BIOL368/F16:Class Journal Week 11

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Isai Lopez

Summary of Myth Six: Prevention vs. Treatment

Intro

  • Vaccines for the HIV virus have been reported to have been near development since the early 2000's comparing the supposed breakthrough to the moon landing
  • The focus on developing an effective vaccine may be dangerous in the long run because it takes attention away from other issues of the virus, such as disease prevention and education of less developed countries.

Progress on vaccines

  • Initial trials for a vaccine began in the late 80's, but as more information came out, the problem became apparent that the virus' ability to mutate and evade would prove difficult to conquer.
  • Research toward understanding the virus has increased dramatically, as funding from the NIH and worldwide has been largely increased since the 90's.
  • Efforts to develop organizations within Africa that aim to develop a vaccine have also made significant progress.
  • Vaccines are less commercially beneficial from a business standpoint because they are administered very few times compared to medicines taken repeatedly.
  • Efforts to develop and test vaccines are continually underway by large medical corporations

Researchers face Significant Challenges

  • The primary impetus has been the gaps in knowledge necessary to effectively combat the virus
    • Specifically, we've not yet discovered the "correlates of immunity" which are understood to be the exact responses by the immune system which allow the host to fight off infection and confer immunity
  • Because there are no cases where the host has fought off HIV completely, the exact conditions under which a defense could be mounted are not understood and cannot be developed accurately.
  • Two pathways for movement through the body exist for the HIV virus, requiring a vaccine to target both forms.

Vaccines in the Pipeline?

  • While news of a development of an HIV vaccine are uplifting, we have to take into account what stage we are in in developing said vaccine.
    • Development can take anywhere from 10-50 years for an effective vaccine
  • The process for moving a vaccine down the "pipeline" is incredibly tedious and rigorously tested. Very few vaccines actually make it far down the testing process.
  • Vaccines must take into account an enormous range of factors and control for all of them to be considered viable.
  • Money is an enormous factor in pushing a vaccine forward, and the support for effective vaccines is not always there.

"Partially Effective" Vaccines

  • Test results are largely variable, with efficacy of HIV vaccines not nearly at levels expected for effective vaccines to other diseases.
  • Some developed vaccines provide a better defense against the virus, while not completely providing immunity to it.
  • Strategies to fight the virus will likely need to include more than just a vaccine, but also prevention strategies and education about the spread of infection.

The Distribution Time Gap

  • The disparity for reaching an effective vaccine is even more pronounced in poorer countries, where access to medicine is reduced.
  • The development of a vaccine will like take longer than a decade, and even longer to mass produce and distribute the vaccine on a global scale.
  • The spread of HIV is still a growing problem in many places, where infection rates are reaching endemic levels.
  • Provisions must be put in place that allow all countries equal access to a vaccine once it is developed.
  • Even further, purchasing power varies among countries, so there needs to be a way for prices to be adjusted for vaccines to be affordable for all patients.
  • The distribution of vaccines is also likely to be an issue, as supply will be the greatest constraint.
  • Efforts must be made to ensure that the choice is not solely between a vaccine and treatment, but rather a combination of the two.
  • The most important current strategy to fight HIV spread remains the education of patients at risk for being exposed to the disease, as well as strategies for how to live a healthy life once exposed.

Colin Wikholm

Summary of Conclusion:

AIDS is a widespread epidemic that will take engagement of the global community to be addressed. This speak to a country's scientific ability, but also to their moral core. Nonetheless, the fight on AIDS has easily-addressed issues that we have yet to consider. First of all, AIDS cannot be fought by an individual country. Many poor countries suffer the worst and thus require international intervention. Although there is extensive research on HIV and AIDS, it very badly needs expansion. What is more, there needs to be a greater focus on prevention. However, the greatest possibility of fighting AIDS effectively is with vaccines, which also needs to be greatly expanded in the research field. And although many argue that investing in AIDS treatment is not cost effective, this is a narrow view. Solving AIDS would be hugely beneficial to the global community. Aside from this, it should be a central concern to the ethical realm of the international community.

