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New England Journal of Medicine. 2006 Jun 8; 354(23):2414-2417.On June 5, 1981, when the Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia in young homosexual men in Los Angeles, few suspected it heralded a pandemic of AIDS. In 1983, a retrovirus (later named the human immunodeficiency virus, or HIV) was isolated from a patient with AIDS. In the 25 years since the first report, more than 65 million persons have been infected with HIV, and more than 25 million have died of AIDS. Worldwide, more than 40 percent of new infections among adults are in young people 15 to 24 years of age. Ninety-five percent of these infections and deaths have occurred in developing countries. Sub-Saharan Africa is home to almost 64 percent of the estimated 38.6 million persons living with HIV infection. In this region, women represent 60 percent of those infected and 77 percent of newly infected persons 15 to 24 years of age. AIDS is now the leading cause of premature death among people 15 to 59 years of age. In the hardest-hit countries, the foundations of society, governance, and national security are eroding, stretching safety nets to the breaking point, with social and economic repercussions that will span generations. (excerpt)
Population 2005. 2002 Sep-Oct; 4(3):8.The HIV/AIDS epidemic shows no sign of leveling off in the hardest hit countries and as much as $10 billion is needed annually to fight it effectively, according to UNAIDS Executive Director Peter Piot. Addressing the 14th international AIDS conference in Barcelona in July, Mr. Piot said that unless the global community provided more assistance to countries with high rates of HIV/AIDS, like debt relief, there could be catastrophic results. “The epidemic hit the world 20 years ago but we failed to contain the increase in HIV cases. The answers point towards politics, power and priorities. $10 billion is needed annually to combat the menace,” he said. Mr. Piot told his audience they must mobilize political support, scale up AIDS prevention and treatment, eliminate stigma, develop a vaccine and arrange funds to fight the disease. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 95-112.This chapter will seek to review and assess, both globally and nationally, UNFPA's experience thus far in encouraging and building partnerships, analysing and reflecting on some of the successes as well as on the constraints and challenges that exist in broadening partnerships. It will also attempt to explore some specific measures that may be taken to nurture and protect effective partnerships that will endure over time. (excerpt)
Report of an International Consultation on AIDS and Human Rights. Geneva, 26-28 July 1989. Organized by the Centre for Human Rights with the technical and financial support of the World Health Organization Global Programme on AIDS.
New York, New York, United Nations, 1991. iii, 57 p.In July 1989, ethicists, lawyers, religious leaders, and health professionals participated in an international consultation on AIDS and human rights in Geneva, Switzerland. The report addressed the public health and human rights rationale for protecting the human rights and dignity of HIV infected people, including those with AIDS. Discrimination and stigmatization only serve to force HIV infected people away from health, educational, and social services and to hinder efforts to prevent and control the spread of HIV. In addition to nondiscrimination, another fundamental human right is the right to life and AIDS threatens life. Governments and the international community are therefore obligated to do all that is necessary to protect human lives. Yet some have enacted restrictions on privacy (compulsory screening and testing), freedom of movement (preventing HIV infected persons from migrating or traveling), and liberty (prison). The participants agreed that everyone has the right to access to up-to-date information and education concerning HIV and AIDS. They did not come to consensus, however, on the need for an international mechanism by which human right abuses towards those with HIV/AIDS can be prevented and redressed. International and health law, human rights, ethics, and policy all must go into any international efforts to preserve human rights of HIV infected persons and to prevent and control the spread of AIDS. The participants requested that this report be distributed to human rights treaty organizations so they can deliberate what action is needed to protect the human rights of those at risk or infected with HIV. They also recommended that governments guarantee that measures relating to HIV/AIDS and concerning HIV infected persons conform to international human rights standards.
