Childen's palliative care has developed rapidly as a discipline, as health care professionals recognize that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming, and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 85% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed.
Written by a group with wide experience of caring for dying children in Africa, this book provides practical, realistic guidance by improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care--including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end of life care, and tips for the professional on compassion and conservation of energy--but always retains the focus on the particular needs of the health care professional in Africa. While containing some theory, the emphasis is on practical action throughout the book. Children's Palliative Care in Africa provides health care professionals working in Africa, and other resource-poor settings, with the confidence, knowledge, and capacity to improve care for the terminally ill child in constrained and demanding environments.

Highly active antiretroviral therapy (HAART) is a therapeutic intervention developed by clinicians and researchers in order to fight the HIV pandemic. It has contributed to a significant reduction in AIDS-related mortality and allowed many previously bed-ridden patients to live healthier, more productive lives. Until the advent of HAART in 1996, a diagnosis of HIV infection was considered a death sentence. A decade later, the disease has been transformed into a serious, yet potentially manageable, medical condition for thousands of people living with HIV/AIDS in the developed world - almost overnight creating a generation of "HIV Survivors" - and forged a global movement to ensure that its Lazarus-like benefit reaches millions more in the developing world.
This book reviews the achievements of HAART over the past decade, and explores the challenges that may arise in the future. It recounts key landmarks in the development and introduction of HAART from the perspective of clinicians, researchers, economists, sociologists, and public policy experts, including the co-discoverers of HIV, Luc Montagnier and Robert Gallo. It explores the evolution of the disease, the evolution of HIV treatment, and the economic, social, and public policy impacts of both HIV and the introduction of HAART.

HIV/AIDS remains a major global health problem, despite the progress made in its prevention and treatment. Addressing this problem is not only a matter of more and better drugs, they need to be widely accessible and be affordable to the poor. This book makes, with a much welcomed interdisciplinary approach, an excellent contribution to understanding how the intellectual property regime can influence health policies and the lives of millions of people affected by the disease. The analysis provided by the various authors that contributed to this book will be of relevance not only to those working in the area of HIV/AIDS, but to those more broadly interested in public health governance and the role of intellectual property rights.' - Carlos Correa, University of Buenos Aires, Argentina'This is an important, innovative and, at times, controversial collection. Inter-disciplinary in approach, this collection will have appeal to those concerned with the global injustice in the context of HIV/AIDS. Investigating the legal, political and economic determinants of access to essential medicines, this is thought provoking collection which will resonate with many in both the academic and public policy community.' - Bryan Mercurio, The Chinese University of Hong Kong This important book brings together leading scholars from multiple disciplines, including intellectual property, human rights, public health, and development studies, as well as activists to critically reflect on the global health governance regime. The Global Governance of HIV/AIDS explores the implications of high international intellectual property standards for access to essential medicines in developing countries. With a focus on HIV/AIDS governance, the volume provides a timely analysis of the international legal and political landscape, the relationship between human rights and intellectual property, and emerging issues in global health policy. It concludes with concrete strategies on how to improve access to HIV/AIDS medicines. This interdisciplinary, global, and up-to-date book will strongly appeal to academics in law, international relations, health policy and public policy, as well as students, policymakers and activists. Contributors include: F.M. Abbott, O. Aginam, T. Amin, L. Biron, A. Denburg, G.E. Evans, J. Harrington, J. Harrison, K. Lee, K.C. Shadlen, P.K. Yu

When addressing the factors shaping HIV prevention programs in sub-Saharan Africa, it is important to consider the role of family planning programs that preceded the epidemic. In this book, Rachel Sullivan Robinson argues that both globally and locally, those working to prevent HIV borrowed and adapted resources, discourses, and strategies used for family planning. By combining statistical analysis of all sub-Saharan African countries with comparative case studies of Malawi, Nigeria, and Senegal, Robinson also shows that the nature of countries' interactions with the international community, the strength and composition of civil society, and the existence of technocratic leaders influenced variation in responses to HIV. Specifically, historical and existing relationships with outside actors, the nature of nongovernmental organizations, and perceptions of previous interventions strongly structured later health interventions through processes of path dependence and policy feedback. This book will be of great use to scholars and practitioners interested in global health, international development, African studies and political science.

