Debate
4
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Tackling AIDS in Africa
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The
fourth debate in week 13 of the class will focus on the prospects for the
control and reduction of the AIDS epidemic in Africa.
While AIDS in the rich West is now treated with combinations of expensive drugs
and campaigns to reduce risky behaviors that contribute to the spread of AIDS,
AIDS continues to wreck social, economic and health havoc, especially in
southern Africa. The Economist states that AIDS is the "most
political disease around," killing more people (19 million) than died in
World War I. Our discussion will focus on the debates about Africa, involving
the major global economic institutions, international organizations and the big
pharmaceutical companies now beginning to develop, test and market
drugs for the effective treatment of AIDS. The article presents some startling figures on the impact of
AIDS on the demographic profile of Africa, especially the dramatic rise in the
number of orphans. Note the shift in the Botswana age-sex pyramid from a
classic pyramid to a chimney outline to 2020. Unlike the West, where the
disease is concentrated in certain high-risk groups, AIDS in Africa reaches
into all populations. But importantly, there are major geographic
differences within Sub-Saharan Africa, with West Africa having generally lower
rates of HIV infection and of AIDS. How much of the difference is attributable
to different cultural practices (under what conditions and across which groups
does sexual intercourse occur) or differential governmental efforts to slow the
spread of the disease (such as condom promotion), is still an open question. Finally,
outsiders are beginning to pay attention, making the case that the AIDS
epidemic in Africa is not just a health crisis but is now extended to issues of
national security. On the one hand, outside interest and health spending is
welcomed by Africans but on the other hand, many governments have been silent
on the subject and resent the loss of autonomy implied by the usurpation of the
AIDS prevention programs by international agencies. Most African governments have
been especially reluctant to empower women who are the silent victims of the
epidemic. (For an evocative account of the destruction by AIDS of women’s’
lives in Malawi,
see the article by Maggie O’Kane, the
award-winning Irish journalist for the Guardian, one of Britain’s
quality newspapers.) The Economist
makes the point that there is hope amid the gloom of the crisis but successful
efforts will require a coordinated effort to a) make effective drugs, such as
AZT and nevirapine, available to those who need them at no or very low
cost; b) to enlist the support of governments who will promote safe sex practices,
including widespread use of condoms; c) to empower and educate women and girls
to challenge traditional male-dominated sexual practices; and d) to learn from
the experience of those countries, such as Uganda or Senegal, who have reversed
the AIDS tidal wave. Begin research for this debate by reading the Economist
article on electronic reserve titled "AIDS – A Mixed Prognosis."
A huge multi-national pharmaceutical company making drugs to
combat AIDS: see the GlaxoSmithKline Company website (search for
AIDS related articles in this site).
Team B
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United Nations
(UNAIDS)
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The United Nations coordinates the world-wide effort to
combat AIDS.
Team C
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Society of Women Against AIDS in Africa
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An international NGO dedicated to empowering women to change
their status vis-à-vis risk of AIDS: see the SWAA
website and related discussions of their objectives.
Team D
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South African Ministry of Health
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The South African Ministry of Health is a frontline
governmental agency late in getting started on health awareness.
Team E
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International AIDS Vaccine Initiative
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The International
AIDS Vaccine Initiative is a charity dedicated to raising money for
AIDS vaccine research, patenting the rights and distributing the vaccine at low
cost.
Questions for the debate to address:
- How serious is the AIDS
crisis in Africa? Is it exaggerated in the media accounts?
- What has caused the AIDS
epidemic in Africa to be markedly
worse than in other regions of the world?
- What are the most effective
programs to combat the AIDS epidemic in Africa? Why?
- Can successful
practices in one country be transferred to another setting? If not, why
not?