The Impact of Change: Shifting Global Architecture and HIV

By Altman, Dennis | Harvard International Review, Fall 2011 | Go to article overview

The Impact of Change: Shifting Global Architecture and HIV


Altman, Dennis, Harvard International Review


AIDS has now been with us for a quarter of a century, and there are people still alive who were among the first people to be diagnosed with HTV after the retrovirus was discovered and named in 1983. Think back to the world of that time: Ronald Reagan was President of the United States, and still locked in what seemed to be a permanent state of hostility with the USSR, whose collapse at the end of the decade was almost entirely unexpected. The greatest economic challenge to the United States was thought then to be Japan, and very few people anticipated the rapid rise of China.

[ILLUSTRATION OMITTED]

AIDS had almost certainly existed in parts of Africa long before it appeared and was named in the United States, but it remains an epidemic particularly marked by its US history. The stigma that developed around its association with male homosexuals and drug users would be widely disseminated, and remains even today. US initiatives, including the development of a People with Aids (PWA) movement, AIDS activism, major progress in biomedical research and funding for international responses through die President's Emergency Plan for AIDS Relief (PEPFAR), the Gates Foundation, and so forth continues to frame much of the global response, although other countries have often been far more progressive than the United States in their policies. This is true of Brazil's early development of widespread treatment access, and of several countries' policies towards homosexual men, drug users, and prisoners. In its policies for injectors within prisom, Iran is ironically more progressive than the United States, although deeply repressive of sexual behaviour outside marriage.

In the first decade or so the United States was not a major presence internationally in the fight against AIDS, although the founding director of the World Health Organization (WHO) Global Program on AIDS, Jonathan Mann, was an American. Mann established the connection between health and human rights as a dominant paradigm for the international approach to the epidemic, one of the most significant moves in recent public health. The decision of the United Nations in the early 1990s to establish UNAIDS, as a unique hybrid body that is intended to coordinate and lead the efforts of all UN agencies in their responses to was led by others, and its founding director, Peter Piot, was Belgian.

US attention increased during the Clinton Administration, which played a significant role in putting HTV and AIDS on the agenda of the Security Council, with its first ever debate on a health issue in January 2000. That debate was followed a year later by a special meeting of the UN General Assembly, where the United States under the new president adopted a cautious position on both prevention and treatment access. Indeed, the final statement released by a coalition of most civil society representatives in New York signalled out the Bush Administration for criticism: "The United States was particularly damaging to the prospects for a strong declaration. Throughout the negotiations they moved time and again to weaken language on HIV prevention, low-cost drugs, and trade agreements and to eliminate commitments on targets for funding and treatment. It's death by diplomacy," said Eric Sawyer, veteran activist and 25-year survivor of HIV/AIDS, as highlighted in Global Network 2006. Specifically, the United States joined with conservative Islamic nations in refusing to name sex workers, men who have sex with men, and drug users as particularly at risk.

The establishment of the Global Fund to Fight MDS, Tuberculosis, and Malaria owed a great deal to advocacy by US academic experts in public health and development, especially Jeffrey Sachs, but it was the UN secretary-general, not the president of the United States, who took the political lead in its establishment, nor was the United States particularly generous in its initial pledges. However, over the next few years, President Bush greatly increased bilateral assistance for AIDS programs, and total US public and private expenditure on AIDS programs and research now amounts to over half of all global spending on the epidemic.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

The Impact of Change: Shifting Global Architecture and HIV
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.