Colin Wikholm 02:59, 15 November 2016 (EST)

Matthew Allegretti

Summary of Preface, Introduction, HIV/AIDS Basics

Preface

  • More than 28 million people on African continent are infected with HIV, with a large concentration in South Africa.
    • Most will die over the next decade.
  • Disproportionately affects poor
  • Treatment Action Campaign goals:
    • Improve healthcare access for South Africans
    • Ensure access to affordable, high quality treatment for all with HIV/AIDS
    • Launched December 10, 1998
    • Litigated against pharmaceutical company lawsuits and tried to provide framework for inexpensive treatment
    • Efforts made to lower mother-to-child transfer rates with effective treatments
  • Many obstacles exist
    • Wealthy countries do not prioritize HIV/AIDS
    • Pharmaceutical companies charge too much for treatment options
  • Antiretroviral medications are shown to improve quality of life for HIV/AIDS victims
  • Many ethical issues surrounding AIDS
  • Book seeks to challenge complacency to the issue of HIV/AIDS

Introduction

  • Already have effective medicine for assisting HIV/AIDS patients
  • Prevention methods are underfunded and lack a vaccine
  • Most cannot afford life extending drugs
  • Wealthy countries are needed to contribute financially to the efforts against HIV/AIDS
  • Misinformation cripples efforts to manage this disease
  • Myths discussed are those held by people and experts in affluent countries
    • 10 are discussed in this book
  • Discussions of HIV/AIDS often revolve around only one small aspect of the complex disease
  • Antiretroviral treatments have been available and effective for those who can afford them since 1996
  • Believe epidemic should be approached with:
    1. Vigorous preventative measures to protect uninfected
    2. Treatment including antiretroviral therapy, prophylaxis, and treatment of opportunistic infections
    3. Continued attack on poverty and inequality that fueled the pandemic from the beginning
    • Immediate action can prevent new infection and prevent more premature deaths
  • Book is a collaborative effort of a variety of fields
    • Connected by organization Partners in Health and research arm, Institute for Health and Social Justice
      • PIH focuses on underserved communities and bringing attention to problems that are ignored by affluent communities and nations
  • Does not explore
    1. Origin of AIDS
    2. AIDS denialism- claims that the disease is a hoax
    • Denialist views have gained sympathy from government officials in South Africa
  • Battle against HIV/AIDS is both a medical effort and an ethical battle, deciding how internationally we value poor, downtrodden communities

HIV/AIDS Basics

What is HIV?

  • HIV causes AIDS
    • Attacks CD4 positive helper T cells
  • Body's response is to make antibodies and more CD4 positive T cells to replenish those lost

What is AIDS?

  • Acquired Immunodeficiency Syndrome
    • Medical designation for a number of symptoms, opportunistic infections and laboratory markers indicating advanced progression of HIV infection

What does it mean to be HIV-Postive?

  • Serological tests look for the presence of antibodies against HIV in blood
    • HIV-positive is infected, but does not necessarily have AIDS
    • In absence of treatment, HIV progresses to AIDS within a decade

How is HIV transmitted?

  • Unprotected sex with infected partner
  • Sharing needles used by an infected person
  • Blood transfusion from infected person
  • Mother to infant
    • Before or during birth
    • Through breast-feeding
  • The fact that HIV-positive people can remain asymptomatic increases chances of spreading the virus

How can infection be prevented?

  • Condoms during sex
  • Elimination of sharing needles
  • Short course of antiretroviral medications to HIV positive mother at the time of delivery drastically reduces transmission
  • Proper monitoring of blood supplies
    • Not all that easy to implement in practice

What is the current medical management of AIDS?

  • ARVs (Antiretrovirals)
    • Usually used in combination with other ARVs
      • Referred to as HAART (Highly Active AntiRetroviral Therapy)
      • Not a cure
    • Have potentially debilitating side effects
    • Patients gain resistance to treatments over time
    • Still work to dramatically enhance life quality

What's the difference between risk and vulnerability?

  • Risk: probability a person could become infected
    • Looks for behaviors associated with possible transmission
    • Unprotected sex with multiple partners, intravenous drug use, etc.
  • Vulnerability: Socioeconomic factors that might drive people to these risk factors
    • Poverty, discrimination, gender inequality, etc.

