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HIV and AIDS

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Coordinating Global Health Policy Responses

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Abstract

Chapter 3 is dedicated to the politics of HIV and AIDS. The spread of and response to this epidemic played perhaps the most significant role in connecting the politics of human rights to the policies of health rights and responsibilities. By tracing the trajectory of the HIV and AIDS epidemic and the debates surrounding it – from its incited moral imperative to fatigue over its persistence – this chapter focuses on the rights/responsibilities dichotomies introduced in the previous chapter. Going further, it highlights the rise of health – including of treatment(s) – as a human right, and the parallel emergence of non-state actors as realizers of health rights. In doing so, this chapter anticipates both the emergence of other zoonoses – emerging infectious diseases (EIDS) – as well as the immersion of non-state actors into the health realm, which has re-ordered the relationship between individual health rights and state guarantors of health (care).

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Notes

  1. 1.

    See Upshur, Ross. (2008). “Ethics and Infectious Disease,” Bulletin of the World Health Organization, Vol. 86, Issue 8 (August), 577–656.

  2. 2.

    Bacterial resistance to antibiotics, a scourge but not an epidemic/pandemic, emerged later.

  3. 3.

    Interviews with Professor Ruben Sher, Johannesburg, South Africa, 2005/6.

  4. 4.

    “The polymerase chain reaction, or PCR, is a technique used to amplify DNA through thermocycling—cycles of temperature changes at fixed time intervals. Using a thermostable DNA polymerase, PCR can create numerous copies of DNA from DNA building blocks called dinucleoside triphosphates or dNTPs. There are three steps in PCR: denaturation, annealing, and elongation. Denaturation is the first step in the cycle and causes the DNA to melt by disrupting hydrogen bonds between the bases resulting in single-stranded DNA. Annealing lowers the temperature enough to allow the binding of oligonucleotide primers to the DNA template. During the elongation step DNA polymerase will synthesize new double-stranded DNA,” available at: http://www.jove.com/science-education/5056/pcr-the-polymerase-chain-reaction.

  5. 5.

    Lakshmi, Vemu et al. “Application of Polymerase Chain Reaction to Detect HIV-1 DNA in Pools of Dried Blood Spots,” Indian Journal of Microbiology, 2011 Jun; Vol. 51, Issue 2, 147–152. Published online 28 January 2011. doi: 10.1007/978-3-319-52006-3_2.

  6. 6.

    See “Immunologie: Biochemische Grundlagen,” available at: http://www.ruhr-uni-bochum.de/biochem/mam/content/mediziner/immunologie.pdf.

  7. 7.

    Original: Bekämpfungsstrategie.

  8. 8.

    Mbali, Mandisa. (2013). South African AIDS Activism and Global Health Politics. Basingstoke: Palgrave Macmillan.

  9. 9.

    See “NAM aidsmap HIV treatments directory, AZT (zidovudine, Retrovir),” available at: http://www.aidsmap.com/resources/treatmentsdirectory/drugs/AZT-zidovudine-iRetroviri/page/1730919/.

  10. 10.

    ECOSOC comprises 54 member (of the UN) Governments elected by the UN General Assembly for overlapping three-year terms. 14 are from Africa; 11 from Asia; 6 from Eastern Europe; 10 from Latin America; 13 from Western Europe and other states. See http://www.un.org/en/ecosoc/about/members.shtml.

  11. 11.

    See UNAIDS at: http://www.oas.org/en/ser/dia/institutional_relations/Documents/Profiles/UNAIDS.pdf.

  12. 12.

    Ibid.

  13. 13.

    See The Henry J. Kaiser Family Foundation, “Global Health Policy, the Global HIV/AIDS Epidemic,” November 30, 2015, available at: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/.

  14. 14.

    See Republic of South Africa, Country Progress Report on the Declaration of Commitment on HIV/AIDS, 2010 Report. (March 31), available at: http://data.unaids.org/pub/Report/2010/southafrica_2010_country_progress_report_en.pdf.

  15. 15.

    See National Center for Biotechnology Information, (2001). “No Time To Lose: Getting More From HIV Prevention,” available at: http://www.ncbi.nlm.nih.gov/books/NBK222902/.

  16. 16.

    See The White House, “The President’s FY2012 Budget and Implementation of the National HIV/AIDS Strategy,” available at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/presidents-fy2012-budget-nhas.pdf. See also Table 3.1.

  17. 17.

    See “Millennium Development Goals and Beyond,” available at: http://www.un.org/millenniumgoals/.

  18. 18.

    See WHO, WHO’s work with the United Nations, HIV/AIDS in the UN, available at: http://www.who.int/un-collaboration/health/unga-hiv/en/.

  19. 19.

    See UNAIDS, “Three Ones” key principles, available at: http://data.unaids.org/UNA-docs/Three-Ones_KeyPrinciples_en.pdf.

  20. 20.

    See “The 3 by 5 Initiative,” available at: http://www.who.int/3by5/newsitem9/en/.

  21. 21.

    General Assembly Resolution A/Res/60/262, available at:

  22. 22.

    See Carter, Michael, “US HIV Travel Ban Has Now Ended,” aidsmap, available at: http://www.aidsmap.com/US-HIV-travel-ban-has-now-ended/page/1437294/.

  23. 23.

    Ibid.

  24. 24.

    See UNAIDS, “90–90–90: An Ambitious Treatment Target to Help End the AIDS Epidemic,” available at: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf.

