Political Challenges to Mounting and Sustaining a Public Health Response to HIV/AIDS in Developing Countries
In June 2001, at the United Nations General Assembly Special Session on HIV/AIDS (known as “UNGASS”), 189 Member States signed a Declaration of Commitment on HIV/AIDS. By all accounts, this was a turning point in the global response to the HIV/AIDS pandemic. The Declaration specified national, regional, and global goals and targets related to preventing new HIV infections, expanding HIV/AIDS care and treatment, and mitigating the social and economic impacts of the pandemic. In subsequent years, reports by the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as by other global health, research, and advocacy organizations, documented progress, or lack thereof, in meeting the 2001 UNGASS goals and targets.
Five years later, in early-June 2006, at the U.N. General Assembly 2006 High Level Meeting on AIDS, Member States unanimously adopted a new Political Declaration on HIV/AIDS reaffirming and strengthening commitments made in 2001. These declarations were not...
KeywordsHealth Care Worker Harm Reduction Global Fund Civil Society Organization Public Health Response
- amfAR (The Foundation for AIDS Research). (2005). Assessing the efficacy of abstinence-only programs for HIV prevention among young people. Issue Brief No. 2 (April). http://www.amfar.org/binary-data/AMFAR_PUBLICATION/download_file/37.pdf (accessed January 18, 2007).
- Cameron, E. (2005). Witness to Aids. London and New York: I.B. Tauris & Co. Ltd.Google Scholar
- Council on Foreign Relations and Milbank Memorial Fund. (2004). Addressing the HIV/AIDS pandemic: A U.S. global AIDS strategy for the long term. (Report available from the Council on Foreign Relations, New York).Google Scholar
- Csete, J. and Wolfe, D. (2007). Closed to Reason: The International Narcotics Control Board and HIV/AIDS. Canadian HIV/AIDS Legal Network and the International Harm Reduction Development (IHRD) Program of the Open Society Institute. http://www.aidslaw.ca/drugpolicy (accessed March 1, 2007).
- Dare, L., Kim, Y., and Farmer, P. (2006). Where AIDS Efforts Lag Shortages of Health Workers Undermine Advances. The Washington Post, A29. December 1. http://www.washingtonpost.com/wp-dyn/content/article/2006/11/30/AR2006113001164.htm (accessed December 1, 2006).
- de Waal, A. (2006). AIDS and power: Why there is no political crisis—yet. London and New York: Zed Books.Google Scholar
- Elizabeth Glaser Pediatric AIDS Foundation (2006). What About Us? Children’s Battle to Access AIDS Treatment. http://www.pedaids.org/News/Publications/Other/Children_s%20Battle%20to%20Access%20AI.aspx (accessed January 26, 2007).
- Farmer, P. (2007). Intelligent Design. Foreign Affairs, 86 (March/April). http://www. foreignaffairs.org/20070301faresponse86213/paul-farmer-laurie-garrett/from-marvelous-momentum-to-health-care-for-all-success-is-possible-with-the-right-programs.html (accessed April 1, 2007).
- Ford, N., Wilson, D., Bunjumong, O., and von Schoen Angere, T. (2004). The role of civil society in protecting public health over commercial interests: lessons from Thailand. Medecins Sans Frontieres Article. February 13, 2004. http://www.msf.org/ msfinternational/invoke.cfm (accessed January 26, 2007).
- Garrett, L. (2007). The challenge of global health. Foreign Affairs, 86 (January/February). http://www.foreignaffairs.org/2007010faessay86103/laurie-garrett/ (accessed January 12, 2007).
- Global AIDS Alliance. (2006). Children left out: Global community failing to scale up the prevention and treatment of pediatric HIV/AIDS. Advocacy Brief. http://www.globalaidsalliance.org/cd_reports_and_videos.cfm (accessed January 24, 2007).
- Howley, K. (2005). Prostituting the Constitution: An adult entertainment magnate takes on foreign aid prudery. reasononline, August 16. http://www.reason.com/news/show/34080.html (accessed January 27, 2007).
- IOM (Institute of Medicine). (2005a). Scaling up treatment for the global AIDS pandemic: challenges and opportunities. Committee on Examining the Probable Consequences of Alternative Patterns of Widespread Antiretroviral Drug Use in Resource-Constrained Settings; James Curran, et al., editors. Washington, DC: The National Academies Press.Google Scholar
- IOM (Institute of Medicine). (2005b). Healers abroad: Responding to the human resource crisis in HIV/AIDS. Washington, DC: The National Academies Press.Google Scholar
- IOM (Institute of Medicine). (2006). Preventing HIV infection among injecting drug users in high risk countries: An assessment of the evidence. Committee on the Prevention of HIV Infection Among Injecting Drug Users in High-Risk Countries. Washington, DC: The National Academies Press.Google Scholar
- IOM (Institute of Medicine). (2007). PEPFAR implementation: Progress and promise. Committee for the Evaluation of PEPFAR. Washington, DC: The National Academies Press.Google Scholar
- International Treatment Preparedness Coalition (ITPC). (2006). Missing the target #3: Stagnation in AIDS treatment scale up puts millions of lives at risk. http://www.aidstreatmentaccess.org (accessed November 28, 2006).
