2 August 2008
analysis
Washington, DC — "The scale up of antiretroviral therapy in the developing world is the most ambitious public health undertaking of our lifetimes, ...We were told it couldn't be done, and shouldn't be done, but we persevered, set ambitious goals and targets, and now 3 million people are on antiretroviral treatment." - Gregg Gonsalves, International Treatment Preparedness Coalition (ITPC)
As the XVII International AIDS Conference gets under way this coming week in Mexico City (http://www.aids2008.org), a report by ITPC is one of many addressing still unresolved debates in the fight against AIDS. ITPC's report, based on detailed case studies in Argentina, Brazil, Dominican Republic, Uganda, Zambia, and Zimbabwe, argues, in contrast to some commentators, that the expansion of the fight against AIDS can help spur improvements in the wider healthcare system, towards the goal of universal care.
Activists are also celebrating the re-authorization of President's Emergency Program for AIDS Relief (PEPFAR), which many observers see as one of few accomplishments that can be claimed for the two terms of President George W. Bush. The program was first passed in 2003, after several years of mobilization by activists in Africa, the United States, and worldwide, that also led to the founding of the Global Fund to Fight Aids, Malaria, and TB, in 2002.
In 2001, USAID administrator Andrew Natsios that antiretroviral treatment programs for Africans were impractical, because Africans "couldn't tell time" (http://www.africaaction.org/docs01/nat0106.htm). His statement, while extreme in its wording, reflected common assumptions. There is no doubt that the effect of AIDS activism has been enormous in the last decade, particularly following the AIDS conference in Durban in 2000, in changing assumptions about the need to act and mobilizing resources.
Yet debates continue about the relative balance between treatment and prevention, between disease-specific programs and broader approaches to healthcare, and about the effectiveness of current programs and the difficulty of adapting them to specific national contexts. These debates - and the fact that the gains in both treatment and prevention still fall far short of reversing the death toll and new infections - are an indication that in fact the fight against AIDS is still only beginning. Despite greatly increased awareness and investment over the last decade, The scale of the response is still too small, and scientific knowledge about the complex virus, the social paths of its transmission, and effective strategies to combat it are far from adequate.
This AfricaFocus Bulletin contains press releases from ITPC and from Health GAP, Also included are links to recent books on AIDS & Africa, and to other reports released recently.
Another AfricaFocus Bulletin sent out today contains the executive summary of the a report from the Black Aids Institute, "Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic."
For previous AfricaFocus Bulletins on health issues, visit http://www.africafocus.org/healthexp.php
@@@@@@@@@@@New in AfricaFocus Bookshop@@@@@@@@@@@
Several recent books explore different aspects of the complexity of AIDS and unresolved issues in the fight against it.
* Toronto Globe & Mail Africa bureau chief Stephanie Nolen in "28: Stories of AIDS in Africa" approaches AIDS through the stories of 28 individuals. One reviewer noted: "Nolen's book stands out for her insightful descriptions of the human costs as well as the its fluid integration into the stories of aspects of socio-economic conditions and up-to-date science research surrounding the pandemic."
Order from
Powell's Books - http://tinyurl.com/5zy36p
Amazon USA - http://tinyurl.com/5pz3mh
Amazon UK - http://tinyurl.com/6zogwq
* Researcher and journalist Helen Epstein, in "The Invisible Cure: Africa, the West, and the Fight Against AIDS," is scathing about simplistic assumptions and faulty policies of the international AIDS establishment, including both multilateral programs and the U.S. PEPFAR. The title is explained by a quote from Beatrice Ware of Uganda. "As a woman living with HIV, I am often asked whether there will ever be a cure for HIV/AIDS, and my answer is that there is already a cure. It lies in the strength of women, families and communities who support and empower each other to break the silence around AIDS and take control of their sexual lives."
Order from:
Powell's Books http://tinyurl.com/6gh7gs
Amazon USA http://tinyurl.com/6s7rmx
Amazon UK http://tinyurl.com/6xxspv
* Researcher David Gisselquist in "Points to Consider: Responses to HIV/AIDS in Africa, Asia, and the Caribbean," sharply criticizes the failure of the international AIDS establishment to pay sufficient attention to the risks of transmission of AIDS through the medical system itself, in the context of generalized epidemics and inadequate health systems. He is particularly critical of the lack of sufficient research to provide reliable estimates of the proportion of cases coming from unsafe injections with reusable needles.
Order from
Powell's Books http://tinyurl.com/5kd5lq,
Amazon USA - http://tinyurl.com/5n5blp or
Amazon UK - http://tinyurl.com/6mbkgf
For a selection of more new books on AIDS in Africa, published in 2007 and 2008, visit the AfricaFocus Bookshop at
http://www.africafocus.org/books/themes.php#aids1 or http://www.africafocus.org/books/themes_uk.php#aids1
@@@@@@@@@@@New in AfricaFocus Bookshop@@@@@@@@@@@
New "From-the-Ground" Report Reformulates Simplistic Argument About HIV/ AIDS and Health Care Systems In A Fundamental Way
International Treatment Preparedness Coalition
http://www.aidstreatmentaccess.org
29 July 2008
Contact: Chris Collins: +1 845 701 0158; ChrisCSF@aol.com Gregg Gonsalves: +27-78-456-3848; gregg.gonsalves@gmail.com Kay Marshall: +1 347-249-6375; nkmarshall@gmail.com
Dr. Jim Kim of Harvard School of Public Health joins International Treatment Preparedness Coalition to release new report and call for broad, systematic approach to HIV/AIDS and health care scale up
New York, Harare, Boston and S o Paulo, 29 July 2008. The International Treatment Preparedness Coalition (ITPC), a group of 1,000+ treatment advocates from more than 125 countries, issued its sixth report on delivery of AIDS treatment today. "issing the Target #6: The HIV/AIDS Response and Health Systems: Building on success to achieve health care for all.: The report is available at http://www.aidstreatmentaccess.org.
The new report, launched during a teleconference with Dr. Jim Yong Kim, Director of the Fran‡ois- Xavier Bagnoud Center for Health and Human Rights (FXB) at Harvard University and advocates from around the world, provides some of the first from-the-ground research to inform the debate on HIV treatment scale up and its interaction with health systems. It includes reports from six countries: Argentina, Brazil, the Dominican Republic, Uganda, Zambia and Zimbabwe. Dr. Kim praised the report and noted that it is both welcome and timely to set the stage for the next phase of research and investigation for AIDS services and health care systems scale up in developing countries.
"The report shows that each country situation is complex. Every country has made thousands of decisions, good and bad. What we are seeing now is that funding for HIV is, for the first time in history, directed at chronic care for a chronic condition. We have the opportunity to think hard about what it will take to keep a large population of people healthy over their entire lives. What we know is that it takes more than just antiretrovirals. This report takes us to the point of reformulating in a fundamental way the argument over HIV and health systems," Dr. Kim said. Matilda Moyo, a co-author of the report's Zimbabwe chapter said, "What we found was that HIV/AIDS services, particularly provision of antiretrivirals, have become a lifeline for the health care system in Zimbabwe. In the midst of the economic and political crises, a consistent focus on HIV health services has been an oasis in a whole desert of the collapsing health delivery system."
Read comments. Write your own.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