What is prevalence and how does it differ from incidence?

  • Prevalence: Percentage of people in a population with a specific disease or condition at any given time.
    • Low prevalence can be falsely reassuring
      • Average value of whole population; can mask small, high risk groups with high prevalence of HIV/AIDS
  • Incidence: rate at which new infections are occurring

Matthew R Allegretti 01:38, 15 November 2016 (EST)

Will Fuchs

Summary of Myth 3-Corruption

  • The standing myth is that funds for relief efforts sent to developing countries afflicted by AIDS are intercepted by corrupt government officials as apposed to going to research and treatment programs.
    • It is a misconception that Americans believe that corruption is one of the big issues in regards to AIDS treatment in developing countries.
  • There are 3 reasons that corruption shouldn't hamper global support to AIDS programs.
    • First, being that there are many anti-corruption initiatives underway in Africa.
    • Second, there are close monitoring of NGO's over the use of their funds to ensure proper use.
    • Third, some countries have developed autonomous HIV/AIDS programs internal to their affairs.

International Efforts to Fight Corruption

  • It is true that corruption does exist in regards to assistance AIDS programs.
    • However corruption is not limited to the developing country's end.
    • Several scandals in the US and Europe that highlight this.
  • Addressing corruption is an international responsibility.
    • Many sovereign powers have ratified initiatives like Anti-Bribery Convention to combat corruption.
    • Serious scrutiny and repercussions are beginning to follow these developing countries.
    • Transparency policies are widespread and enforced.

Building Political Commitment for the AIDS fight

  • African corruption focused upon.
  • Vastly improved
  • Transitions to democracy a good move but doesn't ensure a sweeping cleanse of corruption.
    • The cure to corruption is brought about vigorous accountability.
    • and public education.

Role of Global Institutions

  • New protocol with the executions of philanthropic projects and establishment of new agencies.
  • Ensure that monies flowing into projects are having tangible results or progress.
    • Comfort future donors' investments.

Gains against AIDS

  • Corruption and AIDS can be fought simultaneously
  • Quality control
  • Commercial sex safety precautions against spread of HIV.
    • Community efforts into protection and education

Coalition Building and Political Will

  • Unanimous effort and cooperation between developing countries and developed countries will ensure the best combat against AIDS and corruption.

William P Fuchs 00:05, 15 November 2016 (EST)

Zach Goldstein

Summary of "Myth Four: Prevention vs. Treatment":

  • Myth: Prevention programs are the best way to control spreading of aids in developing world. Costly treatment for people already infected with HIV should wait.
  • No AIDS treatment meant the best way to "cure" was to prevent.
  • HAART is the standard of care for AIDS patients in wealthy countries, in developing countries it is different.
  • Cost of antiretrovirals is decreased, most people still don't have access. People without access are forced to promote prevention because treatment is not a feasible financial option.
  • A force to choose between treatment and prevention in developing countries is highly likely.
  • Four reasons for progression of both treatment and prevention:
    • Moral and social dilemma of denying treatment to millions of infected people
      Death sentence of treatment access for already infected individuals. Drugs to treat AIDS are a ticket to live, stripping people of that ticket is highly immoral. Many people infected with HIV will die in their most productive years of work and parenting. Must focus on the present to fix the future.
    • Structural limits of prevention programs when no treatment is available
      Education has increased but the spread of HIV has not slowed. Inadequate support for prevention programs can be one target issue. Change in attitudes and actions is needed.
    • Synergy between HIV prevention and treatment
      Not mutually exclusive, in fact they support each other especially in voluntary testing. Those who test positive and obtain counseling can contain it and those who test negative can learn practices to best maintain their health. This is mostly beneficial but difficult to achieve due to discrimination and stigma around HIV.
    • Treatment and political leverage
      Treatment is easier to sell than prevention. Emotions interfere with rationality. Combining forces can be the key to alleviating some of this political separation.
  • Separatism is an issue in the world of AIDS prevention and treatment, i.e. not everyone is on the same side. Ability or inability to pay should not be the difference between life and death for people who are diagnosed with the same virus simply because they are not in a wealthy country. Breaking this injustice could be a huge step in correcting worldwide healthcare inequalities.

