Let's go for human testing of vaccine,says UNAIDS

This is a report on the first large-scale human testing of an experimental vaccine in the developing world; the trial was authorized by Thailand's Ministry of Health and supported by the UN program on HIV/AIDS (UNAIDS). This is a significant step toward the development of a safe and effective vaccine against HIV. However, the vaccine's potential for protecting people against HIV cannot be fully predicted. These multiple trials need to be conducted in developed and developing countries to test the efficacy against different HIV strains in different populations worldwide. The trial in Thailand will test the AIDSVAX vaccine developed by VaxGen, Inc. of California. AIDSVAX is not the first experimental AIDS vaccine to be tested in humans. Several vaccine candidates have been given to people involved in small clinical trials in the US. AIDSVAX has been found to be safe and to stimulate an immune response. Hence, it is the first vaccine test to proceed to large-scale human testing ("Phase III" or efficacy trials). There have been disagreements among researchers on which vaccine to use, but urgent needs must readily be addressed without compromising ethics and science.     

Wealth alone does not buy health: Political capacity,democracy, and the spread of AIDS

Although there have been have numerous studies on AIDS documenting its mortality, its epidemiological features, and its relationship to poverty and development, few studies have systematically analyzed how political factors and policies may help curtail the spread of AIDS. In this paper I consider how a variety of domestic factors influence HIV infection rates across countries. I argue that states with higher state capacity are better able to reduce the spread of the HIV/AIDS epidemic. Moreover, I argue that while strong autocracies can implement efficient policies with fewer constraints, democracies tend to be more responsive to the needs of the population and can be more efficient in curtailing the spread of HIV/AIDS. I empirically evaluate the hypotheses using a cross-sectional time-series sample of 117 countries. The empirical results indicate that greater state capacity indeed appears to help curtail HIV/AIDS infection rates.     

Alternative Population Dynamics in Selected HIV/AIDS Modeling Systems: Some Cross-National Comparisons

This paper examines how demographic representations for the different risk populations influence the epidemic outputs of a simple process-based HIV/AIDS model. Alternative demographic specifications are presented in conjunction with transmission rules for both community and regional settings. Then, the existence, or nonexistence, of equilibrium solutions to these various models is determined to evaluate whether the forecast AIDS series will persist indefinitely or eventually terminate. Last, simulations for countries with distinctive birth and death rates are used to summarize the effect of this variation on the timing and size of the epidemic. All the results assume an epidemic that is unaffected by the practice of safer sex.     

By the time you read this one million children infected with HIV will be living in the shadows

Every day, 1000 children become infected with HIV. UNAIDS therefore estimates that by the end of 1997, 1 million children under age 15 years will be living with HIV and experiencing the physical and psychological consequences of infection. Since the beginning of the pandemic, more than 2 million HIV-positive children have been born to HIV-positive mothers, and hundreds of thousands of children have acquired HIV from blood transfusions and through sex or drug use. More than 9 million children are estimated to have had a mother who died due to AIDS. Although AIDS is the most recognized disease in the world, insufficient attention has been given to the impact it is having upon children. Unless the spread of HIV is quickly checked, gains achieved in reducing infant and child death rates will be reversed in many countries. An UNAIDS report estimates that by 2010, AIDS may increase infant mortality by as much as 75% and under-5 child mortality by more than 100% in the worst affected countries in the world. It is clear that AIDS will soon be a major cause of death among children. Since about 90% of children under age 15 years acquire HIV from their mothers, either before or during birth or through breast feeding, reducing the vulnerability of infants to HIV infection means enabling women to prevent themselves from contracting HIV and to procure antiviral drugs which can reduce the risk of mother-to-child HIV transmission.     

Research on human subjects,exploitation, and global principles of ethics

Abstract

In 1997, 5.8 million people became infected with HIV, 30.6 million people were living with HIV/AIDS, and infection was running at about sixteen thousand new infections a day, of which more than 90% were in low income countries. Against this background the urgency and importance of the fight against HIV/AIDS can scarcely be exaggerated. While a cure for AIDS remains elusive research to discover more effective treatment and possible vaccines is vital. It is at this crucial moment that moral criticism has emerged of some of the most promising research towards treatments and vaccines for HIV/AIDS. This criticism has focused on, and purports to be justified by, the major current international principles and protocols on the ethics of research on human subjects. If this criticism is valid and no better ways of prosecuting successful research on AIDS can be found, the consequences, as the figures above indicate, are truly bleak. This paper will attempt to provide an appropriate framework for assessing the ethics of research on human subjects generally and in doing so will assess the relevance and force of the major ethical criticisms that have been levelled at current research on human subjects in the context of HIV/AIDS therapy and vaccines.     