In: Approches de planification familiale en Afrique: bilan et perspectives, sous la direction de Mohammed Bouzidi, Helmut Gorgen, Richard Turkson, Londres, Juillet 1992. London, England, International Planned Parenthood Federation [IPPF], 1992. 83-91.AIDS is a disease and should be treated as such. But the idea of AIDS induces psychological discomfort that can manifest itself in various ways. Family planning associations are urgently called upon to occupy themselves with problems of AIDS because of their interest in family welfare and their closeness to the intimate aspects of life. In 1987 the International Planned Parenthood Federation (IPPF) began a program to assist family planning associations in combatting AIDS. The program required training in all aspects of AIDS and the creation and maintenance of a system to gather and disseminate information on AIDS prevention through condom use and sex education directed to various target groups. Rather than creating new vertical programs devoted to AIDS, strategies were integrated into traditional family planning programs. Some technical structures such as the AIDS prevention unit were created to coordinate regional programs. The Unit has produced educational materials and audiovisual supports on AIDS prevention and reproductive and sexual health in several languages. In 1989 the IPPF African Region was provided with two programs to stimulate and coordinate technical assistance to family planning associations. An English-language program is based in Nairobi and a french-language program is based in Lome, Togo. Assistance to family planning associations is organized around identification of needs, formulation of requests, and implementation of activities related to training, production of IEC materials, and evaluation. The question of AIDS prevention in Africa still lacks an organizing philosophy. For various reasons many individuals with confirmed positive tests are not informed of the results. A goal of the IPPf is to provide information directly and indirectly to target groups to reinforce their power in the process of sexual and affective negotiation. The obstacles and constraints faced by family planning associations and their programs result from the choice of preventive strategy. It is important that family planning associations develop their own strategies as a function of their priorities and plans in the area of IEC. Clients must be made aware of the need to use condoms and to modify their sexual and affective behavior to assure better sexual and reproductive health. The IEC strategy must be based on interpersonal communications and adapted to the specific circumstances of each community.
In: 1st International Congress on AIDS in Asia and other Sexually Transmitted Diseases. Proceedings, Manila, 24-26 November 1987, edited by Ofelia T. Monzon. Manila, Philippines, Philippine Society for Microbiology and Infectious Diseases, 1988. 161-7.An overview is provided of the national, regional, and international educational activities of UNESCO in AIDS prevention. As part of the UN's Global Strategy, the WHO is mandated to lead and coordinate control and prevention programs. UNESCO's role is to assist member states in setting up and implementing IEC programs. Within that function, UNESCO contributes to formal and nonformal curriculum development on quality of life issues, which are multidisciplinary. Preventive education programs have been developed to contain or prevent environmental destruction, unplanned fertility, and drug abuse. Background information on AIDS concentrates on actions taken in 1986 and 1987. Program strategy, goals both long and short range, and objectives are indicated. The UNESCO strategy is integrated into the WHO strategy and contains an interdisciplinary AIDS coordinating committee under the Deputy Director General and a National AIDS Committee. Civic goals are to clarify the threats to human rights and freedoms from unjustified attitudes toward AIDS; health goals are to provide individuals with improved access to information about AIDS consequences, transmission, and means of prevention. Immediate goals are to support the WHO Global Strategy, to establish and evaluate AIDS prevention programs within formal and literacy programs, and to provide technical assistance nationally, regionally, and internationally. Examples of activities at the national level include setting up a national educational program, organizing intensive courses for mobile teams of educators, and monitoring and evaluating program efficiency and effectiveness. Regionally, activities may include providing regional meetings regularly or occasionally to launch campaigns or develop curriculum. International activities can involve establishing an AIDS documentation and clearinghouse for educational materials in schools for developed and developing countries.
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.
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.
