HIV/AIDS Prevention and Treatment Strategies in Developed and Developing Countries

AIDS is a truly global disease. As such, it raises issues that local or regional diseases do not (although some issues may be the same). For example, because AIDS affects both rich and poor countries, AIDS has become a treatable disease far more quickly than regional, poor-country diseases such as malaria. However, patented treatments for AIDS, while affordable for patients in rich countries, have not been widely available to many patients in poor countries. AIDS is also an infectious disease that is largely preventable. This means that public education and prevention measures (such as free condom distribution and needle exchange programs) are capable of slowing the spread of the disease. AIDS is also a sexually transmitted disease (although it can also be transmitted through blood transfusions, needlesharing, and mother-to-child). Many cultures have taboos about sex in general and homosexual intercourse in particular. This aspect of the disease complicates both treatment and prevention due to the stigma associated with sexually transmitted diseases. Combine such taboos with the fear associated with infectious, lifethreatening diseases, and the discriminatory treatment of marginalized members of society, and you have a potent and complex global problem that defies easy solutions.

Due to the nature of the disease itself, prevention, treatment and human rights protection must all form part of any comprehensive AIDS strategy. These are the three central issues that must be addressed simultaneously in order to deal effectively with the AIDS pandemic. Each of these issues involves a host of subsidiary issues. For example, treatment raises issues such as the cost of patented medicine, the rights of governments to suspend patent rights, the availability of health workers and infrastructure and the availability of international aid to finance national AIDS strategies. Moreover, prevention, treatment and human rights protection are inter-related issues. For example, the rights of women affect their ability to use prevention strategies. Moreover, the stigma associated with HIV/AIDS, together with a lack of legal protection against discrimination, may deter people from seeking testing and treatment. Finally, a lack of access to treatment can create a sense of futility with respect to seeking testing, which in turn can contribute to the spread of the disease.

This chapter will examine these issues in different parts of the globe. While AIDS is a global disease, its impact varies from one country to the next and from one region to the next. Variations in cultural values, affected groups, infection rates, legal systems, economic resources and human resources mean that HIV/AIDS must be considered in specific contexts. This chapter therefore seeks to paint a global picture of the AIDS pandemic one issue, one country and one region at a time, by analyzing the key issues in country-specific and region-specific contexts. The chapter ends with a consideration of how experiences with HIV/AIDS might inform the strategies adopted to address the global pandemics of the future, such as H5N1 influenza.