China's 100 Per Cent Condom Use Program: Customising the Thai Experience

This paper examines the adoption and roll-out of a 100 Per Cent Condom Use Program (100% CUP) in the People's Republic of China (PRC). It first details the initial implementation of a 100% CUP in Thailand and explains how this created a framework for action in other developing countries. It then examines the implementation of pilot programs in China. We conclude that governmental authorities in the PRC now actively target designated high-risk populations such as female sex workers in order to combat the spread of sexually transmissible infections and HIV/AIDS. This has resulted in the introduction of new legal frameworks and the use of widespread media publicity to promote condom use and safer-sex strategies. However, the more effective implementation of a national 100% CUP in China requires attention to the problems associated with the legal and social marginalisation of female sex workers, which is reinforced by police-led crackdowns on prostitution.     

Securitising HIV/AIDS in the Xinjiang Uyghur Autonomous Region

For the People's Republic of China, the localised HIV/AIDS epidemics in the Xinjiang Uyghur Autonomous Region are emerging as threats to those persons affected by the disease, but also to the stability of Xinjiang. This article examines the HIV/AIDS epidemic in Xinjiang and considers the impacts it may have on human and political security. The authors argue that due to its remote location and the religious, cultural and ethnic diversity of its population, and current political situation, Xinjiang poses difficult obstacles to effective programs in tackling HIV/AIDS, and the pandemic has disproportionately affected the minority nationalities in the region compared to their Han counterparts. If the HIV/AIDS pandemic among minority nationalities in Xinjiang continues to grow, it has the potential to further weaken social cohesion there, as well as Uyghur human security. Therefore, a HIV/AIDS pandemic in Xinjiang could tip the balance in terms of ethnic and regional stability.     

Medical Research Council Programme on AIDS in Uganda – the first 10 years

Abstract

The Medical Research Council (MRC) Programme on AIDS in Uganda is based at the Uganda Virus Research Institute of the Ugandan Ministry of Health in Entebbe on the shores of Lake Victoria. The programme was established following a request in 1988 from the Ugandan Government to the UK Government for assistance with AIDS, which had recently been discovered to be a large and growing health problem in the country. At that time Uganda had the worst published rates of HIV infection in the world. Over the past 10 years, Uganda has to some extent controlled its AIDS problem while other countries have been overtaken by even worse epidemics. From the outset of the epidemic Ugandan political leaders have discussed the dangers that HIV infection presented to the country and looked for support from community and opinion leaders, including religious groups. They have used available human resources in a relevant manner to trigger important social changes. Sex education is becoming integrated into the school curriculum, programmes have been established to improve the treatment of sexually transmitted diseases throughout the country, and the use of condoms has been actively and widely promoted through free distribution and social marketing. In Uganda today, experts estimate that 10–25% of the urban population and 4–10% of the rural population are infected with HIV.     

Minding Your Peers and Queers: Female sex workers in the AIDS discourse in Australia and South-east Asia {1}

Sex workers have been incorporated into the Western AIDS discourse initially as a category of 'risk group'. The model of 'peer education' developed successfully by gay men in the West has been used with sex workers in Australia and is being exported to South-east Asia. This paper shows that the role of the 'peer educator' is paradoxical, and embedded in locally specific laws, cultural factors and power relations involving the sex industry. Ignoring the politico-cultural context can mean that peer workers are involved in their own surveillance and in reinforcing the stigma of sex work. The 'Asian prostitute' has been characterised both as an exotic commodity and as the focus of 'AIDS panic'; however, alternative voices express both complexity of the sex industry and more immediate concerns which need to be confronted before HIV/AIDS can be given meaning.     

Time‐Dependent Functions for Avoidance Behaviors Made in Response to the Circulation of HIV and AIDS

Interventions aimed at preventing HIV transmission include avoidance behaviors like condom use and reduced partner acquisition. In turn., engagement in such activities might also entail changed patterns of travel to evade contact with infected individuals. One method of estimating the effects of these actions on the observed distribution of HIV/AIDS involves the specification of space‐time models that imitate the epidemic process. This paper presents an application of this procedure where prevention is construed as a continuous population response to the evolving distribution of HIV and AIDS. This task entails the construction of models with time‐dependent parameters adapted to predicted prevalence or incidence measures to represent the effects of specific avoidance behaviors. In this respect, a multiregion model is described that serves as a baseline for analyzing the impact of preventative actions on the HIV/AIDS epidemic in Western Europe. A series of adaptation functions are derived within this system for imitating both changed rates of partner acquisition and altered travel behaviors. The results elicit modifications to the behavior of the baseline epidemic that are generated by each of these functions. Then, the conditions supporting space‐time variations in rates of survival between core countries (relatively low) and those in the periphery (relatively high) are investigated. The discussion considers the implications of these results for health policies that promote avoidance behaviors.     