SCIENCE. 1991 Mar 15; 251:1312-3.AIDS scientists met in February 1991 to discuss international trials of AIDS vaccines because of the urgency in conducting such trials since the US Food and Drug Administration approved 6 vaccines for trails. Major problems discussed were how to insure access to potential AIDS vaccines to developing countries, where to conduct future tests of vaccine efficacy, and which of the leading institutions should coordinate such an effort. The most difficult issue centered around who assumes the risks and who benefits. Many researchers considered conducting AIDS vaccine trials in developing countries since they have a large population varied in age and gender at high risk of HIV infection. Assuming an HIV vaccine is effective, additional questions must be addressed: How can a developing country afford a vaccine at free market prices? If that country does get the vaccine should not other developing countries also get it? Who will pay for it and distribute it? WHO has already contacted ministries of health about AIDS trials. Other organizations, e.g., the US Centers for Disease Control and the US National Institutes of Health, also already involved in international AIDS vaccine research do not want to be kept out of the Phase III trials. Some recommended that WHO be the international umbrella, others suggested that no organization control all the research. Nevertheless the vaccine will be produced in a rich country, and if left to the free market, it will be too expensive. 1 suggestions is a 2-tiered pricing plan in which rich countries pay higher prices thereby subsidizing the price in poor countries. Another is a patent exchange where the vaccine developers donate the vaccine patent to an international organization and they in turn can get an extension on an existing patent. Another alternative includes removing AIDS vaccines from the private sector altogether.
In: Heterosexual transmission of AIDS: proceedings of the Second Contraceptive Research and Development (CONRAD) Program International Workshop, held in Norfolk, Virginia, February 1-3, 1989, edited by Nancy J. Alexander, Henry L. Gabelnick, and Jeffery M. Spieler. New York, New York, Wiley-Liss, 1990. 1-8.The acquired immune deficiency syndrome (AIDS) was officially recognized by the World Health Organization in 1987; WHO developed a global AIDS strategy in 1988 that aimed to: 1) prevent the human immunodeficiency virus (HIV) infection; 2) reduce the personal and social effects of the HIV infection; and 3) coordinate national and international efforts in the war against AIDS. Who's Global Programme on Aids (GPA) receives update reports from 177 countries on the incidence of seroprevalence of HIV-1 and HIV-2 among its member countries. Based on serological study data the number of infected persons worldwide is estimated at 5 million. The world has been divided into 4 HIV/AIDS transmission pattern countries: 1) Pattern I countries are where the dominant mode of transmission is among homosexual or bisexual males and intravenous drug users. Areas of concentration include North America, Western Europe, Australia and New Zealand; 2) Pattern II countries are where heterosexual transmission is the dominant mode of transmission and includes Sub-Saharan Africa; 3) Latin America and the Caribbean have a combination pattern I and II; and 4) Pattern III are the remaining countries with small numbers of cases.
In: Workshop on the Integration of AIDS Related Curricula into Family Planning Training Programs, Quality Hotel, Arlington, Virginia, May 10-11, 1988. Documents, distributed by The Family Planning Management Training Project [FPMT] of Management Sciences for Health [MSI] Boston, Massachusetts, Management Sciences for Health, The Family Planning Management Training Project, 1988 May.  p..Current objectives in the fight against AIDS are focused on reducing transmission. International cooperation must be guided by principles including allowing the World Health Organization and participating governments, not donors, to determine policy; work done in developing countries must achieve the same standards as in the US; relationships between health and population programs, donor agencies and governments must be characterized by cooperation, not competition; and flexibility is necessary to respond to new information. Sensitivity is essential, as the control of AIDS involves personal issues, and the diagnosis of AIDS has profound implications. Surveillance is essential to detect and control infection and to guide public policy. As few infections currently result from medical injection, interventions have focused on the difficult problem of modifying sexual behavior, with little success. Social research is essential to determine means of behavior modification and to evaluate their efficacy. A brief history of the AIDS epidemic, as well as a summary of its epidemiology are provided. Efforts to control the spread of AIDS and to care for victims are draining the resources of basic health care programs, interfering with the delivery of primary health care. The extra demands that will be placed on family planning programs, including the shift in emphasis to barrier methods will strain these programs. WHO is currently undertaking a global effort to reduce morbidity and mortality from HIV infections and prevent transmission. Its strategies focus on preventing sexual, blood borne and perinatal transmission, therapeutic drugs against HIV, vaccine development, and helping infected people, and society, deal with the illness. Other agencies which have developed programs are USAID, the DHHS and the Centers for Disease control in the US.