Global Issues in Health - Term Paper Example

Id: Global Issues in Health Introduction HIV/AIDS has become a global health issue, which consistently raises concerns among communities due to the rapid spread and the impact that it has on the world populations, especially in the less developed countries. The sub Saharan Africa is among the regions with high HIV prevalence. It tops in the number of infections among adults according to a global 2008 survey, which indicated that South Africa and other less developed countries in the region such as Malawi, Zimbabwe, Botswana, Namibia and Zambia are the most vulnerable to HIV infections. East and South East Asian countries are also key areas that are known to have high HIV prevalence (UNAIDS, 2008). This paper presents social scientific analyses of the HIV issue and the policies that have been formulated to deal with it. It also highlights organizations and actions to address the issue. Social Scientific Analysis of the HIV Issue Social changes occurring among world populations have a significant influence on the rate of HIV transmission. As people migrate from one region to the other in search of better livelihoods, they spread their cultures globally leading to the emergence of a hybrid of populations with diverse customs, which are core to the spread of HIV. For example, premarital sex is a widespread practice in the U.S, which dates back in the 1950s (David, 2000). The number of people engaging in premarital sex is increasing, ranging from 75% at the age of 20 years to 95% at the age of 45 years in 2000. The U.S is a developed country where people from all over the world seek education, employment as well as investment opportunities. Even though cultural diversity has much positive influence to the society, the interaction between people of different nationalities in the country makes it impossible for some people to preserve their national cultures, which hampers efforts to control of the spread of HIV. In Vietnam, teenage sex is also held responsible for the spread of HIV. The changes in teenage sexual behaviours are understood to be as a result of globalization, which has largely affected the local culture and customs. The country presents investment opportunities for many foreigners who have introduced their own culture in the country and hence the changes. Many other countries are experiencing HIV spread as a result of globalization even to the interior parts of the countries as travelers engage in unprotected sex with the locals (Hamlyn et al. 2007). Global movements and communication have been made possible by technological advancements, which have facilitated the spread of diseases, especially in third world countries that do not have sufficient capacity to control immigration. They usually have no strong mechanisms to prevent the infiltration of infected immigrants in the country even though they are not the only cause of HIV spread. For example, South Africa which is one of the developing countries that is vulnerable to infected immigrants especially due to the upcoming FIFA world cup. On the other hand, immigrants who may engage in unprotected sex are exposed to the dangers of HIV infection especially with the current rating of the country among those with high HIV preference. Apart from the world cup event, globalization of many social and socio-economic activities is a major contributor to the changes in the social behaviours in the contemporary society, leading to the spread of HIV (Lee, 2003). Zungu-Dirwayi et al. (2004) attribute the rising rates of HIV infections to inter-dependence of countries globally in economic and technological issues. The less developed countries provide cheap labour to industries from the developed countries and therefore they highly depend on the thriving economies for employment (Lee & Collins, 2005). The movement of people to places away from their families in search of employment is likely to change their sexual practices especially when spouses are separated. It is also possible for the young people to discard their culture as their early adulthood is spent in foreign cultures. However, with increased globalization of trade, even the sex industry became globalized, with Thailand, Kenya, Zimbambwe, Indonesia and New Guinea being amongst the countries where many commercial sex workers derive their livelihoods from the industry. In Thailand, sex tourists are estimated to be “500, 000 per year with a total income of US$ 4.3 billion” (Thailandbuddy.com). In Kenya, Kibicho (2009) observes that the sex industry is a thriving business. Even though there lacks information regarding the annual income, he points out that it is a major employer with more than 50,000 commercial sex workers operating in the coastal towns that are the major tourist destinations. Zimbambwe was found to have more than 12,000 commercial sex workers in the major towns such as Harare (Ngugi & Sebstad, 1996). Jeckins (1994) observes that the sex workers who earn lowest amounts in Papua New Guinea serve 300-900 clients, earning approximately $4500-$8000 annually, while the highest paid usually serve 50-100 clients, earning $20,000-$50,000 per year. In Indonesia, the trade is well established with commercial sex workers ranging from high class who serve wealthy locals and foreigners, the middle level workers who serve the middle income locals and tourists and the lowest class that serves low income locals. The earnings range from $50-$1500 per week (Wirawan et al. 1993). Sex tourism has encouraged involvement of minors in sexual activities. The fact that people have become aware that HIV prevalence is high between the ages of 15 to 25 years, children below 15 years are being targeted for sex by tourists . Kenya, Tanzania and many other coastal towns in the Sub Saharan Africa are engaged in efforts to fight against child abuse especially involvement of children in sex trade (Mohiddin & Johnston, 2006). The use of ARVs has been widely applied in many countries and has helped in prolonging the lives of the infected people. The society is yet to accept living together with people infected with HIV and