The Response to HIV/AIDS and the Construction of National Legitimacy: Lessons from Uganda

Uganda faces continual challenges as a low‐income nation reliant on international donors and non‐state actors. It was also one of the first countries to face a population‐wide HIV epidemic, a disease that can strain state capacity to its limits. One would expect that such a combination would weaken the governance structures in a developing country; yet, if anything, the Ugandan state has emerged from its HIV crisis with its legitimacy bolstered. This article reviews the Ugandan response to HIV/AIDS, analysing the ways in which the epidemic has provided a new arena for the Ugandan state to engage with international actors.     

Understanding the Southern African ‘Anomaly’: Poverty,Endemic Disease and HIV

The epicentre of the global HIV epidemic is southern Africa. Previous explanations point to migration patterns and highly skewed income distribution, both thought to promote risky sexual behaviour. This study emphasizes the importance of common infectious and parasitic diseases that increase the likelihood of HIV transmission by increasing contagiousness and vulnerability to infection. Using multiple regression analysis on country‐level data, the authors find that socio‐economic variables explain statistically only one‐tenth of the difference in HIV prevalence between southern Africa and other low‐ and middle‐income countries. Measures of five cofactor infections together with the socio‐economic variables, however, explain statistically about two‐thirds of the southern Africa difference in HIV prevalence. They conclude that the relative affluence of countries in southern Africa and historical migration patterns have tended to mask the vulnerability of the majority of their populations who are poor and who have very high prevalence of infectious and parasitic diseases. Those diseases replicate a cycle of poverty that produces biological vulnerability through coinfections. An important implication of this research is that integrating treatment of endemic diseases with other HIV‐prevention policies may be necessary to slow the spread of HIV.     

Knowledge,Morality and ‘Kastom’: SikAIDS among Young Yupno People,Finisterre Range,Papua New Guinea

ABSTRACT This paper investigates the extent of knowledge about HIV/AIDS among young Yupno women and men. Local understanding of sikAIDS is shaped by cultural, moral and religious concepts and processes that are based on social values and practices. Difficulties these young people face in accessing information about HIV/AIDS and using it to implement preventative measures — for example by obtaining condoms — have to be seen in the framework of ‘kastom’ and a moral discourse coined and influenced by the Lutheran Church. As the research shows, there is an urgent need for a broad and contextually sensitive approach to sexual health, including information about conception, family planning methods, and sexually transmitted diseases when planning awareness campaigns for teenagers in rural regions.     

An international public health crisis: can global institutions respond effectively to HIV/AIDS?

The United Nations Millennium Project (2005 UN Millennium Project , 2005 . Combating AIDS in the developing world ( London : Taskforce on HIV/AIDS, Malaria, TB, and Access to Essential Medicines: Working Group on HIV/AIDS, Earthscan ). [Google Scholar]) describes the HIV/AIDS epidemic as a ‘global catastrophe, threatening social and economic stability in the most affected areas, while spreading relentlessly into new regions’. Multilateral institutions under the leadership of the Joint United Nations Program on HIV/AIDS and World Health Organization have been charged with coordinating the worldwide response. Yet with attention and funding diverted between bilateral, regional and multilateral aid providers, and little discernible success in containing the global epidemic to date, it remains an open question whether traditional global institutions are able to effectively combat HIV/AIDS. It is argued that bilateral relationships are still heavily relied upon at present as traditional multilateral arrangements struggle for resources and political attention. The critical questions discussed here are whether global institutions should, can and will respond effectively to the HIV/AIDS crisis. This analysis finds that the most readily organised and deployed global response will likely involve an alliance of public and private agencies that can escape some of the domestic, political and organisational constraints inherent in existing HIV/AIDS funding arrangements. Ultimately, newer hybrid arrangements that have emerged recently, like the Global Fund to Fight AIDS, Tuberculosis and Malaria, may offer a more enduring global regime to control the HIV/AIDS epidemic. The corollary is that UN agencies alone in their traditional form, hampered by multilateral practicalities, will be less effective.     

Poverty, debt and Africa's HIV/AIDS crisis

As Africa enters its third decade of structural adjustment pressures, the promised advantages of economic restructuring—as hailed by the various lending bodies— have not been forthcoming. The indelible picture emanating from the continent is one of a people relegated to a position of extreme poverty as state managers and the international community either fail to, or seem unable to, pursue policies that will secure the basic needs of its citizens. To compound matters, HIV and AIDS are threatening to erode the continent's already fragile development capacity. Predicated on the continent's limited economic capabilities, this article charts the relationship between poverty, debt relief and the politics of effective response to HIV/AIDS in Africa. The article begins with an assessment of the societal causes and consequences of the epidemic, moving on to contextualize the case for debts cancellation. It concludes by examining the crucial relationship between debt relief and the successful implementation of effective strategies against the pandemic in Africa.     

