Politics and the AIDS Epidemic - Coursework Example

Politics and AIDS Acquired Immunodeficiency or AIDS is caused by infection with Human immunodeficiency virus or HIV. The first cases of AIDS were reported in 1981. Since then, severe hundreds of thousands of cases have been reported all over the world, including the US. AIDS has contributed to significant mortality and morbidity all over the world and continues to do so. AIDS has claimed more than 25 million lives all over the wold and has affected more than 40 million individuals (Kates, 2004). In the United States alone, more than 1.2 million individuals have been affected and more than 5 hundred thousand people have succumbed to the disease (Kates, 2004). The part of the world that is affected worst by HIV infection is the sub-Saharan Africa. As of now, their is neither a cure nor a vaccine for AIDS. Thus, combating the disease is a major challenge for health care providers and biomedical scientists. AIDS and HIV infection represents one of the most public -pressing public health policy and public health problem in the world. Currently AIDS is pandemic and has significant impact on the health care costs. In the current era, HIV infection is considered to be in the end stage of a chronic disease with rapid spread among Hispanics and Blacks (Fox, 1990). Though the disease was first identified in 1981, the mode of transmission of the disease and causating agent was discovered only in 1984. In 1985, detection of the virus was developed and applied to blood transfusions. In 1987, anti-retroviral agents were manufactured and since then there has been constant upgrading of drugs to combat infection, but with no cure or vaccine for the disease. Currently, it is estimated that 850,000 to 950,000 Americans are living with HIV infection/AIDS (Kates, 2004). The disease is a national epidemic with severe effect on specific groups like injection drug users, gay and bisexual men, young individuals and racial and ethnic minorities. Currently, it is also increasingly affecting communities which are economically backward and also women. Since the time AIDS was diagnosed for the first time in the United States, the relationships among politics, science and health care policy have changed drastically. In the 1980s, the HIV epidemic's politics were dominated mainly by four interacting factors fear and fascination, individuals involved in the contraction and spread of the disease, endemic problems of the social policy of United States and the impact of scientific knowledge advances on policy (Fox, 1990). During the initial years, politics was considered as inimical for prevention, but not it is considered as central. The main challenge is to facilitate prevention of spread of the virus through policies that protect the most vulnerable population. During the first decade of the AIDS epidemic in the US, the policies were hostile to several areas of research like sexuality and meedle exchange. The political climate last decade was more sympathetic and effective health policies were not there because of two important issues. One was the issue as to whether efforts towards prevention was to be targeted for high risk populations and high risk geographic areas alone, or, must be broadly based. The other was issue was uncertainty of involvement of democratic participation including various local health departments, federal government agencies and community-based organizations (Bayer, 1997). As far as international politics with regard to HIV infection/AIDS is concerned, World Bank has a major role to play for international health with regard to AIDS pandemic. The bank is mainly responsible for various efforts to combat factors contributing to the AIDS like poverty, in countries of Asia, Africa and Latin America. Initially, several structural adjustment programs which were often criticized by the critics were promoted. These developed several negative consequences and the World Bank, along with International Monetary Fund focused on health related issues. AIDS evoked political response and also government action. It was initially evident among urban gay men who formed a politically organized gay community to create information and service. Examples of such organizations include Gay Men's Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP). These organizations lobbied the federal government for favorable policies and funding. Initially, children with HIV positive status were isolated from classmates, although were not kept out of school. The civil rights organizations and various government organizations have countered this action leading to no discrimination of children with HIV serology positive status (Kates, 2004). There is lot of criticism over the fact that the then president of early 1980s, Ronald Reagan did not mention about AIDS until 1987, 6 years after the epidemic started. Infact, his government was reluctant to promote use of condom as a preventive measure (Kates, 2004). When the epidemic spread to groups other than gays, like color and drug users, competition for funding developed. Several disagreements arose about prevention methods, especially needle exchange programs. While several Hispanics and African Americans viewed needle exchange as a means to facilitate and promote drug abuse in their communities, others supported the role of needle exchange programs in the curbing of transmission of HIV (Singer, 1997). According to a top CDC official (n.a., 1992), "senior staff selection and funding for family planning and AIDS have all been directed by the Reagan/Bush administration with an interest in politics and conservative morality, rather than public health." Reagan ignored the epidemic probably because the infection mainly occurred in gay communities. Reagan has been accused of apathy and is actually held responsible for millions of deaths because of the disease. However, it is difficult to predict the course of the epidemic in case Reagan had acted quickly at the beginning itself (Kates, 2004). The US administration was reluctant to discuss various key issues related to the disease like needle use, homosexuality and prostitution and this exemplified the larger problem during the confrontation of the disease. The infection spreads in an intimate way and hence is a challenge to leadership. It also surrounds the epidemic with some amount of stigma and also discrimination towards the infected individuals, contributing to reluctance in counseling, testing and treatment. In addition to these, additional conditions like status of the individuals and treatment of women complicated the crisis and the confrontation strategies. Discrimination and stigma decrease access to services and make it more difficult to treatment. In countries like Thailand and India, more than 40 percent of serology positive individuals had their results leaked to others without their consent. In Philippines, more than 50 percent of individuals reported discrimination in health care facilities (UNAIDS/World Health Organization, 2003). One SSA nations that is currently seeing decline in HIV positive rates is Uganda. Contributors for the decline are condom use promotion, AIDS awareness programs, even for military personnel and screening programs (International Crisis Group, 2004). Because of these efficient programs, the seroprevalence rate in Uganda has dropped from 18 percent in 1993 to 6 percent in 2003 (International Crisis Group, 2004). Political factors are the most important factors to combat the disease and this can be asserted by the success of policies of Uganda. In South Africa, Thabo Meiki, the President of the country has been criticized of lack of political commitment towards combating the disease. His was skeptic about need of action. The prevalence of seropositive rates are very high, more than 20 percent, highest in the world (U.S. Census Bureau, 2004). The scenario has been similar in other parts of the world too. Thus, failed leadership, delay in admittance of the existence of the disease, lack of political commitment, sluggishness in accumulation resources to combat the disease. Thus, politics surrounding the disease are complicated and are threatened by various actions and inactions by what are popular politically and are profitable, rather than effectiveness. The epidemic is rampant in poor areas and thus, globally funded programs are key to fight the disease. The future of the crisis of AIDS is uncertain, but is dependent on the political climate. References Bayer, R. (1997). Science, politics, and AIDS prevention policy. J Acquir Immune Defic Syndr Hum Retrovirol., 14 Suppl 2, S22-9. Fox, D.M. (1990). Chronic Disease and Disadvantage: The New Politics of HIV Infection. Journal of Health Politics, Policy and Law, 15(2):341-355. International Crisis Group (2004) HIV/AIDS as a Security Issue in Africa: Lessons From Uganda (ICG, Kampala/Brussels) ICG Issues Report no. 3 Kates J, Sorian R, Crowley JS, Summers TA.(2002). Critical policy challenges in the third decade of the HIV/AIDS epidemic. Am J Public Health, 92(7), 1060-3. n.a. (1992). Feds defend AIDS policy as HIV rate increases among women worldwide. Wash Memo Alan Guttmacher Inst., (12), 3-4. Singer M. (1997). Needle exchange and AIDS prevention: controversies, policies and research. Med Anthropol., 18(1), 1-12. UNAIDS/World Health Organization (2003) AIDS Epidemic Update (UNIADS, Geneva) U.S. Census Bureau (2004) The AIDS Pandemic in the 21st Century (U.S. Government Printing Office, Washington D.C.) 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