10: The AIDS/HIV Global Epidemic Flashcards
definition of epidemic
something regionally concentrated that stays within borers
definition of pandemic
epidemic on steroids in terms of intensity, spread of the virus and geographical extensions/reach
chronology of the AIDS/HIV global epidemic
debate, interdisciplinary dialogue and problem of sources
- HIV/AIDs obliges us to engage with various disciplines
- bottom-up documentary evidence is not enough especially when we want to engage with the genealogy of the story
origins of the AIDS/HIV global epidemic
most credible hypothesis is that it originated in central Africa in the 1920s/1930s from chimpanzees that were infected to humans
spread via urbanisation, prostitution, trade, migrations, medical campaigns against tropical diseases, migration, etc.
- story of the modern age as a story of greater integration and interdependence
- unexpected and unwanted consequences of campaigns to eradicate some viruses (with limited resources, they often used unsterilised needles)
case of Haiti: prostitution and blood trade
- Haiti being one of the most important hubs of blood banks
- multiple plasma centres
- in the American media in the early 1980s, it became the fourth H of the pandemic (homosexuals, heroin users, haemophiliacs, Haiti)
when and how did AIDS become a global health crisis?
first reports in the US in 1981
- unseen and unprecedented cases of what was then an extremely rare disease
slowness of medical/political response
linked to specific groups/lifestyles so presented as a problem of a group and not a health crisis
- easy and politically convenient to present AIDS as the problem of a group and lifestyle more than a health crisis
- popularisation of the idea that there was a patient zero that acted promiscuously
part of culture wars and ensuing stigma
- AIDS culturalismes as the disease of homosexuals or capitalist disease
- narrative and discussion politicised and therefore culturalised
- white males also had the social and economic means as well as political agency the tother groups lacked
American disease?
grassroots activism and mobilisation
- linked to the gay activism of the previous decade
- decentralised, horizontal organisation like ACT UP that was capable of going global and became an important lobby and pressure and the local, regional, national and global level
- also development of their own medical expertise
what policies and strategies were adopted to face the escalation of the AIDS crisis?
campaigns against prejudice and ignorance
- education on transmission
practical solution vs. cultural/social norms
- promotion of practical programs that were difficult to implement because they went against consolidated powerful cultural and social norms
- social, cultural and political obstacles
action at the local level: global challenge/local responses
- interplay and interaction between the global and local
- global challenge that required and eventually produced global responses, but which also had to be tackled initially and primarily at a local level
abstinence and monogamy
- position taken by influential institutions like the Catholic church
- effective way of containing the virus
- bottom up mobilisation offered a different message: that education was important and you can live a more responsible life but the full cooperation of science with politics and funding is the key to solve the issue
medical research for drugs and vaccines
- strongly pressured by lobbies
- major disappointments
increasingly, international action
- global phenomenon that spread so major global institutions stepped in
- WHO with global program on ADIS, UN AIDS
- combination of global and local as a distinctive mark that highlights the transformation of international politics and global history in the past half of a century
results of policies and strategies adopted to face the escalation of the AIDS crisis
political/cultural clash
increasing awareness
- no one was out of reach (cases of celebrities being central like Freddie Mercury and Magic Johnson)
- increasingly powerful messages in normalising the virus
heavy investments in medical research at institutional state and non-state non-institutional level
- big donors stepping in
- research finally delivered via antiretroviral therapies
development of ART
- effective to manage/contain the virus but costly and had side effects
what changed once AIDS became potentially curable?
highly expensive medications
- global businesses with unequal access
- international campaigns in reducing the price of drugs to make them easily accessible
AIDS became less visible in the first world
- quasi-disappeared from the public and political conversation
- decline in attention means decline in the propensity to behave responsibly and accordingly
shift of attention to Africa
- virus as booming in Africa with political, social and demographic consequences
- to get out of the emergency and flatten the curve, you need effective public policies with political action and heavy funding
- first world mostly gotten out of the emergency
medical exceptionalism
- informed the idea that there could be a scientific, technocratic and political solution in the end
- narrative of the 1990s is one that tends to depoliticise AIDS/HIV as an issue
what does the AIDS epidemic tell us about IR and contemporary globalisation?
shattered enthusiasm on global integration and progress
- challenge to an optimistic narrative of globalisation
- global pandemic challenges the idea that interdependence and greater integration only has positive outcomes
revealed dangers of global integration
- conditions for the development, spread and ultimate globalisation of the virus itself
confirmed and strengthened global hierarchies
- AIDS progressively the disease of the poor on a global scale and within national communities
deficit of global governance and tension between globality and globalisation
- globalisation as the depth of integration and the possibility for things to circulate globally, but globality as the fact of being able to create a global community that has specifically institutionalised ways to govern
- AIDS showing that we are global in terms of globalisation but not globality with a clear deficit of global governance
