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INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1991; 21(3):505-10.This article asks the reader to carefully consider the personal implications of AIDS were either he or close friends and relatives afflicted with the syndrome. We are urged to acknowledge the limited capabilities of personal and social response to the epidemic, and recognize the associated degree of social inequity and knowledge deficiency which exists. Summaries of 3 articles are discussed as highly integrated in their common call for global solidarity in the fight against HIV infections and AIDS. Pros and cons of Cuba's evolving response to AIDS are considered, paying attention to the country's recent abandonment of health policy which isolated those infected with HIV, in favor of renewed social integration of these individuals. Brazil's inadequate, untimely, and erred response to AIDS is then strongly criticized in the 2nd article summary. Finally, the 3rd article by Dr. Jonathan Mann, former head of the World Health Organization's Global program on AIDS, on AIDS prevention in the 1990s is discussed. Covering behavioral change and the critical role of political factors in AIDS prevention, Mann asserts the need to apply current concepts and strategies, while developing new ones, and to reassess values and concepts guiding work in the field. AIDS and its associated crises threaten the survival of humanity. It is not just a disease to be solved by information, but is intimately linked to issues of sexuality, health, and human behavior which are in turn shaped by social, political, economic, and cultural factors. Strong, concerted political resolve is essential in developing, implementing, and sustaining an action agenda against AIDS set by people with AIDS and those at risk of infection. Vision, resources, and leadership are called for in this war closely linked to the struggle for worldwide social justice.
SCIENCE. 1991 Oct 25; 254:511-2.The 1st Director of the World Health Organization's (WHO) Global Program on AIDS (GPA) abruptly resigned March, 1990. Jonathan Mann led the GPA in an innovative, aggressive, and comparatively non-bureaucratic style since its inception in 1986, building a staff of nearly 200 under an eventual 1990 budget of $90 million. Mann's non-conformist style and ever-growing budget, however, ran counter to the bureaucratic forces in WHO, causing him to leave for a position at Harvard University. A 12-year WHO veteran, Michael H. Merson succeeded Mann, and has since managed the GPA in a more conventional, bureaucratic manner. Senior staff have resigned, and the budget will drop to only $75 million for 1992. Staff replacements are used to the bureaucratic structure and demands of WHO, but lack experience in the field of AIDS. This paper discusses the markedly different management styles and approaches of Merson and Mann, with concern voiced over the future of the GPA. Critics are uncertain of GPA's present direction, and whether or not it is a necessary, positive change in the fight against the AIDS pandemic. As AIDS appears with less frequency and centrality i the world's media, the GPA is needed now even more than just a few years ago to inform the world of the dangers of AIDS. Merson is expected to promote relatively simple treatment options for AIDS, with some emphasis upon technological fixes like the condom. With cuts to the behavioral research budget, however, it is almost certain that inadequate steps will be taken to effect behavioral change for the prevention and control of HIV infection.