An estimated forty million people carry the human immunodeficiency virus (HIV), and five million more become newly infected annually. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected individuals live in the poorest regions of the world, where ART is virtually nonexistent. The consequent death toll in these regionsâ€"especially sub-Saharan Africaâ€"is begetting economic and social collapse. To inform the multiple efforts underway to deploy antiretroviral drugs in resource-poor settings, the Institute of Medicine committee was asked to conduct an independent review and assessment of rapid scale-up ART programs. It was also asked to identify the components of effective implementation programs. At the heart of the committee's report lie five imperatives: Immediately introduce and scale up ART programs in resource-poor settings. Devise strategies to ensure high levels of patient adherence to complicated treatment regimens. Rapidly address human-resource shortages to avoid the failure of program implementation. Continuously monitor and evaluate the programs to form the most effective guidelines and treatment regimens for each population. Prepare to sustain ART for decades.

HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

This ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme’s demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS(UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. Several aspects of the global response – the strategies adopted, the roads taken and not taken, and the lessons learned – can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics. Included in the coverage: The response before the global response Building and coordinating a multi-sectoral response Containing the global spread of HIV Addressing stigma, discrimination, and human rights Rethinking global AIDS governance UNAIDS and its place in the global response The AIDS Pandemic: Searching for a Global Response recounts the global response to the AIDS pandemic from its inception to today. Policymakers, students, faculty, journalists, researchers, and health professionals interested in HIV/AIDS, global health, global pandemics, and the history of medicine will find it highly compelling and consequential. It will also interest those involved in global affairs, global governance, international relations, and international development.

"The focus here is on ways to increase impact of health service innovations that have been tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting, sustainable basis." -- p.i Preface.

The global expansion of HIV programming (HIV "scale-up") and the growth of global health in the past decade reshaped politics, power, civic relations, and citizen subjectivities in countries across the globe. This book draws on interdisciplinary research from numerous sites in the Global South to examine the political dimensions of HIV and global health programming. The chapters reflect extensive methodological diversity and geographic range, yet exhibit striking resonance with the book’s core themes. Collectively, the authors paint a complex global portrait of a unique period in the social history of HIV, as the pandemic enters its fourth decade, and the global response reaches its peak. The book contemplates "scale-up" (and, subsequently, "scale-down") as an object of analysis and an historical shift in the politics of response to global crisis. Ultimately, HIV/AIDS campaigns provide a template for the broader expansion of global health projects and institutions. These transnational shifts and expansions necessitate further critical evaluations across social science and public health disciplines. By collecting diverse perspectives on the political legacies of HIV and global health, this book provides a unique history of the present, cataloguing emerging practices and policies that will have long-term social impacts. This book was originally published as a special issue of Global Public Health.

It has now been 25 years since the apocryphal report in the CDC Morbidity and Mortality Weekly Report dated June 5, 1981 entitled, “Pneumocystis Pneumonia - Los Angeles”, which announced what was to become HIV/AIDS. HIV has now affected virtually all countries that have looked for it and has had a devastating impact on the public health and medical care infrastructure around the world. HIV/AIDS has also disproportionately affected nations with the least capacity to confront it, especially the developing world nations in Sub-Saharan Africa, South and Southeast Asia, and the emerging republics of Eastern and Central Asia. The pandemic, unlike any other disease of our time, has had profound impacts on the practice of public health itself: bringing affected communities into decision making; demanding North-South partnerships and collaborations; and changing the basic conduct of clinical and prevention trials research. While much has been written in scholarly publications for medical, epidemiologic and disease control specialists, there is no comprehensive review of the public health impact and response to HIV/AIDS in the developing world. This edited volume seeks to systematically describe the emergence and form of the epidemics (epidemiology), the social, community and political response, and the various measures to confront and control the epidemic, with varying levels of success. Of particular importance are strategies that appear to have been useful in ameliorating the epidemic, while contrasting the situation in a neighboring country or region where contrasting prevention or care initiatives have had a deleterious outcome. Common to all responses has been the international multi-sectoral response represented by the Global Fund for HIV/AIDS, Malaria and Tuberculosis, the President's Emergency Plan for AIDS Relief, and the Gates Foundation, among others, to promote HIV pharmacologic therapy in resource-poor settings. The chapter authors will explore the political challenges in meeting HIV/AIDS prevention and care in concert with the public health realities in specific country and regional context.