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The HIV Pandemic

Local and global implications

Edited by Eduard J Beck, Nicholas Mays, Alan W Whiteside, and José M Zuniga

An affordable paperpack edition of this successful book
Contains case studies from 28 countries, giving up-to-date accounts of the different ways they have responded to the HIV/AIDS epidemic
Utilises data from all over the world, including some countries not commonly discussed but which have important lessons to offer
Thematic and analytical chapters draw out the principle lessons
Contributors from the individual countries combine with international experts to provide in-depth local knowledge allied to international expertise

The HIV Pandemic

Local and global implications

Edited by Eduard J Beck, Nicholas Mays, Alan W Whiteside, and José M Zuniga

Description

A quarter of a century since the first recognition of 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 to patients, and how the resulting activity is monitored and evaluated in order to improve the effectiveness, efficiency, equity and acceptability of the response.

This 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 analyse specific country and organisational responses. There is no perfect health system, but the evidence provided here allows the sharing of knowledge, and a opportunity to assess the impact and reactions, to an epidemic that must be considered a long term issue.

The HIV Pandemic

Local and global implications

Edited by Eduard J Beck, Nicholas Mays, Alan W Whiteside, and José M Zuniga

The Pandemic
1:The HIV Pandemic and Health Systems: An Introduction, EJ Beck, N Mays
2:The Evolving HIV Pandemic, CA Hankins, KA Stanecki, P Ghys, H Marais
3:Social and Economic Impact of the HIV Pandemic, T Quinlan, A Whiteside
4:Determinants of the HIV Pandemic in Developing Countries, E Stillwaggon
Prevention, Treatment and Care: Advances in Knowledge
5:HIV Prevention Programmes: an Overview, SA Strathdee, M-L Newell, FI Bastos, TL Patterson
6:Antiretroviral Treatment and Care of HIV, JMA Lange
7:HIV Vaccines: Development and Future Use, J Esparza, M-L Chang, HD Gayle
8:Ethical Issues and HAART, N Gilmore
9:Legal and Human Rights Implications, D Patterson, L Forman
10:Strategic Information for HIV Programmes, P DeLay, N Massoud, DL Rugg, KA Stanecki, M Carael
11:The Contribution of Cost-effectiveness Analysis, G Harling, L Soderstrom
Country Responses
12:Botswana, L Lush, E Darkoh, SL Ramotlhwa
13:Ethiopia, Y Kitaw, D Haile Mariam, A Demissie, D Wolday, T Messele, E Aberra, T Belay, A Kassa
14:Nigeria, A Ogundiran, B Fatunmbi, BT Costatinos
15:Senegal, C Simms, P Salif Sow, E Sy
16:South Africa, D McCoy, R Wood, L Dudley, P Barron
17:Uganda, JO Parkhurst, F Ssengooba, D Serwadda
18:Cambodia, G Morineau, M van Pelt, F Bourdier, RC Wolf
19:China, Ma Shao-Jun, S Hillier, Kong-Lai Zhang, J Shen, Liu Min, Jin Chen-Gang
20:India, R Priya, N Kumarasamy, I Qadeer, AK Ganesh, S Solomon, SM Crowe
21:Indonesia, S Gunawan, S Kosen, C Simms
22:Philippines, OT Monzon, R Poblete
23:Thailand, V Tangcharoensathien, W Phoolcharoen, S Thanprasertsuk, C Suraratdecha
24:Barbados, ER Walrond, TC Roach
25:Cuba, MI Lantero Abreu, J Waller, J Joanes Fiol, J Perez Avila, R Torres Peña, M Santín Peña, R Ochoa Soto, G Estevez Torres
26:Haiti, A Augustin, DW Fitzgerald, JW Pape
27:Jamaica, R Carr, JP Figueroa, PR Carr
28:Argentina, G Hamilton, C Falistocco, P Cahn, C Zala
29:Brazil, ML Petersen, C Travassos, FI Bastos, MA Hacker, EJ Beck, J Carvalho de Noronha
30:Costa Rica, J Salas Martínez, I Salom
31:France, YA Flori, C Moty-Monnereau, E Patouillard, F Dabis, R Salamon
32:Italy, F Taroni, G France, A Tramarin, E Conti, A Donatini, FA Compostella
33:Russian Federation, J Stachowiak, A Peryshkina, S Lessof
34:Spain, J Castilla, I Noguer, JR Repullo
35:Ukraine, V Lekhan, V Rudiy, E Nolte, J Jacobi, L Andrushchak, A Shcherbinska, Y Kruglov
36:United Kingdom, J Imrie, S Dougan, K Gray, MW Adler, AM Johnson, BG Evans, BS Peters
37:Canada, MLA Rusch, V Alfonso, CA Hankins, JSG Montaner, M O'Shaughnessy, RS Hogg
38:Mexico, JA Izazola-Licea, C Avila-Figueroa, S Gómez-Fraga
39:United States of America, B Fetter, DH Morgan, J Levi
Global and National Responses
40:The UN response to the HIV Pandemic, E van Praag, KL Dehne, V Chandra-Mouli
41:Donor, Lender and Research Agencies' Response to the HIV Crisis, C Simms
42:Financing HIV: the Roles of International Financial Institutions, MA Lewis, SA Stout
43:Fiscal and Macroeconomic Aspects of the HIV Pandemic, M Haacker
44:Trade, Intellectual Property and Access to Affordable HIV Medications, J Fleet, B N'Daw
45:Country Level Public-Private Partnerships for Successful HIV Treatment Programmes, J Bos, O Schellekens, A de Groot
46:Developing Human Resources for the HIV Pandemic, N Dreesch, MR Dal Poz, G Gedik, O Adams, TG Evans
47:The Contribution of Civil Society, JM Zuniga
48:The Role of Community Involvement in HIV Programmes in South Africa, RA Roberts, A Hickey, Z Rosner
Strengthening the Response
49:Responding Effectively to the HIV Pandemic, CA Hankins, C Fontaine, M Sidibe
50:Some Lessons Learned, EJ Beck, N Mays