therefore few people would like to declare their status, making it impossible to help the healthy people to avoid from engaging in unprotected sex with the infected (Sittitrai, 2001). There are rising cases of sexual abuse of school going children by their teachers as well as parents and guardians. The people who have been entrusted with the care of children have turned them into their sex prey. Goldman, (2007) observes that in the UK, 8% and 12% of children below the age of 18 years were sexually abused in 2005 while the abuse was higher in the US with 17% and 18% of boys and respectively being abused. Goldman believes that most of the cases are unreported due to intimidation of the victims. Children acquire infections at an early age, which is endangering successive generations (Matovu & Makumbi, 2007). On the other hand, intravenous drug use is increasing among young people. Mexico City is among the leading cities in this practice. It is also on the rise in Russia and many other Sub-Saharan African countries such as Kenya, Ethiopia, Somali and South Africa (UNAIDS, 2008). The fact that many governments have declared war on drugs makes drug use an undercover practice. For example, the U.S declared war on drugs, which involves incarceration, and denial of various privileges in the society, including parenting rights. Many women who have been convicted of drug use or dealing in drugs have had their children adopted and their parenting rights denied (Don et al. 2005). This has not stopped the use of drugs but rather has resulted in illegal use in secrecy. Consequently, intravenous drug users tend to apply the same needles to inject the drugs in to their bodies, which facilitate HIV transmission among them. Scientific advancements have significantly facilitated efforts to prevent mother to child HIV transmission, which was a major threat to the children born in regions with high HIV prevalence. Moreover, scientific research has enhanced the effective management of the disease to prolong the lives of the infected persons. Etiebet et al. (2004) observes that scientific research has also helped in eliminating doubts regarding HIV transmission globally. For example, in the days just after the discovery of the HIV virus, the infected people were segregated for fear of infecting others, but the stigma has reduced after people realized how the disease is transmitted. There have emerged scientific methods of HIV mapping that are significant in determining the prevalence among vicarious populations globally. This has helped in providing warning to governments and other stakeholders to enhance interventions. For example, some countries have made significant advancements in research regarding HIV prevalence between men and women of different marital status, circumcised and uncircumcised men as well as many other diverse groups in the society. The results of the scientific research have been applied and researchers are in the process of establishing whether the biomedical interventions are useful in controlling the spread of HIV (Matovu & Makumbi, 2007). However, there is still little evidence regarding the success of biomedical interventions and research to establish a cure for the disease is still ongoing. Global Policy Responses to Address HIV Issues Many countries have developed policies to deal with the HIV pandemic that has claimed the lives of many people and still continues to spread thereby endangering the health of the world population. There are various programs that the federal government has rolled out to help the infected people to acquire drugs and also to campaign against new infections. For example, currently there is a five year Global HIV/Aids strategy that is whereby the government has sacrificed $15 billion to support the HIV control (Martin, 2003). The U.S Global AIDS policy and HIV prevention is focused on “abstinence and prevention, prostitution and sex trafficking, family planning, comprehensive prevention for women and youth as well as female condoms” (U.S. Global AIDS Policy and HIV Prevention, 2008). Other objectives are aimed at promotion of abstinence as well as sensitizing people against the use of drugs, which is a major factor that is contributing to HIV transmission among drug users and promotion of access to ARVs, which are aimed at helping the people to remain productive while living with HIV (Jarlais, 1996). The UK has also developed policies to support HIV prevention and care for the infected. First, the Department of health set up policies through the national strategy for sexual health and HIV implementation action plan (Department of Health, 2002). They include; the policy on unsafe sex to enhance the availability of condoms in the UK, The policy on HIV diagnosis that requires HIV testing services to be available to all citizens, the HIV prevention Policy that required the criminalization of irresponsible spread of HIV, the policy on HIV prevention and education that aims at sensitizing the people about the dangers of engaging in risky sexual activities and the sex and relationships education policy for schools. The deportation policy has been relaxed for HIV victims in a bid to help them to access drugs. Extradition of immigrants from the UK on the basis of HIV status has been suspended until the suitable drugs to prolong the lives of the patients are made accessible in their countries of origin. This is a positive development from the home office to enhance HIV control. Plans have also been implemented regarding provision of information on HIV to the public as well as making condoms accessible to all (Scriven & Garman, 2005). The government has launched major programs through the Department of Health in the UK aimed at preventing the spread of sexually transmitted diseases, with the major focus on HIV. They include; the Independent Advisory Group on Sexual Health and HIV, NCSP, as well as the Expert Advisory Group on AIDS. The UK HIV policy offers guidelines regarding access for treatment and drugs for HIV patients. The Department of Health sets aside funds each year to support the primary prevention policy, which is given to various