Zachary T. Goldstein 16:31, 13 November 2016 (EST)Zachary T. Goldstein


Courtney L. Merriam

Summary of Myth 7 "Profits vs. Health"

This chapter addresses the myth based around the scope and influence of major pharmaceutical companies and how this scope and influence

can be a significant obstacle to individual’s living with HIV/AIDS and how they seek treatment. The chapter highlights the fact that while the pharmaceutical companies do have strong pull, there are other factors at play. Two practical questions are brought up that encompass the goals of individuals fighting AIDS. 1: how can those with a high chance of infection protect themselves, and 2: how can all people with AIDS, in every part of the world, in spite of income or wealth, get access to medicine. With regard to these questions, these large drug companies can either help or get in the way.

History has shown that activists have been able to secure decisive victories against large pharmaceutical companies in the fight against AIDS,

where individual health was put before quarterly profits. Still, pharmaceutical companies are still fiscally based entities, and as some of the most profitable businesses in the world, work towards ever increasing their profits, while, perhaps secondarily, producing lifesaving drugs. This massive amount of money is concentrated in the upper echelons of these companies, for example, five highest paid company executives received upwards of $150 million in 2001, which is more than several impoverished nation’s health budget as a whole.

This inequality is attributed to legal rules governing intellectual property, and consequently, the development, or lack thereof, of certain drugs by

multiple companies. Company representatives defend this high profit margin by claiming its necessary in the face of possible failures and losses due to chasing innovation. Some critics however point out that some of these companies spend far more on advertising than on actual research and innovation.

Several trade agreements regarding international companies and intellectual property have been developed since the early 1990s. The Trade

Related Aspects of Intellectual Property Rights (TRIPS) agreement has allowed for some poorer nations to continue developing certain drugs for a set period of time after a developed nation has patented it. It also includes clauses for parallel importation and compulsory licensing for certain pharmaceutically related emergency situations. Parallel importation is simply purchasing a drug in a country where it is inexpensive and selling it in another country where the price is high. This can help poorer countries find cheaper drugs on a global market. Compulsory licensing involves a government asking a patent holder to give them a temporary license to produce, use, sell, or import the patented drug.

Strategic cooperation between large companies and the activists is necessary for solid progress in AIDS research. The large companies, while

motivated by profit, are still essential for the continued production and development of AIDS medicines for poor individuals in underdeveloped nations. A variety of options exist for pushing for better medicine availability that involve the efforts of every involved entity, from developed governments and multinational pharmaceutical companies, to less developed national governments and private activist agencies. The problems created by the AIDS epidemic don’t have simple answers. While most of these large companies value profit over compassion, they are still instrumental in the fight against AIDS, and must be led by the ethically inclined and vigilant civil citizens.

Courtney L. Merriam 13:34, 14 November 2016 (EST):

Mia Huddleston

Summary of Myth 5: Obstacles to AIDS Treatment in Poor Countries

Myth: AIDS treatment for the poor is not feasible technically due to excessive costs, inadequate infrastructure, and the risk of spreading drug-resistant strains of the virus

High cost of treatment ARV costs have declined due to the entry of generic drug manufacturers. This entry, along with public pressure has influenced major research-based pharmaceutical companies to lower prices on AIDS medications in poorer regions. This has resulted in the drug price decreasing from $10,000 per year to almost $200 per year. However, this doesn’t factor in additional costs such as storage, monitoring, and clinical management of side effects. There are also new institutes and partnerships working to make HAART affordable in poor communities such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM). It is also important to asses the cost of not treating the millions of people living with HIV/AIDS. Studies show that treatment with ARVs can save health systems money due to the decrease in costly medical bills for treatment of opportunistic infections.

