UNAIDS rejects claims of exaggeration and bias

Lay, Paul R. De; Cock, Kevin M. De

doi:10.1038/448251c

Cited by 4 publications

(3 citation statements)

References 1 publication

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“…Hence, the 'long-term wave' of an HIV epidemic is rarely fully appreciated. Furthermore, contrary to the argument that funding has been disproportionate to the burden of disease, De Lay & De Cock (2007) and Stuckler, King, Robinson & McKee (2008) suggest that spending on HIV prevention and treating AIDS illnesses has not been over and above the funding needed.…”

Section: Review Of the Aids-exceptionalism Debatementioning

confidence: 70%

Why HIV/AIDS should be treated as exceptional: arguments from sub-Saharan Africa and Eastern Europe

Wenham

Ahmed

Whiteside

2011

African Journal of AIDS Research

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The idea that HIV and AIDS gets too much attention and funding emerged in 2008 with a call to end 'AIDS exceptionalism.' This article outlines a short history of AIDS exceptionalism - the idea that HIV and AIDS require a response above and beyond 'normal' health interventions and is privileged in terms of attention and resources when compared with other diseases - and the reasons for the backlash to this idea. We argue that in some settings HIV and AIDS must be treated as exceptional. These are the hyperendemic countries of southern Africa, where HIV epidemics have shown substantial and lasting demographic and social impact, and parts of Eastern Europe where the epidemic is augmenting troubling demographic changes, such as declines in fertility rates and population growth, and impacting society in nuanced ways. Also included are resource-poor settings, mostly in Africa, where the combination of the high number of HIV infections and the cost of treatment have created issues concerning donor dependency and sustainable responses. An HIV epidemic must be seen as a long-wave event, with complex challenges to both HIV prevention and treatment responses. The article reviews the available data and literature to provide evidence for our arguments. We conclude that the perception that AIDS exceptionalism is outdated ignores the complexity of different HIV epidemics and obfuscates the challenges to effective responses.

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Section: Review Of the Aids-exceptionalism Debatementioning

confidence: 70%

Why HIV/AIDS should be treated as exceptional: arguments from sub-Saharan Africa and Eastern Europe

Wenham

Ahmed

Whiteside

2011

African Journal of AIDS Research

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“…Stillwaggon 2006). UNAIDS has responded by defending its record and emphasising that the challenge is to 'know the local epidemic'-i.e., the specific socio-economic context and cultural factors that structure HIV risk in different settings-and craft interventions accordingly (De Lay and De Cock 2007;De Cock and De Lay 2008). This increasingly open-ended and pragmatic stance, however, does not resonate well with the literature stressing the centrality of poverty in driving the AIDS epidemic, particularly in Africa (e.g.…”

Section: Introductionmentioning

confidence: 83%

Poverty, Sex and HIV

Nattrass

2009

AIDS Behav

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There is an ongoing debate about the relative importance of economic factors (notably poverty) and sexual behavior in driving the AIDS epidemic. This paper draws on relevant research and cross-country regression analysis to argue that the impact of economic determinants is dwarfed by contextual factors within Africa. The regression analysis suggests that controlling for per capita income, calories per capita and the ratio of female to male participation rates (none of which were statistically significant): being a Southern African country increases expected HIV prevalence 8.3 times; being in the rest of Sub-Saharan Africa 3 times; being a predominantly Protestant country 2.5 times; and being a predominantly Muslim country reduces expected HIV prevalence to 62% of the base case. Including the share of income going to the poor did not improve the model and was itself statistically insignificant. The analysis suggests that poverty may play a role in the HIV epidemic in some countries (and may well be a factor affecting the vulnerability of some people to HIV infection in all countries) but that its overall impact is dwarfed by social and behavioral factors.

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“…UNAIDS and WHO responded defensively, noting that those against AIDS exceptionalism attributed the UN agencies more power than they had to address the epidemic [ 37 ]. Research and policy looked to justify the role of HIV/AIDS programmes within broader health and development frameworks.…”

Section: Discussionmentioning

confidence: 99%

The history of AIDS exceptionalism

Wenham

Whiteside

2010

Journal of the International AIDS Society

118

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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.

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UNAIDS rejects claims of exaggeration and bias

Cited by 4 publications

References 1 publication

Why HIV/AIDS should be treated as exceptional: arguments from sub-Saharan Africa and Eastern Europe

Why HIV/AIDS should be treated as exceptional: arguments from sub-Saharan Africa and Eastern Europe

Poverty, Sex and HIV

The history of AIDS exceptionalism

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