  25. 25.

    Ibid.

  26. 26.

    See UN, “Sustainable Development Goals: 17 Goals to Transform our World,” available at: http://www.un.org/sustainabledevelopment/.

  27. 27.

    See “Transforming our world: the 2030 Agenda for Sustainable Development,” available at: https://sustainabledevelopment.un.org/post2015/transformingourworld; see also Resolution A/RES/70/1, “Transforming our world; the 2030 Agenda for Sustainable Development”

  28. 28.

    See Robert-Koch-Institut https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2011/17_2011.html.

  29. 29.

    See http://www.unaids.org/en/regionscountries/countries/germany/.

  30. 30.

    This is not meant as a suggestion that blood banks be used as testing points. What it is meant to point out is that too few people use health care access to undergo an HIV test. As a result, even blood that is tested and which tests negative, continues to carry a (in the West almost negligible, but nonetheless existent) chance of infection.

  31. 31.

    See IHME (2015). “Financing Global Health, Viz Hub, Flows of Health Financing,” available at: http://vizhub.healthdata.org/fgh/.

  32. 32.

    Ibid.

  33. 33.

    IHME (2004). “Financing Global Health, Viz Hub, Flows of Health Financing,” available at: http://vizhub.healthdata.org/fgh/.

  34. 34.

    Johnson, Judith A. (2008). CRS Report for Congress: AIDS Funding for Federal Government Programs: FY1981–FY2009. (23 April), available at: http://fpc.state.gov/documents/organization/104280.pdf.

  35. 35.

    US$5.8 billion was spent by the USG directly; an additional US$ 970 million went to the Global Fund; US$58 million went to UN agencies; and US$14 million was channeled to development banks; and US$280 million was spent by NGOs.

  36. 36.

    See National Center for Biotechnology Information (2001). “No Time To Lose: Getting More From HIV Prevention,” available at: http://www.ncbi.nlm.nih.gov/books/NBK222902/.

  37. 37.

    See The White House, “The President’s FY 2012 Budget and Implementation of the National HIV/AIDS Strategy,” available at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/presidents-fy2012-budget-nhas.pdf.

  38. 38.

    See Martin, Gayle H. (2003). “A Comparative Analysis of the Financing of HIV/AIDS Programmes in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe,” prepared for the Social Aspects of HIV/AIDS and Health Research Programme for the Health Sciences Research Council, available at: http://www.wsu.ac.za/hsrc/html/2050-8.pdf.

  39. 39.

    See Republic of South Africa, Country Progress Report on the Declaration of Commitment on HIV/AIDS, 2010 Report. (March 31), available at: http://data.unaids.org/pub/Report/2010/southafrica_2010_country_progress_report_en.pdf.

  40. 40.

    As of February 18, 2016.

  41. 41.

    See IHME, (2014). “Financing Global Health, Viz Hub, Flows of Health Financing,” available at: http://vizhub.healthdata.org/fgh/.

  42. 42.

    Smith J.H. and A. Whiteside. (2010). “The History of AIDS Exceptionalism”. Journal of the International AIDS Society, doi: 10.1007/978-3-319-52006-3_2.

  43. 43.

    Simelela, N.P. and W.D.F. Venter. (2014). “A Brief History of South Africa’s Response to AIDS,” SAMJ, Vol. 104, Issues 3 (Suppl 1) (March).

  44. 44.

    See new UNAIDS goals, for example 90–90–90 explained in the Timeline.

  45. 45.

    The HI-virus is difficult to pin down because it continually mutates. See, for example, Streek, Hendrik and Douglas F. Nixon (2010). “T Cell Immunity in Acute HIV-1 Infection,” Journal of Infectious Diseases, Vol. 202 (Supplement 2), S302–S308. doi: 10.1007/978-3-319-52006-3_2; and McMichael, Andrew. J. et al. (2010). “Review: The Immune Response During HIV-1 Infection: Clues for Vaccine Development,” Nature Reviews Immunology, Vol. 10, 11–23 (January). doi: 10.1007/978-3-319-52006-3_2.

  46. 46.

    See‚ “HIV and AIDS in Eastern Europe & Central Asia,” available at: http://www.avert.org/professionals/hiv-around-world/eastern-europe-central-asia.

  47. 47.

    Though it was annulled, the act had severe detrimental consequences for human rights and for the fight against the HIV and AIDS epidemic. See Human Rights Watch (2014) “Uganda: Anti-Homosexuality Act’s Heavy Toll. Discriminatory Law Prompts Arrests, Attacks, Evictions, Flight,” (14 May), available at https://www.hrw.org/news/2014/05/14/uganda-anti-homosexuality-acts-heavy-toll.

  48. 48.

    Forthcoming research by Prof. Dr. Till Bärnighausen, Institut für Public Health, Heidelberg.

  49. 49.

    Centers for Disease Control and Prevention, “Prevalence of Diagnosed and Undiagnosed HIV Infection—United States, 2008–2012,” Morbidity and Mortality Weekly Report (MMWR), 26 June 2015/Vol 64, Issue 24, 657–662, available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6424a2.htm?s_cid=mm6424a2_e.

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  1. University of Warwick, Warwick, United Kingdom

    Annamarie Bindenagel Šehović

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Bindenagel Šehović, A. (2017). HIV and AIDS. In: Coordinating Global Health Policy Responses. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-52006-3_3

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