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Responding to public health challenges at the global and local levels can give rise to an array of tensions. To assure sustainable public health, these tensions need to be meaningfully balanced. Using empirical evidence and lived experiences relating to HIV from the global south, this book enunciates the many dimensions of national-level responses to HIV/AIDS including conceptual, philosophical, and methodological perspectives from public health, public policy, bioethics, and social sciences. Calling out glaring neglects, the book makes a bold recommendation for the destabilization of the naturalness with which national HIV/AIDS responses ignore the socio-political and medico-ethical dimensions of HIV. The case made is grounded in the philosophy of social public health. Such a critical perspective is not unique to Ghana's response to HIV/AIDS but serves as emblematic voice for similarly situated settings of the global south. The book is also timely.It is written at a time when public health actors are repositioning themselves to be competent users of not only pharmaceutic vaccines, but also social vaccines. Topics explored in the chapters include:Public health approaches to HIV and AIDSAccess to life-saving public health goods by persons infected or affected by HIV“They are criminals”: AIDS, the law, harm reduction, and the socially excludedDeveloping socially and ethically responsive National AIDS policiesBalancing the Socio-political and Medico-ethical Dimensions of HIV: A Social Public Health Approach is compelling reading for a broad spectrum of readers. The book will appeal to professionals, scholars, and students in public health, public policy, bioethics, and social sciences, as well as medical anthropologists, sociologists, and global health scholars. Public health economists, lay politicians, and civil society organizations advocating for health equity will find the book useful as well.

The political impact of HIV/AIDS varies greatly and is difficult to map. States depend on how governments choose to manage the political implications of HIV and AIDS, both those stemming from the erosions of its own capacity as well as those that originate from their changing relationship on a national and international level. Across the developing world, HIV/AIDS is slowly killing adults in their most productive years, hollowing out state structures, deepening poverty and raising profound questions that touch on the organization of all aspects of social, economic and political life. With the epidemic showing scant signs of slowing down, this innovative volume assesses how HIV/AIDS affects governance and, conversely, how governance affects the course of the epidemic. In particular, the volume:

Young people are particularly vulnerable to HIV: 15-24 year olds account for 50 percent of new cases. Five to six thousand youths become infected every day, most of them in developing countries. The UN General Assembly Special Session on AIDS in June 2001 set a number of goals to drive efforts to reduce prevalence in this age group. This report provides evidence-based recommendations for policy-makers, program managers and researchers to guide efforts towards meeting the UN goals on HIV/AIDS and young people. These goals aim to decrease prevalence and vulnerability; and to increase access to information, skills and services. This report provides a systematic review of the effectiveness of interventions provided: through schools, health services, mass media, communities, and to young people who are most vulnerable to HIV infection.--Publisher's description.

This evaluation assesses the development effectiveness of the World Bank's country-level HIV/AIDS assistance defined as policy dialogue, analytic work, and lending with the explicit objective of reducing the scope or impact of the AIDS epidemic. The evaluation identifies findings from this experience and makes recommendations to improve the relevance, efficiency and efficacy of ongoing and future activities. This is the first comprehensive evaluation of the World Bank's HIV/AIDS support to countries, from the beginning of the epidemic through mid-2004. Because the Bank's assistance is for impl.

This is not another book about how AIDS is out of control in Africa and Third World nations, or one complaining about the inadequacy of secured funds to fight the pandemic. The author looks objectively at countries that have succeeded in reducing HIV infection rates…along with a worrisome flip side to the progress. The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs—stressing increased monogamy and delayed sexual activity for young people—have made the greatest headway in fighting or preventing the disease's spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results. As National Review journalist Rod Dreher put it, Rather than pay for clinics, gadgets and medical procedures—especially in the important earlier years of its response to the epidemic—Uganda mobilized human resources. In a New York Times interview, Green cited evidence that partner reduction, promoted as mutual faithfulness, is the single most effective way of reducing the spread of AIDS.That deceptively simple solution is not merely about medical advances or condom use. It is about the ABC model: Abstain, Be faithful, and use Condoms if A and B are impossible. Yet deeply rooted Western biases have obstructed the effectiveness of AIDS prevention. Many Western scientists have attacked the ABC approach as impossible and moralistic. Some Western activists and HIV carriers have been outraged, thinking the approach passes moral judgment on their behaviors. But there is also a troubling suspicion among a growing number of scientists who support the ABC model that certain opponents may simply be AIDS profiteers, more interested in protecting their incomes than battling the disease. This book is a bellwether in the escalating controversy, offering persuasive evidence in support of the ABC approach and exposing the fallacies and motivations of its opponents.

Globally, action to prevent HIV spread is inadequate. Over 16,000 new infections occur every day. Yet we are not helpless in the face of disaster, as shown by the rich prevention experience analyzed in this valuable new compendium. “Best pr- tice” exists—a set of tried and tested ways of slowing the spread of HIV, of persuading and enabling people to protect themselves and others from the virus. Individually, features of best practice can be found almost everywhere. The tragedy, on a world scale, is that prevention is spotty, not comprehensive; the measures are not being applied on anywhere near the scale needed, or with the right focus or synergy. The national response may concentrate solely on sex workers, for example. Elsewhere, efforts may go into school education for the young, but ignore the risks and vulnerability of men who have sex with men. Action may be patchy geographically. AIDS prevention may not benefit from adequate commitment from all parts and sectors of society, compromising the sustainability of the response. In some countries matters are still worse—there is still hardly any action at all against AIDS and scarcely any effort to make HIV visible. It is no wonder that the epidemic is still emerging and in some places is altogether out of control.