As news headlines report staggering numbers of people infected with HIV or AIDS across the globe and as stereotypes of typical AIDS patients become less and less specific to particular sexual orientations and ethnic backgrounds, the AIDS pandemic shows little sign of relenting. AIDS crosses geopolitical and social barriers, and social and behavioral scientists are confronted with the new challenge of developing scientific inquiry and corresponding interventions around participatory, community-based, and community-focused methods. These interventions are increasingly targeting the contextual influences on individual behavior, such as peer groups, social networks and support systems, and community norms. Community-level interventions also draw on local resources and are respectful of sociocultural circumstances and traditions. This book articulates how the social and behavioral sciences can respond to HIV/AIDS. It is written for all who have a stake in AIDS research, stimulating discussion and debate about the natures of community research and intervention broadly across such disciplines as public health, community health education, urban planning, psychology, sociology, anthropology, and philosophy of science. The book proposes alternative perspectives on means of ascertaining knowledge about the HIV/AIDS pandemic and the inclusion of community collaboration in interventions.

The global response to HIV/AIDS has been a major aspect of global health and development policy over the last three decades. The book illustrates the devastating health impacts of the epidemic, with life expectancy in some countries falling to the lowest levels observed anywhere, and the remarkable success of the global HIV/AIDS response in reversing such extreme outcomes. Concerns about the implications of HIV/AIDS for economic development have played a role in motivating the global HIV/AIDS response. However, evidence on the impacts of HIV/AIDS on economic growth or poverty is weak, and the magnitude and relevance of such economic effects appears trivial compared to the consequences for life and health. Because of the success in extending access to treatment globally, HIV/AIDS has effectively transitioned into a chronic disease. This means that HIV/AIDS absorbs not only a substantial chunk of current global and national financial resources, but that these spending needs are projected to persist over decades. The costs of the HIV/AIDS response thus resemble a long-term financial liability, shaped by past and current policies. Relatedly, the calculus of cost-effectiveness of HIV/AIDS interventions has changed. People who become infected with HIV can now expect to not die because of AIDS; at the same time, each HIV infection results in medical needs and expenditures extending over decades. The book presents a framework for integrating these financial consequences and the transmission dynamics of HIV in the analysis of cost-effectiveness of HIV/AIDS interventions and in the design of HIV/AIDS programs.

In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles." Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH--sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties. Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.

Das Acquired Immune Deficiency Syndrome - AIDS - ist eines der gro/3ten medizinischen Probleme unserer Zeit. Der Erreger, das HTLV III/LA V-Virus, dtirfte in Afrika entstanden sein; die Krank- heit AIDS wurde in den Vereinigten Staaten erstmals bekannt und definiert; sie greift nun auch auf den europaischen Kontinent tiber. Arzte, Soziologen, Epidemiologen und nicht zuletzt auch Politiker sind durch diese Infektionskrankheit und ihre infauste Prognose mit meist todlichem Ausgang, vor aHem aber durch ihre enorm rasche, einer geometrischen Reihe folgende Ausbreitung zutiefst beunru- higt. Die Medien haben sich aus verschiedenen Motiven heraus intensiv mit AIDS beschaftigt, und eine gewisse Beunruhigung in der Bevolkerung, aber auch in der Arzteschaft se1bst ausge1ost. Am 20. April 1985 hat in Wien ein Symposium stattgefunden, das sich mit der Problematik von AIDS auseinandergesetzt hat. Erste Fachleute aus Osterreich haben tiber die "AIDS-Lage" berichtet und die Manuskripte ihrer Vortrage zur VerfUgung gestellt; daraus ist dieser Band entstanden. Sicherlich wird dieses Buch dazu beitragen, die Probleme der AIDS-Forschung, deren Ergebnisse sich stan dig andern und vermehren, besser zu verstehen. Unser Dank gilt vor aHem den Vortragenden und Autoren, au/3erdem der Firma Bender + Co fUr die finanzieHe Untersttitzung und dem Verlag fUr die rasche VerOffentlichung. Wien, im November 1985 F. Gschnait und K. Wolff Inhaltsverzeichnis Gschnait, F., Hutterer, J.: AIDS 1985: Ein Uberblick ........ .

Witchcraft and a Life in the New South Africa reconstructs the biography of an ordinary South African, Jimmy Mohale. Born in 1964, Jimmy came of age in rural South Africa during apartheid, then studied at university and worked as a teacher during the anti-apartheid struggle. In 2005, Jimmy died from an undiagnosed sickness, probably related to AIDS. Jimmy gradually came to see the unanticipated misfortune he experienced as a result of his father's witchcraft and sought remedies from diviners rather than from biomedical doctors. This study casts new light on scholarly understandings of the connections between South African politics, witchcraft and the AIDS pandemic.