The HIV Pandemic

Local and global implications

Edited by Eduard J Beck, Nicholas Mays, Alan W Whiteside, and José M Zuniga

Author Information

Edited by Eduard J Beck, Associate Professor of Epidemiology, McGill University, Canada, Nicholas Mays, Professor of Health Policy, London School of Hygiene and Tropical Medicine, UK, Alan W Whiteside, Professor and Director, Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa, and José M Zuniga, Executive Officer, International Association of Physicians in AIDS Care, Chicago, USA

Contributors:

Endalamaw Aberra, World Health Organization, Ethiopia
Orvill Adams, Director, Orvill Adams & Associates; Former Director of Human Resources, Health Department, World Health Organization, Switzerland
Michael W Adler, Professor of Genitourinary Medicine, University College London, UK
Victor Alfonso, BC Centre of Excellence in HIV/AIDS, Canada
Lidia Andrushchak, Social Mobilization and Partnership Adviser, UNAIDS, Ukraine
Antoine Augustin, President and CEO, March Foundation, Haiti
Carlos Avila-Figueroa, Ministry of Health, Mexico
Peter Barron, Health Systems Trust, South Africa
Francisco I Bastos, Senior Researcher, Oswaldo Cruz Foundation, Brazil
Eduard J Beck, Associate Professor of Epidemiology, McGill University, Canada
Teklu Belay, HIV/AIDS Prevention and Control Office, National AIDS Control Secretariat, Ethiopia
Jasper Bos, Head of Product Development, PharmAccess Foundation, The Netherlands
Frédéric Bourdier, Anthropologist, Scientific Coordinator for HIV/AIDS Policies in Cambodia, Institute for Research and Development, France
Pedro Cahn, Assistant Professor of Infectious Diseases, University of Buenos Aires Medical School, and Director, Fundación Huésped, Argentina
Michel Carael, Professor of Medical Sociology, Free University of Brussels, Belgium
Peter R Carr, PAHO/WHO Consultant (retired), and Lecturer, Department of Community Medicine and Psychiatry, University of the West Indies, Jamaica
Robert Carr, Health Management Consultant, Jamaica
José C de Noronha, Researcher, Oswaldo Cruz Foundation, Brazil
Jesus Castilla, Consultant Epidemiologist, Instituto de Salud Publica de Navarra, Spain
Venkatraman Chandra-Mouli, Coordinator, Adolescent Health and Development, World Health Organization, Switzerland
Marie-Louise Chang, World Health Organization, Switzerland
Fernando Antonio Compostella, Director of Regional Health and Social Agency (Veneto), Italy
Emma Conti, Specialist, Infectious Diseases, San Bortolo Hospital, Italy
Berhe Tesfu Costantinos, President, Centre for Human Environment, Ethiopia
Suzanne M Crowe, Professor, Macfarlane Burnet Institute for Medical Research and Public Health, Australia
François Dabis, Institut de Santé Publique, Epidémiologie et Développement, Université Victor Segalen, France
Mario R Dal Poz, Associate Professor, Institute of Social Medicine, University of the State of Rio de Janeiro, Brazil; and Coordinator of Human Resources for Health, World Health Organization, Switzerland
Ernest Darkoh, Chairman, BroadReach Healthcare, USA
Arie C de Groot, Managing Director, Future Africa, Switzerland
Karl L Dehne, UNAIDS Country Coordinator, Zimbabwe
Paul R. DeLay, UNAIDS, Switzerland
Araya Demissie, Consultant, Health Information and Promotion Specialist , Ethiopia
Andrea Donatini, Economic Evaluation Unit, LHU Parma, Italy
Sarah Dougan, Senior Scientist (Epidemiology), Health Protection Agency, UK
Norbert Dreesch, Technical Officer, Human Resources for Health Department, World Health Organization, Switzerland
Lilian Dudley, Managing Director/Public Health Specialist, Health Systems Trust, South Africa
José Esparza, Senior Adviser, HIV Vaccines, Bill & Melinda Gates Foundation, USA
Barry G Evans, Consultant Epidemiologist, Health Protection Agency, UK
Timothy G Evans, Assistant Director-General, Evidence and Information for Policy, World Health Organization, Switzerland