- IRIN (2006). Swaziland: Nurses fleeing the HIV/AIDS frontline. (December 11). http://www.irinnews.org/report.asp?ReportID=56698&SelectRegion=Southern_Africa (accessed January 24, 2007).
- Lakshmanan, I.A.R. (2007). Drug costs imperil Brazil AIDS fight: [3 Edition]. Boston Globe. Boston, Mass: Jan 3, 2007; pg. A.1.Google Scholar
- Martinez, Y. (2006). Comprensive care for HIV/AIDS: The challenge goes beyond antiretroviral accessibility. The Heinz School Review (no volume number). http://journal.heinz.cmu.edu/articles/comprehensive-care-hiv/aids (accessed January 26, 2007).
- Medecins Sans Frontieres. (2006). A key source of affordable medicines is at risk of drying up: The case of Novartis’s challenge against the Indian government. Medecins San Frontieres Briefing Note, December 2006. http://www.accessmed-msf.org/prod/publications (accessed January 26, 2007).
- Medecins Sans Frontieres. (2006). Bold Solutions to Africa’s Health Worker Shortage. http://www.physiciansforhumanrights.org/library/documents/reports/report-boldsolutions-2006.pdf (accessed January 26, 2007).
- Nissaramanesh, B., Trace, M., and Roberts, M. 2005. The rise of harm reduction in the Islamic Republic of Iran. http://www.internationaldrugpolicy.net/reports/BeckleyFoundation_BriefingPaper_08.pdf (accessed January 27, 2007).
- NRC (National Research Council) and IOM (Institute of Medicine). 1995. Preventing HIV transmission: the role of sterile needles and bleach. Washington, DC: National Academy Press.Google Scholar
- Open Society Institute. (2006). Harm reduction developments 2005: Countries with injection-driven HIV epidemics. New York: International Harm Reduction Development Program (IHRD) of the Open Society Institute. Report available at: www.soros.org/harm-reduction.
- PEPFAR (The President’s Emergency Plan for AIDS Relief). (2006). Report on Work Force Capacity and HIV/AIDS. http://www.state.gov/documents/organization/69651.pdf (accessed January 25, 2007).
- Phoolcharoaen, W., Ungchusak, K., Sittitrai, W., and Brown, T. (1998). Thailand: lessons from a strong national response to HIV/AIDS. AIDS, 12, Suppl B,S123–S135.Google Scholar
- The Prostitution Pledge. (2005, July 4). The New York Times (reproduced in International Herald Tribune). http://www.iht.com/articles/2005/07/03/opinion/edaids.php (accessed January 27, 2007).
- UNAIDS. (2001). HIV prevention needs and successes: a tale of three countries . Geneva: UNAIDS.Google Scholar
- UNAIDS. (2004). Global Resource Tracking Consortium for AIDS, Financing the response to AIDS. Geneva: UNAIDS.Google Scholar
- UNAIDS. (2005). Resource needs for an expanded response to AIDS in low and middle income countries. Geneva: UNAIDS.Google Scholar
- UNAIDS. (2006a). 2006 Report on the global AIDS epidemic. Geneva: UNAIDS.Google Scholar
- UNAIDS. (2006b). Towards universal access: assessment by the Joint United Nations Programme on HIV/AIDS on scaling up HIV prevention, treatment, care and support. United Nations General Assembly , A/60/737. http://data.unaids.org/Pub/InformationNote/2006/20060324_HLM_GA_A60737_en.pdf (accessed January 25, 2007).
- United Nations. (2006). Resolution adopted by the General Assembly, 60/262. Political Declaration on HIV/AIDS, paragraphs 39–41. New York: United Nations. http// data.unaids.org/pub/Report/2006/20060615_HLM_PoliticalDeclaration_ARES60262_ en.pdf (accessed January 16, 2007).Google Scholar
- World Bank. (2003). Averting AIDS Crises in Eastern Europe and Central Asia: A regional support strategy. Washington, D.C.: The World Bank.Google Scholar
- World Health Organization. (2006). Working Together for Health. The World Health Report, 2006. http://www.who.int/whr/2006/whr06_en.pdf (accessed January 26, 2007).