The HIV Pandemic: Local and Global Implications

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As we approach the 25th anniversary of the first recognition fo HIV/AIDS in 1981, this book reflects on the international impact of the disease. It has persistently remained a global issue, with more than 50 million people worldwide estimated to have been infected since that date. This ambitious book, written by 165 authors from 30 countries, offers a multi-country comparative study that examines how the response to the common, global threat of HIV is shaped by the history, culture, institutions and health systems of the individual countries affected.

Increasingly the shift of health systems has been from prevention only as the main containment strategy, to a strategy that includes scaling up HIV treatment, and care and prevention services, including antiretroviral therapy. Thus, all parts of the health system must be involved; policy makers, healthcare professionals and users of the services have been forced to think differently about how services are financed, how resources are allocated, how systems are structured and organized, how services are delivered by patients, and how the resulting activity is monitored and evaluated in order to improve the effectiveness, efficiency, equity and acceptability of the response.

The book is unique in attempting to describe and assess a range of responses across the globe by situating them within the characteristics of each country and its health system. Most chapters combine a health policy expert with an HIV specialist, allowing both a 'top down' health system approach and a 'bottom up' HIV-specific perspective. There are thematic and analytical sections, which provide an overview and some suggestions for solutions to the most serious outstanding issues, and chapters which analyze specific country and organizational responses. There is no perfect health system, but the evidence provided here allows the sharing of knowledge, and an opportunity to assess the impact and reactions, to an epidemic that must be considered a long term issue.

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Product Details

  • ISBN-13: 9780199237401
  • Publisher: Oxford University Press
  • Publication date: 2/9/2008
  • Pages: 840
  • Product dimensions: 9.60 (w) x 6.50 (h) x 1.80 (d)

Meet the Author

Alan W Whiteside is an elected Member of Governing Council of the International AIDS Society, a member of the Governing Council of Waterford Kamhlaba College, and one of the Commissioners of the UN Commission on HIV/AIDS and Governance in Africa. He has written the forthcoming OUP book HIV/AIDS: A Very Short Introduction. Nicholas Mays has served as Director of Health Services Research at the King's Fund, the UK's leading independent health policy and management foundation. He has also acted as principal adviser in the Social Policy Branch of the New Zealand Treasury. Professor Mays is editor of the Journal of Health Services Research and Policy, published by the Royal Society of Medicine Press. Eduard Beck has recently taken up a post in the HIV Department of the World Health Organisation in Geneva.

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Table of Contents

1 The HIV pandemic and health systems : an introduction 3
2 The evolving HIV pandemic 21
3 Social and economic impact of the HIV pandemic 36
4 Determinants of the HIV pandemic in developing countries 50
5 HIV prevention programmes : an overview 67
6 Antiretroviral treatment and care of HIV 86
7 HIV vaccines : development and future use 105
8 Ethical issues and HAART 117
9 Legal and human rights implications 134
10 Strategic information for HIV programmes 146
11 The contribution of cost-effectiveness analysis 164
12 Botswana 181
13 Ethiopia 198
14 Nigeria 215
15 Senegal 228
16 South Africa 240
17 Uganda 255
18 Cambodia 270
19 China 282
20 India 300
21 Indonesia 317
22 The Philippines 333
23 Thailand 348
24 Barbados 364
25 Cuba 379
26 Haiti 393
27 Jamaica 404
28 Argentina 416
29 Brazil 429
30 Costa Rica 447
31 France 460
32 Italy 476
33 Russian Federation 488
34 Spain 502
35 Ukraine 514
36 The United Kingdom 529
37 Canada 545
38 Mexico 564
39 The United States of America 577
40 The UN response to the HIV pandemic 593
41 Donor, lender and research agencies' response to the HIV crisis 607
42 Financing HIV : the roles of international financial institutions 625
43 Fiscal and macroeconomic aspects of the HIV pandemic 642
44 Trade, intellectual property and access to affordable HIV medications 660
45 Country-level public-private partnerships for successful HIV treatment programmes 674
46 Developing human resources for the HIV pandemic 688
47 The contribution of civil society 706
48 The role of community involvement in HIV programmes in South Africa 720
49 Responding effectively to the HIV pandemic 737
50 Some lessons learned 757
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