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In the history of public health, HIV/AIDS is unique; it has widespread and long-lasting demographic, social, economic and political impacts. The global response has been unprecedented. AIDS exceptionalism - the idea that the disease requires a response above and beyond "normal" health interventions - began as a Western response to the originally terrifying and lethal nature of the virus. More recently, AIDS exceptionalism came to refer to the disease-specific global response and the resources dedicated to addressing the epidemic. There has been a backlash against this exceptionalism, with critics claiming that HIV/AIDS receives a disproportionate amount of international aid and health funding.This paper situations this debate in historical perspective. By reviewing histories of the disease, policy developments and funding patterns, it charts how the meaning of AIDS exceptionalism has shifted over three decades. It argues that while the connotation of the term has changed, the epidemic has maintained its course, and therefore some of the justifications for exceptionalism remain.

BackgroundThe World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) stands to significantly reduce tobacco-related mortality by accelerating the introduction of evidence-based tobacco control measures. However, the extent to which States Parties have implemented the Convention varies considerably. Article 5.3 of the FCTC, is intended to insulate policy-making from the tobacco industry’s political influence, and aims to address barriers to strong implementation of the Convention associated with tobacco industry political activity. This paper quantitatively assesses implementation of Article 5.3’s Guidelines for Implementation, evaluates the strength of Parties’ efforts to implement specific recommendations, and explores how different approaches to implementation expose the policy process to continuing industry influence.MethodsWe cross-referenced a broad range of documentary data (including FCTC Party reports and World Bank data on the governance of conflicts of interest in public administration) against Article 5.3 implementation guidelines (n = 24) for 155 Parties, and performed an in-depth thematic analysis to examine the strength of implementation for specific recommendations.ResultsAcross all Parties, 16% of guideline recommendations reviewed have been implemented. Eighty-three percent of Parties that have taken some action under Article 5.3 have introduced less than a third of the guidelines. Most compliance with the guidelines is achieved through pre-existing policy instruments introduced independently of the FCTC, which rarely cover all relevant policy actors and fall short of the guideline recommendations. Measures introduced in response to the FCTC are typically restricted to health ministries and not explicit about third parties acting on behalf of the industry. Parties systematically overlook recommendations that facilitate industry monitoring.ConclusionHighly selective and incomplete implementation of specific guideline recommendations facilitates extensive ongoing opportunities for industry policy influence. Stronger commitment to implementation is required to ensure consistently strong compliance with the FCTC internationally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-017-0234-8) contains supplementary material, which is available to authorized users.

Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded in feminist political economy approaches, to evaluate the gendered effects of the COVID-19 pandemic and response in four case studies: China, Hong Kong, Canada, and the UK. Through a rapid scoping of documentation of the gendered effects of the outbreak, it applies the matrix framework to analyse findings, identifying common themes across the case studies: financial discrimination, crisis in care, and unequal risks and secondary effects. Results point to transnational structural conditions which put women on the front lines of the pandemic at work and at home while denying them health, economic and personal securityeffects that are exacerbated where racism and other forms of discrimination intersect with gender inequities. Given that women and people living at the intersections of multiple inequities are made additionally vulnerable by pandemic responses, intersectional feminist responses should be prioritised at the beginning of any crises.

The 2015 to 2017 outbreak of Zika generated global attention on the risk of a spectrum of neurological disorders posed to women and their unborn children-including, but not limited to, microcephaly-that came to be known as congenital Zika syndrome (CZS). Images of women cradling babies born with CZS underscored the gendered nature of the epidemic. Nonetheless, the media attention towards the highly gendered dimensions of the outbreak was not matched by a recognition of the importance of female participation in the decision-making for the control of the Aedes aegypti mosquito, the vector responsible for the spread of Zika. Moreover, while women were the target population of the public health response to the epidemic, the impact of arbovirus policies on women was largely neglected. This paradox-the absence of gender in the policy response to a problem where the gender dimensions were evident from the start-adds to other questions about the sustainability of arbovirus control. The Zika epidemic is but one element of a broader problem with arboviruses-including dengue fever, yellow fever, and chikungunya-which by and large remain neglected across Latin America (and much of the world). Dengue fever, spread by the same A. aegypti mosquito, has shown considerable growth across the continent in recent years [1]. For example, Brazil reported close to 1.5 million cases of the disease between 2014 and 2016 [2]. This is mirrored across Latin America, where there have been almost 700,000 reported cases so far in 2019 alone [3]. Similarly, the region is witnessing the highest rates of other diseases transmitted by A. aegypti. This includes yellow fever-particularly in Brazil [4] [5]-and chikungunya, which was only introduced to the hemisphere in 2013 and is now present in almost every country in the region, causing a significant morbidity burden [6]. Another question pertains to the complex history of arbovirus control in the region, which has demonstrated some notable, if only temporary, successes [7]. Recognition of this history and of the historical ecology of mosquitoes in the region is essential for the effectiveness of present programs, which thus far have repeated the mistakes of the past. Brazil has eliminated A aegypti numerous times [8] [9]. Nonetheless, the preference for vertical programs focusing on the "war" against Aedes has led to short-lived results, with mosquitoes returning within years, due, in a large part, to the absence of a coordinated regional response and the failure to consider and integrate the socioeconomic and structural determinants that enable mosquitoes to thrive. These include substandard living conditions, including those that result from rapid urbanization, increasing population density, poor quality housing, and inadequate sanitary and health facilities, along with lasting public sector deficiencies such as lack of routine water

Background The Zika outbreak provides pertinent case study for considering the impact of health emergencies on abortion decision-making and/or for positioning abortion in global health security debates. Main body This paper provides a baseline of contemporary debates taking place in the intersection of two key health policy areas, and seeks to understand how health emergency preparedness frameworks and the broader global health security infrastructure is prepared to respond to future crises which implicate sexual and reproductive rights. Our paper suggests there are three key themes that emerge from the literature; 1) the lack of consideration of sexual and reproductive health (SRH) services in outbreak response 2) structural inequalities permeate the landscape of health emergencies, epitomised by Zika, and 3) the need for rights based approaches to health. Conclusion Global health security planning and response should specifically include programmatic activity for SRH provision during health emergencies.

Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

Global health security and universal health coverage have been frequently considered as “two sides of the same coin”. Yet, greater analysis is required as to whether and where these two ideals converge, and what important differences exist. A consequence of ignoring their individual characteristics is to distort global and local health priorities in an effort to streamline policymaking and funding activities. This paper examines the areas of convergence and divergence between global health security and universal health coverage, both conceptually and empirically. We consider analytical concepts of risk and human rights as fundamental to both goals, but also identify differences in priorities between the two ideals. We support the argument that the process of health system strengthening provides the most promising mechanism of benefiting both goals.