Inadequate Infrastructure Instead of looking at the lack or inadequacies of infrastructure in these areas, they can be seen as an opportunity to expand and improve. Many countries’ infrastructure has more strengths than expected. For example, almost every country in the world has some health service mechanism of expanding childhood immunizations and NGOs and private mission hospitals fill most of the gaps. Specialists are finding more and more ways to ease the delivery of ARVs in these countries and sharing information of how to respond to drug side effects. When expensive monitoring cannot be used, algorithms and more inexpensive tests are being developed to be used in their place. When infrastructure may be lacking, new partnerships and alliances can be forged to connect these regions with the medicine people need and information and training health workers need. Although these regions are lacking material resources and tools, their social resources can be used to develop a more reliable health care delivery system. This can be seen in the example of the Haitian DOT-HAART program which used directly observed treatment (DOT) to help treat AIDS patients.

Fears about drug resistance There are three major ways drug resistance can occur; incorrect prescribing or mishandling of medications, patients failure to adhere to treatment regimes, and drug supply interruptions. To avoid these scenarios, triple ARV therapy is recommend along with monitoring the patient as much as possible and the option of a secondary regimen if the first treatment fails. Drugs have been streamlined to reduce the number of pills a patient needs to take to stay on the strict schedule necessary for treatment. Drug supply will work best following already set delivery systems in place such as TB.

Mia Huddleston 16:34, 14 November 2016 (EST)

Matthew K. Oki

Summary of "Myth 8: Limited Resources"

  • Myth: Since financial resources are so limited, there should be a priority for programs that address the basic needs for health and hygiene. Trying to divert funds to complicated, expensive projects is not worth it.
  • Due to poor living conditions, a majority of health risks includes “old” diseases like malaria or tuberculosis, not only “new” diseases like AIDS.
  • The main response to this myth is that high cost treatments, like ARV, should continue to be used because they do not privilege the interests of a few at the cost of many.
  • Considerations for the role of ARV therapy:
    • HIV/AIDS Demographics:
      • AIDS predominantly kills young adults, the most productive members of society.
      • It also significantly reduces the life expectancy in developing countries without AIDS treatment
      • There is a strong monetary relationship between a country’s average life expectancy and its ability to create economic growth.
    • HIV/AIDS, Agriculture, and Famine:
      • Mortality in young farm workers is great due to AIDS, which disrupts many countries main job force. (Agriculture work directly/indirectly provides livelihoods for as many as 80% of the population.)
      • Once a farm family member is sick, much of the rest of the family’s efforts turn to that sick member of the family.
    • Interactions between AIDS and Tuberculosis
      • Widespread ARV treatment will also strengthen efforts to control other diseases like tuberculosis.
      • AIDS acts as an accelerator of TB
    • Household Dynamics and Children’s Health:
      • The death of a young adult member in a family can have devastating impacts on the amount of food and money that family can obtain.
      • A 50% decrease in food consumption and income were correlated with families that had a member with AIDS.
    • The Orphan Crisis
      • All of these previous factors lead to a profound amount of orphans, which many societies cannot handle. So, they end up on the streets.
    • Impact of HIV/AIDS on Health Care Systems
      • All of these patients of AIDS are overwhelming health care systems and hospitals, but an increase in ARV treatment can prevent a continued increase in HIV-positive patients.
      • The increase in HIV-positive patients leads to an increase in HIV-negative patient death.
  • The high expense of ARV therapy is actually cost-effective when looking at immense cost of not treating the vast populations of HIV-positive patients.

Matthew K. Oki 19:25, 14 November 2016 (EST):

Avery Vernon-Moore

Myth 10: "Even with good intentions, ordinary people in rich countries can do little to help in the struggle against AIDS in poor countries.