Carlos Falistocco, Medical Adviser to the National HIV/AIDS Programme, Ministry of Health, Argentina
Dr Bayo S Fatunmbi, Adviser on Roll Back Malaria, World Health Organization, Nigeria
Bruce Fetter, Professor of History, University of Wisconsin, USA
J Peter Figueroa, Ministry of Health, Jamaica
José J Joanes Fiol, Specialist in Epidemiology, National HIV/AIDS/STI Program, Cuba
Daniel William Fitzgerald, Assistant Professor of Medicine, Cornell University, USA
Julian Fleet, Senior Adviser, UNAIDS, Geneva, Switzerland
Yves-Antoine Flori, Professor of Economics, Institut de Santé Publique, d'Epidémiologie et Développement (ISPED), Université de Bordeaux, 2 Victor Segalen, France
Christopher Fontaine, Communications Officer, UNAIDS , Switzerland
Lisa Forman, Doctoral Candidate, Faculty of Law, University of Toronto, Canada
George France, Senior Researcher, Istituto de Studi sui Sistemi Regionali e Federali e sulle Autonomie, Consiglio Nazionale delle Ricerche, Italy
AK Ganesh, YRG Centre for AIDS Research and Education, India
Helene D Gayle, Director, HIV, TB and Reproductive Health, Bill and Melinda Gates Foundation, USA
Gulin Gedik, World Health Organization, Switzerland
Peter D Ghys, Manager, Epidemic and Impact Monitoring, UNAIDS, Switzerland
Norbert Gilmore, Professor of Medicine, McGill University, Canada
Sandra Gomez-Fraga, Ministry of Health, Mexico
Kimberly Gray, Research Officer, Department of Genitourinary Medicine, King's College London, UK
Suriadi Gunawan, Senior Researcher, National Institute of Health Research and Development, Indonesia
Markus Haacker, International Monetary Fund, USA
Mariana A Hacker, Junior Researcher, Oswaldo Cruz Foundation, Brazil
Damen Haile Mariam, Department of Community Health, Faculty of Medicine, Addis Ababa University, Ethiopia
Gabriela Hamilton, Director, National HIV/AIDS Programme, Ministry of Health, Argentina
Catherine A Hankins, Associate Director and Chief Scientific Advisor, Joint United Nations Programme on HIV/AIDS (UNAIDS), Switzerland
Guy Harling, Desmond Tutu HIV Center, University of Cape Town, South Africa
Alison Hickey, Manager, AIDS Budget Unit, Institute for Democracy in South Africa (Idasa), South Africa
Sheila Hillier, Professor of Medical Sociology, and Head, Centre of Human Science and Medical Ethics, Barts and The London School of Medicine and Dentistry, UK
Dr Robert S Hogg, BC Centre of Excellence in HIV/AIDS, Canada
John Imrie, Senior Research Fellow, University College London, UK
José A. Izazola-Licea, Team Leader, Resource Tracking and Projections Unit, UNAIDS, Switzerland
Jantine Jacobi, UNAIDS, Switzerland
Jin Cheng-Gang, Associate Professor, School of Public Health and Family Medicine, Capital University of Medical Sciences, People's Republic of China
Anne M Johnson, Head, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, UK
Afework Kassa, HIV/AIDS/STI Team, Disease Control and Prevention Department, Ministry of Health, Ethiopia
Yayehyirad Kitaw, Senior Consultant, Health Development, Ethiopia
Soewarta Kosen, Chief, Health Economics & Policy Analysis Research Group, National Institute of Health Research & Development, Indonesia
Yuriy Kruglov, Epidemiologist, Ukrainian AIDS Centre, Ukraine
N Kumarasamy, Chief Medical Officer, YRG Centre for AIDS Research and Education, India
JMA Lange, Professor of Medicine, AMC/University of Amsterdam, The Netherlands
Maria Isela Lantero Abreu, Specialist in Epidemiology, and Coordinator, National HIV/AIDS/STI Programme, Ministry of Public Health, Cuba
Valeriya Lekhan, Professor of Medicine, and Head, Department of Social Medicine and Health Management, Dniepropetrovsk State Medical Academy, Ukraine
Suszy Lessof, Project Manager, European Observatory on Health Systems and Policies, Belgium
Jeffrey Levi, Associate Professor of Health Policy, George Washington University, USA