A deeply personal account of Elton John's life during the era of AIDS and an inspiring call to action.
In the 1980s, Elton John saw friend after friend, loved one after loved one, perish needlessly from AIDS. He befriended Ryan White, a young Indiana boy ostracized because of his HIV infection. Ryan's inspiring life and devastating death led Elton to two realizations: His own life was a mess. And he had to do something to help stop the AIDS crisis.
Since then, Elton has dedicated himself to overcoming the plague and the stigma of AIDS. The Elton John AIDS Foundation has raised and donated $275 million to date to fighting the disease worldwide. "Love Is the Cure" includes stories of Elton's close friendships with Ryan White, Freddie Mercury, Princess Diana, Elizabeth Taylor, and others, and the story of the Elton John AIDS Foundation.
Sales of "Love Is the Cure" benefit the Elton John AIDS Foundation.

This study brings together health-care professionals and scholars from a variety of disciplines who seek to understand, and prevent, the transmission of HIV. The biological and social factors concerned with the spread and impact of HIV/AIDS has resulted in dedicated research from each of the disciplines and provided unique insights into the disease. By assembling their insights in one multidisciplinary volume, this book provides a more complete picture of the complex disease, and demonstrates why preventing the spread of HIV will require interdisciplinary collaboration.

Dawning Answers charts the legacy of the global HIV/AIDS epidemic to the theory and practice of public health. Richly detailed chapters describe how advances in techniques and startegies to monitor health events, develop public policy, set funding priorities, mobilize communities, support the adoption of safer behaviors, ensure access to needed prevention and treatment services, and involve affected populations in public health research, intervention, and evaluation, all owe a substantial debt to those who have adapted, redefined, and extended these techniques and startegies in response to HIV/AIDS. The book offers thoughtful analyses from experts in various fields and disciplines. Although most of the examples reflect the U.S. experience, relevant examples from other countries are cited, and an entire chapter is devoted to the evolving impact of HIV/AIDS on global health and development. Devastating as the losses from AIDS have been, the many public health lessons learned as a result of the epidemic have positively influenced other domains of public health and will continue to exert an influence on new approaches to health assessment, policy development, and assurance.

In Viral Sex, leading AIDS researcher Jaap Goudsmit illuminates the origins and nature of the world's most lethal epidemic. This fascinating epidemiological whodunit, or...`howdunit' (The Lancet), takes us on a journey from the African rainforest, to ancient Egypt, to pioneering research labs in the U.S. and Europe.

The concept of `viral sex', Goudsmit explains, is central to understanding the AIDS crisis. HIV not only produces offspring that are almost exact copies of the parents, but also reproduces sexually, creating a recombinant population of variants. This `viral sex' gives HIV an edge in adapting to new hosts, enabling it to survive the leap from ape to man. Goudsmit argues that the man-made phenomenon of deforestation and human encroachment on the African monkey habitat provided the opportunity for the SIV virus to jump to its new host, human beings, who then brought HIV out of the Cameroon rainforest at the turn of the century.

Provocative, vividly written, and impeccably researched, Viral Sex instills readers with a new sense of the urgent need to contain HIV and other similarly lethal viruses before they spread beyond the grasp of even the most sophisticated science.

This book examines the issues surrounding the growing epidemic of women and children with HIV and AIDS. It explores such issues as discrimination in employment, housing, health care, and education, and looks at medical testing, confidentiality, reproductive freedom, income assistance, child welfare, and child custody. Focusing on the federal and state statutes that protect women and children with HIV and AIDS from discrimination, this book also examines the statutes that govern the operation of the public systems to which significant numbers of women with HIV and AIDS turn to for financial and medical needs, housing assistance, and social services. Clear and accessible, this book is vital reading for anyone interested in learning more about the policies, provisions, and legal concepts surrounding this issue.

By drawing on the latest discoveries in virology, microbiology, and immunology, Mirko Grmek depicts the AIDS epidemic not as an isolated incident but as part of the long, but far from peaceful, coexistence of humans and viruses.

William Clark's At War Within takes us on a fascinating tour through the immune system, examining the history of its discovery, the ways in which it protects us, and how it may bring its full force to bear at the wrong time or in the wrong place.

Scientists have only gradually come to realize that this elegant defence system not only has the potential to help, as in the case of smallpox, but also the potential to do profound harm in health problems ranging from allergies to AIDS, and from organ transplants to cancer. Dr Clark discusses the myriad of medical problems involving the immune system, and systematically explains each one, making the complexities of this delicately balanced mechanism comprehensible to the lay reader.