Summary of response: This destructive myth began due to the quick increase in people who contract HIV-1 and develop AIDS daily. Awareness that we can take action is key, and we can move forward by looking back at what has already been accomplished for inspiration and a starting point to take action. So far, action has been taken to make pharmaceuticals which were available in the United States more accessible to those in poorer countries, and become more familiarized with the scientific knowledge behind HIV and AIDS. The next step is to determine what more can be done. Research studies, clinical practice, prevention campaigns and public health campaigns are among the many different approaches one could take to make some impact. Education on this topic is heavily encouraged, since there are often many myths believed about AIDS. Joining activists to create organizations and make your voice heard can help educate not only yourself, but many other people who are unaware of these myths, or even petition to convince lawmakers to allocate more funds to global AIDS work. Along with some public funds being allocated to this cause, people should also be fundraising privately since this is such a large scale health crisis. Money can make a huge difference in the success of finding a treatment for AIDS, this also ties back to the importance of those of us who are more privileged to be living in wealthier countries becoming educated and doing our part to stop the AIDS crisis, because we have the ability to raise the large amount of money that is needed.

Avery Vernon-Moore 16:56, 14 November 2016 (EST)

Jordan T. Detamore

  • Myth 2: How HIV spreads is not a mystery. To stop it, people simply need to give up promiscuous sex, drug use, and other dangerous behaviors. HIV continues to proliferate in poor regions of the world because people from these areas refuse to alter their traditions and lifestyles in response to the crisis.
  • Response: There has always been an attempt to assign blame for the AIDS epidemic from common people as well as medical and political leaders. The groups of people that have been blamed include gays, Haitians, promiscuous Africans. People's unwillingness to use condoms, reduce their number of sexual partners and avoid sharing needles has also been blamed for the spread of the disease. While lifestyle choices can increase the probability of contracting AIDS, this chapter discusses how some people do not have a choice.
    • Impact of Poverty and Economic Insecurity: Poverty limits people's options for protecting themselves and puts people in a riskier situation for contracting AIDS. The article argues that some women have no other option than to have many sexual partners. Additionally they may not be able to afford condoms or have the freedom to negotiate the use of condoms. This is due to the fact that some women only have their partners to depend on for survival. Some women depend on their husbands who may attract the disease in extramarital affairs while others rely on prostitution in order to survive. The article argues that individual decisions are not to blame, but instead the structure of the society. This also relates to men who find themselves using drugs due to their living conditions in a poor community with little economic opportunity.
    • AIDS and Structural Racism: Racial and ethnic minorities in the U.S. continue to be affected disproportionately by HIV and AIDS. African-Americans and Latinos are affected by the disease far more than white Americans
    • Gender Discrimination and Violence Against Women: Sexual violence and violent relationships in general do not allow women to protect themselves. Women in vulnerable positions are unable to negotiate condom use.
    • The Effects of Labor Migration: In poor regions men must oftentimes travel for work. The long periods away from home oftentimes lead to extramarital affairs and drug use. These multi person relationships are dangerous for all involved as one person could spread disease to all other members.
    • Social Instability, Armed Conflict, and War: Militarization and armed conflict also increase the risk of AIDS. War leads to migration of both soldiers and refugees which spreads the disease. War also is associated with higher rates of rape and the deterioration of health, education, and infrastructure.
    • Structural Violence and Realistic Prevention Strategies: AIDS prevention must take into account the social constructs that perpetuate the disease rather than just blaming the habits of individuals. Prevention must take into account poverty, inequality, racism, gender discrimination, and other factors. Further educating both men and women about the risks and affects of AIDS needs to happen in countries across the world and new legislation must come about that protects those who are vulnerable.
  • Jordan T. Detamore 20:36, 14 November 2016 (EST):