Maureen A Lewis, Senior Fellow, Center for Global Development, USA
Liu Min, Associate Professor, Department of Epidemiology, Peking University, People's Republic of China
Lu Fan, Division of Epidemiology, National Center for HIV/AIDS Control and Prevention, China Center for Disease Control and Prevention, People's Republic of China
Louisiana Lush, Senior Health and HIV/AIDS Adviser, Department of International Development, UK
Shao-Jun Ma, Department of Epidemiology, School of Basic Medicine, Peking Union Medical College, People's Republic of China
Hein Marais, Geneva, Switzerland
Nicole Massoud, Monitoring and Evaluation Adviser, UNAIDS Secretariat, Switzerland
Nicholas Mays, Professor of Health Policy, London School of Hygiene and Tropical Medicine UK
David McCoy, Public Health Specialist, National Health Service, UK
Tsehaynesh Messele, Ethio-Netherlands AIDS Research Project, Ethiopian Health and Nutrition Research Institute Ethiopia
Julio SG Montaner, Professor of Medicine, and Chair in AIDS, University of British Columbia, Canada
Ofelia T Monzon, President Emeritus and Member of the Board, AIDS Society of the Philippines, The Philippines
Douglas H Morgan, Director, Division of Service Systems, HIV/AIDS Bureau, Health Resources and Services Administration, US Department of Health and Human Services, USA
Guy Morineau, Senior Surveillance and Evaluation Officer, Family Health International, Cambodia
Céline Moty-Monnereau, Assistant Hospitalo-Universitaire, Université Victor Segalen, and Centre Hospitalo-Universitaire de Bordeaux, France
Béchir N'Daw, Programme Development Adviser, Intellectual Property and Trade, UNAIDS, Switzerland
Marie-Louise Newell, Professor of Paediatric Epidemiology, Institute of Child Health, University College London, UK
Isabel Noguer, Head, HIV/AIDS Surveillance, National Centre of Epidemiology, Instituto de Salud Carlos III, Spain
Ellen Nolte, Senior Lecturer, London School of Hygiene and Tropical Medicine, UK
Rosaida Ochoa Soto, Assistant Professor, University of Havana, Cuba
Adeniyi Ogundiran, Adviser on HIV/AIDS, World Health Organization, Nigeria
Michael O'Shaughnessy, Vice President, Provincial/Tertiary Programs and Research, Providence Health Care, Canada
Jean William Pape, Professor of Medicine, Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University USA
Justin O Parkhurst, Lecturer, London School of Hygiene and Tropical Medicine, UK
Edith Patouillard, Assistant, Institut de Santé Publique, d'Epidémiologie et Développement (ISPED), Université Bordeaux 2 Victor Segalen France
David Patterson, Consultant, Canada
Thomas L Patterson
Professor of Psychiatry, University of California, San Diego, USA
Jorge Perez Avila, Professor of Clinical Pharmacology and Infectious Diseases, Instituto de Medicina Tropical, Cuba
Alena N Peryshkina, Director, AIDS Infoshare, Russian Federation
Barry S Peters, Senior Lecturer, Guy's, Kings & St. Thomas' School of Medicine, Kings College London, UK
Maya L Petersen, Doctoral Student in Epidemiology, University of California, Berkeley, USA
Wiput Phoolcharoen, Ministry of Public Health, Thailand
Peter Piot, Executive Director, UNAIDS, Switzerland
Roderick E Poblete, Secretariat, Philippine National AIDS Council, The Philippines
Ritu Priya, Associate Professor, Centre for Social Medicine and Community Health, Jawaharlal Nehru University, India
Imrana Qadeer, Professor, Centre for Social Medicine and Community Health, Jawaharlal Nehru University, India
Tim Quinlan, Research Director, HEARD, University of KwaZulu-Natal, South Africa
Sergolame Lekoko Ramotlhwa, Operations Manager, National Anti-retroviral Therapy (ART) Program, Ministry of Health Botswana
José Ramon Repullo, Professor and Head, Department of Health Planning and Financing, National School of Public Health, Instituto de Salud Carlos III, Spain
