Politics Of AIDS Essay

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From the discovery of a new epidemic disease among healthy young men in the United States in 1981, acquired immune deficiency syndrome, or AIDS, has been a very political disease. The new disease was first described as gay-related immune deficiency, an association that has affected the course of the disease ever since. The perception that AIDS was primarily a disease of promiscuous male homosexuals slowed government response in the United States and created considerable moral panic worldwide.

Today perhaps thirty-five million people are infected with human immunodeficiency virus or HIV, the cause of AIDS, a minority of whom has access to the complex antiretroviral drugs that can control, but not treat, the disease. In parts of southern Africa, the virus has infected more than a quarter of the young adult population, reducing life expectancy and creating enormous strains on social and health services. The long-term effects on social stability and development are not yet well understood, and it is not known how deaths from AIDS are a factor in ongoing instability in countries such as the Congo and Zimbabwe.

While the first major medical and governmental responses to HIV and AIDS came in developed countries where public health and gay movements were more established, it became apparent that AIDS was far more severe in some of the world’s poorest countries, above all in sub-Saharan Africa. In 1986, the World Health Organization established the Global Program on AIDS, which in the early 1990s was replaced by UNAIDS, a program intended to promote coordination across all United Nations agencies. In 2000 there was a specific debate on the impact of AIDS on the peace and security in Africa in the UN Security Council, followed by two special sessions of the General Assembly to address the global crisis. A commitment to combating HIV is specifically mentioned in the United Nation’s Millennium Development Goals as well.

Responses to the AIDS epidemic were strongest in countries that combined government commitment to fighting the disease with strong civil society organizations, and Brazil, Thailand, and Uganda are often cited as exemplars of good responses. However, the situation in Uganda has become far more complex over recent years, as moralism has affected what was originally a very effective prevention program.

The politics around treatments and prevention are rather different. As antiretroviral drugs (ARVs) have become more effective, access to them has become a major concern, with considerable tension between major pharmaceutical companies and governments over supply and access to generic drugs. The provision of ARVs are testing international trade and property agreements, with a gradual acceptance that profits and intellectual property should not be barriers to providing lifesaving medicines.

Prevention, on the other hand, requires a change to intimate behaviors, mainly sexual but also drug-related and needle usage, which many governments are reluctant to acknowledge. Although intravenous drug and needle users and homosexual men are the most vulnerable demographics in many countries, especially in Asia, Latin America, and the former Soviet Union, programs directed to educate and assist these groups are often underfunded, as prevention is often hampered by laws and social stigma. For example, the money made available by the Bush administration through the President’s Emergency Plan for AIDS Relief required an emphasis on abstinence education as a preventive measure instead of promoting safe sexual practices, and there is considerable controversy about the effectiveness of abstinence on stemming sexual disease.

The most controversial responses to the epidemic came in South Africa, where after years of dilatory response South African President Thabo Mbeki expressed skepticism about the role of HIV in causing AIDS and the effectiveness of ARVs. It is estimated that President Mbeki’s denial resulted in more than three hundred thousand deaths that could have been prevented had the South African government made readily available drugs, which generated the most significant grassroots AIDS movement to date: the Treatments Action Campaign. AIDS policies started to change toward the end of Mbeki’s term in office, but it remains an unfortunate reminder of the negative importance of government inaction and denial.

South African activism drew heavily on earlier examples of AIDS treatment and prevention from Western countries, especially the United States, which pioneered community mobilization in result to the epidemic and introduced global symbols such as the red ribbon and the label “People living with AIDS. ”The AIDS epidemic remains a case study of globalization, both in terms of the spread of discourses and treatment.

Bibliography:

  1. Altman, Dennis. Power and Community: Organizational and Cultural Responses to AIDS. London:Taylor and Francis, 1994.
  2. Barnett,Tony, and Alan Whiteside. AIDS in the Twenty-First Century: Disease and Globalization. New York: Palgrave Macmillan, 2003.
  3. De Waal, Alex. AIDS and Power: Why There Is No Political Crisis—Yet. New York: Zed Books, 2006.
  4. Epstein, Helen. The Invisible Cure: Africa, the West, and the Fight against AIDS. New York: Farrar, Straus and Giroux, 2007.
  5. Fourie, Pieter. The Political Management of HIV and AIDS in South Africa: One Burden Too Many? New York: Palgrave Macmillan, 2006.
  6. Lieberman, Evan. Boundaries of Contagion: How Ethnic Politics Have Shaped Government Responses to AIDS. Princeton, N.J.: Princeton University Press, 2009.
  7. Pisani, Elizabeth. The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS. New York: Norton, 2008.
  8. Poku, Nana K. AIDS in Africa: How the Poor Are Dying. Cambridge, U.K.: Polity Press, 2005.

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