Historically, the fields of public health and human rights have remained largely separate. The AIDS pandemic, however, made it clear that a complex relationship exists between the two fields. Women and children have proven to be extremely vulnerable to infection with HIV due to their inability to protect themselves in intimate relationships, their sexual exploitation, and their lack of economic and educational alternatives. On the other hand, coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known or suspected of having AIDS, and decrease the effectiveness of public health measures. Protecting and promoting human rights is becoming one of the key means of preserving the health of individuals and populations. A penetrating analysis of the close relationship between public health and human rights, this book makes a compelling case for synergy between the two fields. Using the AIDS pandemic as a lens, the authors demonstrate that human health cannot be maintained without respect for the dignity and rights of persons, and that human rights cannot be deemed adequate and comprehensive without ensuring the health of individuals and populations. In the course of their analysis, Gostin and Lazzarini tackle some of the most vexing issues of our time, including the universality of human rights and the counter-claims of cultural relativity. Taking a cue from environmental impact assessments, they propose a human rights impact assessment for examining health policies. Such a tool will be invaluable for evaluating real-world public health problems and is bound to become essential for teaching human rights in schools of public health, medicine, government, and law. The volume critically examines such issues as HIV testing, screening, partner notification, isolation, quarantine, and criminalization of persons with HIV/AIDS, all within the framework of international human rights law. The authors evaluate the public health effects of a wide range of AIDS policies in developed as well as developing countries. The role of women in society receives special emphasis. Finally, the book presents three case histories that are important in the HIV/AIDS pandemic: discrimination and the transmission of HIV and tuberculosis in an occupational health care setting; breast feeding in the least developed countries; and confidentiality and the right of sexual partners to know of potential exposure to HIV. The cases challenge readers with some of the complex questions facing policy-makers, scientists, and public health professionals, and exemplify a method for analysing these problems from a human rights perspective. Gostin and Lazzarini have written a book that will be a valuable addition to the libraries of public health teachers and practitioners, legal scholars, bioethicists, policy makers, and public rights activists.

This ground-breaking work is the first book to present a Darwinian perspective on infectious disease. It views disease-producing bacteria and viruses as parasites and explains the history of disease as a host-parasite relationship, one which can evolve in many different ways and with radically different effects on the host population. The author's evolutionary approach is interdisciplinary, drawing on theory and example from the fields of epidemiology, molecular genetics, biochemistry, physiology, evolutionary ecology, and the ecology of populations and communities.

The rapidly proliferating research on the human immunodeficiency virus (HIV), now well in its second decade, continues to generate new information at a rate heretofore unparalleled in medicine. As a direct result, the increasing variety of methods for the prevention, diagnosis, and treatment of HIV and AIDS has made it difficult for physicians to keep abreast of the optimal management approaches in the field. The HIV Manual is an immensely practical, accessible, and up-to-date summary of the wide range of clinically relevant information on HIV-infected adults. It deals with the key issues and frequently encountered problems in HIV clinical care, and includes a special section on the symptom-based approach to diagnosis. In addition, this concise reference contains several chapters discussing topics rarely covered in similar books on the subject, such as HIV testing, initial evaluation, future anti-HIV therapies, alternative therapies, and nutrition.
The format is specifically designed for the busy practitioner's convenience. Subheadings clearly outline the principal elements of each chapter and treatment regimens are encapsulated in boxes so that needed material can be located with ease. The diagnostic and treatment guidelines are easy to follow and even where a concensus on treatment is lacking, the authors have made recommendations based on the existing data. This manual is intended to serve the information needs of health professionals involved in the care and treatment of HIV-infected patients in the clinical setting. It will also provide an easy-to-read guide for the general reader interested in finding out more about the diagnosis and prevention of HIV and AIDS.

THE PIONEERING WORK IN HIV MEDICINE, COMPLETELY REVISED FOR THE FIRST TIME SINCE 2012 The 17th edition of Bartlett's Medical Management of HIV Infection offers the best-available clinical guidance for treatment of patients with HIV. Edited by preeminent and pioneering authorities in HIV research and clinical care, it has earned its status as the definitive work for physicians, physician assistants, nurse practitioners, pharmacists, and anyone working in the care of persons with HIV. Updated to reflect the most recent innovations in HIV prevention and therapy, this text balances new and old approaches to produce a guide to clinical management in any setting. Coverage includes: * New approaches to prevention of HIV and prevention of infection in patients with HIV * Laboratory protocols for screening and treatment * Antiretroviral therapies (including dosage and adverse effects and drug interactions ) * HIV treatment in resource-limited settings * Management of infections A portable, navigable guide to an exquisitely complex field, Bartlett's Medical Management of HIV Infection is the continuing standard for practice and education in the field of HIV.