trusts involved in HIV prevention through testing and providing education on sexual health. Upon the recommendations of the National Aids Trust, focus is geared towards surveillance and testing to help in understanding the dynamics of the pandemic (Adawy, 2008). This has led to an increase in the number of people diagnosed with HIV, especially the immigrants. The Terrence Higgins trust has significantly helped people to access HIV tests in the UK playing a major role in increasing the number of diagnosed patients, which is significant in preventing new infections. The African HIV policy network is a major program that has been launched by the Department of Health to promote HIV testing among the Africans living in the UK (Coovadia, 2009). The National Blood Service developed a policy that was aimed at controlling blood donation to prevent the spread of HIV. Other international organizations have also been in the forefront in the fight against HIV. UNAIDS is one of the strong organizations that has a mission of supporting HIV programs especially in third world countries. It is assisting third world governments to develop policies that are geared towards HIV prevention. The current efforts are mainly focused on establishing coordination among stakeholders to help poor economies to accomplish their HIV prevention objectives (UNAIDS, 2008). Haiti is among the beneficiaries especially after the HIV programs in the country were disrupted by the earthquake disaster in January 2010. The United Nations general assembly supports the fight against HIV among other pandemics. This has been accomplished through provision of funds such as UNAIDS and others that cater for a HIV and other humanitarian issues such as United Nations Development Fund for Women (UNIFEM) and United Nations Population Fund (UNFPA) among others to help nations to deal with the HIV pandemic. The Global Fund has helped many governments to conduct HIV programs while collaborating with stakeholders. The funds have been used to promote information sharing on a global scale through the program dubbed “break the silence”. It involved discussions regarding approaches to HIV prevention whereby interested parties in the fight against HIV were interconnected through e-mail forums. Civil societies played a significant role in enhancing the exchange of ideas. The forum presented an opportunity for advocacy issues that helped in incorporating important issues in the UN policy on HIV (Coovadia, 2009). NGOs that work closely with communities globally were given an opportunity to present the feedback and the views of the communities regarding the government’s and NGOs’ interventions in HIV prevention. In Africa, the major policy objectives in the developing countries are aimed at reducing stigmatization and the spread of HIV. For example, the government of South Africa which is one of the countries with the highest level of HIV preference in Africa developed a discrimination policy aimed at eliminating prejudice against people living with HIV. Initially, they could not be recruited in the army. However, the recent HIV policy of 2009 allowed the recruitment and deployment of HIV positive people. However, their deployment is supposed to be selective (Mohiddin & Johnston, 2006). Other policies that have also been adopted by other African states to promote HIV prevention include those that are supported by international organizations such as the United Nations, which include; prevention of mother child transmission, awareness creation, sex education, provision for condoms and circumcision among other prevention strategies. For example, the Kenyan government, which is among the Sub Saharan countries that have high HIV prevalence (Kibicho, 2009) engaged in a campaign to promote male circumcision as a way of controlling the spread of the infections. It is also recognized in many African countries such as South Africa, Zimbabwe, Uganda, Tanzania and Swaziland among others. The circumcision age varies between different states. Developing countries are also engaging in such efforts. The U.S is among the developed countries that have embraced male circumcision as a tool for HIV prevention (Awires et al. 2007). However, there are health concerns about circumcised men misunderstanding their low prevalence in relation to the uncircumcised men. Conclusion The changes that have occurred in the global social systems are significant in the spread of HIV, which has become a major global health issue. Economies are becoming inter-dependent in economic and technological aspects, thereby lacking control of immigration especially in the developing countries. Globalization of sports is also a major factor that has contributed to the movement of people from one country to the other thereby spreading or being exposed to HIV infections. The sex industry is growing rapidly and is currently pronounced even in the developing countries. Together with drug use, commercial sex workers are blamed for the spread of HIV. Biomedical advancements have led to the discovery of new methods of controlling the spread of HIV. However, a cure for the pandemic has not been established though research is still ongoing. HIV mapping has helped in documenting its prevalence among world populations. Governments and other international as well as non governmental organizations are playing a significant role in the prevention of the spread of HIV. The U.S has devoted resources towards helping third world countries to cope with the HIV pandemic. The UK government has developed policies to enhance the control of new infections through the department of health. There are various trusts that have been funded to spearhead the anti HIV campaigns. The United Nations is among the international organizations that have been active in the HIV prevention. African countries are also improving their HIV campaigns through appropriate policies. References Adawy, M. E. 2008. “Workshop Attendees Gender and HIV: Policy Lessons for Low Prevalence Scenarios”. Journal of Acquired Immune Deficiency Syndromes, Vol. 51, 3 pp 73-127. 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