Shivum Desai

Summary of myth one

  • Myth is that AIDS is only an Africa problem. In wealthy countries like the US, AIDS is no longer poses a threat.
  • More than 70% of people living with AIDS live and die in Africa.
  • The long history of colonialism and neoliberal economic and trade policies which has shaped Africa today has contributed to the environment in which HIV proliferates.
  • This article describes that AIDS is only the latest of Europe’s offenses on Africa. Starting with disease and military violence to now AIDS.
  • The poor in these Euro-African communities did not have access to healthcare like the Europeans that ruled them.
  • When European countries began to leave in the 1960’s, these African countries faced poverty, weak institutions, disease brought about by colonialism and other problems.
  • Many African countries borrowed from European countries. This, along with corruption of African regimes led to debt.
    • The IMF encourage reorganizing that promoted a switch from big government to a larger emphasis on the private sector to help stimulate growth and do away with poverty.
  • The reorganizing of African government’s by the IMF. As the reports came out in 1981 of the successes and failures of these program, so did the first reports of AIDS.
    • Which meant that these reorganization plans had neglected healthcare in these countries.
  • Many of the countries in which AID is most prevalent, spend most of their money on servicing their debt than they do on healthcare.
  • Overall, this article is blaming European countries for the prevalence and spread of the HIV virus. As well as African countries’ inability to combat the disease.
  • HIV is spreading fastest in Caribbean, Asia, and Eastern Europe. Particularly in run down and poor areas.
  • Disempowerment of woman and armed conflict tend to be the highest driving factors.
  • Eastern Europe and Central Asia
    • 1.2 million people living with HIV
    • in Russia most infections are due to drug use.
    • In Ukraine ¾ of HIV infections ae due to drugs
    • Rising drug use and HIV after fall of USSR due to unemployment.
  • Asia
    • Home to more people with HIV in world other than Africa.
    • estimated to be 10-15 million by 2010.
    • aids education is yeas behind that of African countries.
    • 20-25 million infected in india
  • Caribbean and Latin America
    • leading cause of death in ages 15-44 in Caribbean is HIV.
    • in Caribbean HIV is spread most through gay sex.
    • Haiti has a 6% HIV, highest in west.
    • Cuba has low rate because it supplies high quality health care to citizens and good education of disease.
  • Resurgence of HIV/AIDS in High Income Countries
    • Aggressive HIV education and prevention campaigns significantly cut infection rates in US.
    • However infection and morality rates have not declined since mid 1998
      • due to upward trends in risk behaviors and infection levels.
    • African Americans make up 12%
    • Latinos are 15%
  • International effort is the only solution

Shivum A Desai 21:11, 14 November 2016 (EST):

Anindita Varshneya

  • Myth: AIDS does not affect Americans, so any fight towards finding a treatment for AIDS from Americans is charity work.
  • Response:
    • HIV/AIDS and Global Health Equity
      • Currently, wealthy nations are combatting infectious diseases like HIV/AIDS and TB by highly protecting their borders to prevent people with potential infections from entering. Instead of border control, these types of diseases should be solved at a global scale to reduce overall risks.
      • Economic problems are the primary obstacle preventing this type of large scale efforts. If the UN, and other globally influential organizations, were to get involved and coordinate low and high-economy countries, these types of solutions could be attempted.
    • Economic Impacts of HIV/AIDS Pandemic
      • Wealthy countries, including the US, would benefit greatly from a reduction in the HIV/AIDS pandemic as it would allow them to have more business success abroad. Many international countries have started acting on this idea, and are implementing treatment programs for their employees.
      • The economic effects of HIV/AIDS in highly affected areas are profound. Some African countries are reported to have a potential loss in GDP of about 25% in the short future as a result of this infectious disease.
      • If this disease is not fixed, the economic issues will continue to spread to other European and Asian countries. The contributions of wealthy countries would allow for 8 million people to be saved by 2010, and would allow for significant global economic gains. Because so many American exports go to Africa, treatment for HIV/AIDS in poorer countries isn't charity -- it is a contribution to the future of the global economy.
    • AIDS as a Security Issue
      • Because of the several different aspects of life and society that AIDS affects, it is considered a pandemic and a threat to security. Despite the fact that many wealthy countries aren't willing to invest in humanitarian issues, they are willing to invest in security issues.
      • In response to research or this topic, in 2000 the American government announced that AIDS is a threat to national security.
    • The Moral Stakes
      • Investment to the HIV/AIDS pandemic can most strongly be argued for using basic human rights: Right to health care is an inalienable right to all people. Furthermore, WHO constitution states that every person should have access to the highest standard of care, so by not providing HIV/AIDS care to people in poorer countries is unethical.
      • Americans often criticize other countries for not acting morally towards their citizens, but if America applied the same type of policy to themselves, there would be a major increase in commitment in the fight against diseases like AIDS.

--Anindita Varshneya 14:54, 15 November 2016 (EST)

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