, the concepts of behavioralism, and learning new behaviors for person-centered reasons, are foreign to much of Africa.