Timothy C Roach, Associate Lecturer, School of Clinical Medicine and Research, University of the West Indies, Barbados
Reid Austin Roberts, Treatment Literacy Researcher, Treatment Action Campaign (TAC), South Africa
Zachary Rosner, Pritzker School of Medicine, University of Chicago, USA
Volodymyr Rudiy, Ukrainian Director, Health Financing and Management EU Project, Ukraine
Deborah L Rugg, Associate Director for Monitoring and Evaluation, Global AIDS Program, US Centers for Disease Control, USA
Melanie LA Rusch, Michael Smith Foundation for Health Research, University of British Columbia, and BC Centre for Excellence in HIV/AIDS, Canada
R Salamon, Professor of Public Health, University of Bordeaux 2, France
Dr Ignacio Salom Echeverria, Clinical Immunologist, Costa Rica
Jessica Salas Martinez, Adviser to the Deputy Minister of Health, Costa Rica
Manuel Santin Peña, Specialist in Epidemiology, Direccion Nacional Epidemiologica, MINSAP, Cuba
Onno Schellekens, PharmAccess, The Netherlands
Dr David Serwadda, Director, Institute of Public Health, Makerere University, Uganda
Alla Shcherbinska, Professor of Medicine, Institute of Epidemiology and Infectious Diseases, AMS, Ukraine
Jay J Shen, Associate Professor of Health Economics and Policies, Governors State University, USA
Michel Sidibe, UNAIDS, Switzerland
Chris Simms, Independent Consultant, Canada
Lee Soderstrom, Associate Professor of Economics, McGill University, Canada
Suniti Solomon, Director, YRG Centre for AIDS Research and Education, Voluntary Health Services, India
Papa Salif Sow, Professor of Medicine, Department of Infectious Diseases, Dakar University Teaching Hospital Senegal
Freddie Ssengooba, Lecturer, Health Policy Planning & Management, Institute of Public Health, Makerere University, Uganda
Julie Stachowiak, Research Associate, Johns Hopkins University Bloomberg School of Public Health, USA
Karen A Stanecki, UNAIDS, Switzerland
Eileen Stillwaggon, Associate Professor of Economics, Gettysburg College, USA
Susan A Stout, Manager, Results Secretariat, Operations Policy and Country Services, World Bank, USA
Steffanie A Strathdee, Professor and Harold Simon Chair and Chief, Division of International Health & Cross Cultural Medicine, Family and Preventive Medicine, University of California, San Diego, USA
Chutima Suraratdecha, Ministry of Public Health, Thailand
Elhadj Sy, United Nations Development Programme, USA
Viroj Tancharoensathien, Ministry of Public Health, Thailand
Francesco Taroni, Professor of Social Medicine, University of Bologna, Italy
Sombat Thanprasertsuk, Ministry of Public Health, Thailand
Gonzalo Estévez Torres, Deputy Minister of Public Health, Specialist in Epidemiology, Cuba
Rigoberto Torres Peña, Specialist in Epidemiology, Ministry of Public Health, Cuba
Andrea Tramarin, U O de Malattie Infettive e Tropicali, San Bortolo Hospital (Vicenza), Italy
Claudia Travassos, Senior Researcher, Oswaldo Cruz Foundation, Brazil
Maurits H van Pelt, Consultant on Health and Poverty, Cambodia
Eric van Praag Country Director, Tanzania, Family Health International
John Waller, Freelance Health Data Analyst in the British National Health Service, UK
ER Walrond, Professor Emeritus of Surgery, University of the West Indies, Barbados
Alan Whiteside, Professor and Director of the Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, South Africa
Dawit Wolday, Senior Researcher, Ethio-Netherlands AIDS Research Project, Ethiopian Health and Nutrition Research Institute, Ethiopia
R Cameron Wolf, Senior Technical Advisor for Monitoring and Evaluation, USAID, USA
Robin Wood, Professor of Medicine, University of Cape Town, South Africa
Carlos Zala, Director, Clinical Research, Fundación Huésped, Argentina
Kong-Lai Zhang, Professor of Epidemiology, Peking Union Medical College, People's Republic of China
José M Zuniga, President and CEO, International Association of Physicians in AIDS Care, USA