Reconstructing the Space-Time Structure of the HIV/AIDS Epidemic for the Countries of Western Europe

This paper applies a compartmental epidemic modelling system to the estimation of HIV infection transfers between the nations of Western Europe for the period 1973–98. This multiregional model imitates the formation of disease contacts by both local and international travel, where the latter is assumed to have the lower sensitivity to the effects of spatial separation. This system is calibrated in two stages: first, disease parameter sets are found to best fit the timing of recorded AIDS incidence in each nation; and second, these sets are entered into a multiregion setting to identify the travel parameters that support the lags between these series. The outputs include estimates for the first year of HIV incidence in each country and the subsequent pathways of infection transfer that connect these dates. The results indicate the contrasting roles of the southern and northern countries within the continental epidemic and point to national variations in the recent delaying effects on AIDS incidence of drug combination therapies.     

海外移民与宗教仪式回传——甲午年新加坡修德善堂养心社宋大峰祖师金像百年回銮

论文以甲午年(2014年)闰九月新加坡修德善堂养心社宋大峰祖师金像百年回銮活动为例,分析了当代社会海外移民通过将源自中国的传统文化习俗回传而对中国乡村社会所产生的影响。从宗教层面看,祖师百年回銮实现了信仰体系的循环与完善,为中国传统文化的传播与改善注入了新元素。从移民历史来看,潮人移居海外,同时在海外将潮人信仰理念传播开来。中国实施改革开放后,与移民共同迁移的祖师信仰也可以实现"返乡"——仪式回传。祖师信仰及其仪式的回传,结合中国本土宗教文化的复苏,在一定程度上影响了原乡地方社会的信仰体系。从慈善事业角度看,善堂的慈善事业,救济贫苦,施医赠药,造福人类。在潮汕乡村,随着宗教信仰的苏醒,慈善事业也随之兴起,这对发展中国慈善事业有重要意义,同时慈善事业在中国乡村的发展,也影响了乡村的地方经济。     

AIDS Activism in Pakistan: Diminishing Funds,Evasive State

This article draws on a year of ethnographic fieldwork in the HIV/AIDS sector of Pakistan at the moment of rolling back a World Bank‐financed programme. Classified by UN agencies as at ‘high risk’ of a generalized HIV epidemic, Pakistan has an epidemiology driven by injecting drug use, and a Penal Code and Islamist legislation which criminalize non‐therapeutic drug use and extra‐marital sex. In recent years, a sharp increase in the numbers of registered HIV‐positive people has necessitated a shift from HIV prevention among ‘high risk groups’ to the provision of care to those living with HIV/AIDS. The rolling back of external funding, which was further compounded by the effects of devolution on the Ministry of Health, created challenges for AIDS activism in Pakistan, as reflected in the everyday lives — and deaths — of the patient‐activists and their community‐based organizations. This article recounts the story of one such aspiring AIDS activist caught in multiple dilemmas emanating from these macro‐processes. This story throws light on the limitations of the complex agency of actors in development, and shows how the shifting loci of power from the state to non‐state entities in the global neoliberal order impacts the provision of vital services like HIV prevention and AIDS control.     

Hidden Child Workers: Young Carers in Zimbabwe

Drawing on an interview‐based case study of young people caring for dependent adult members of their households in Harare, this paper connects the experiences of young carers in Zimbabwe to global forces—namely the HIV/AIDS pandemic and economic liberalisation. It is argued, firstly, that care‐giving by young people is a largely hidden and unappreciated aspect of national economies which is growing as an outcome of conservative macroeconomic policies and the HIV/AIDS explosion. Secondly, that young people have a right to recognition of their work as work. Thirdly, while acknowledging that conceptualising childhood is problematic, there needs to be less emphasis on northern myths of childhood as a time of play and innocence and more attention on defending children's rights to work as well as to be supported in their work under appropriate circumstances. The articulation between global processes and the localised experiences of individual children as providers of care within the home contributes to efforts to re‐introduce social reproduction as an important (but often missing) aspect of debates around globalisation. In addition, this article adds to the growing literature on the geographies of childhood while tackling the imbalance within that literature, whereby working young people and those of the global South are relatively neglected. Suggestions are offered in the conclusions for policy recommendations to recognise and support young carers in Africa, while calling for further research.