Should Wealthy Nations Promote Anti HIV – AIDS Efforts in Poor Nations

1.0 Introduction

In recent years, the global attention has shifted to the effects of HIV/AIDs in developing countries. Wealthy nations were the pioneers of anti-HIV medications that were found to enhance people’s health and prolong their lives. With such great developments, wealthy nations felt that the drugs needed to reach millions of people suffering elsewhere. Most of the people affected by the ravages of AIDS live in the developing nations. Unfortunately, only a small 2% of them have enough access to the necessary drugs. There is a major concern on the ways Africa and other nations are handling this menace. HIV/AIDS is a pandemic and affects all (Bonnel 2000, pp. 820-855; Farmer et al., 2001, pp.:404-409). While the effort of one country in stopping the disease is considered helpful, the involvement of many is believed to produce a resounding victory. Having realized this fact, the question remains, “Should wealthy nations promote anti-HIV/AIDS efforts in poor nations?” This paper seeks to evaluate the reports and the scholarly sources to answer this vital question.

The international AIDS pandemic has continued to gain momentum. Currently, there are approximately 36 million infected people. This group is very susceptible to illnesses and prone to early death if the suitable medical care for pro-longing their lives is not applied. The AIDS pandemic has now become a big cause of political, social, and economic instability. For the wealthy nations there has been drastic success realized in the fight against AIDS. This development has been realized mainly through the antiretroviral therapy. Survival and good quality life has become possible through access to the treatment. However, the antiretroviral therapy is still inaccessible in many developing nations (Porter, Babiker, Bhaskaran, Darbyshire, Pezzotti, Porter & Walker, 2003, pp. pp. 1267-1274). HIV/AIDS interventions in the developing nations have had the focus on prevention alone.

2.10 Global HIV/AIDS Action Trends

There has been a significant increase in the rates of death caused by HIV/AIDS in poor and developing nations in the recent years. As a result, the prevention of HIV/AIDS and treatment for the infected ones has become an international health priority (Gupta, Parkhurst, Ogden, Aggleton & Mahal, 2008, pp. 764-75).

2.11 Challenges of HIV/AIDS in Developing Countries

The extent of the damage brought about by HIV/AIDS in the developing countries is a consequence of the limited financial resources, little educational opportunities, and insufficient infrastructure. These factors together with social, economic, epidemiological, political, technological, and cultural matters affect HIV pharmacotherapy accomplishment in poor countries (Maponga, 2006, par. 2-11). In order to address these challenges international collaboration is very vital and is considered as a strategy of attaining equitable treatment of HIV. There has been an ever increasing support from wealthy nations to promote anti-HIV/AIDS efforts in poor countries (Hallman, 2005, pp. 37-50). Wealthy nations, like the United States, have been very supportive through a comprehensive structure of mutually supportive approaches that have been found to deal with the issue of access to the essential drugs.

There have been objections in the past towards the treatment of HIV/AIDS in developing nations. It was due to several reasons: the absence of sufficient medical infrastructure to offer a safe and effective treatment of AIDS, the challenges associated with the adherence to complex medication procedures would enhance and spread resistance of drugs, and the fact that antiretroviral drugs are quite costly. The cost of treatment is very high even for the developed countries like the United States, let alone other wealthy nations (Farmer et al., 2001, pp.:404-409). The financing for such treatment has siphoned a lot of resources away from prevention programs of HIV and other development goals. Additionally, political leaders in developing countries, especially in Africa, have had less commitment needed to underpin a great global endeavor of providing the treatment against AIDS.

2.12 The Treatment of HIV in Wealthy Countries

A partially effective treatment of those infected by HIV was reached in 1986; barely few years after the disease was noticed (Gupta et al., 2008, pp. 764-75). The first antiretroviral drug, Zidovudine (AZT), was found out to be effective in reducing deaths and accompanying opportunistic attacks in people with advanced infection of HIV. Developments continued through other discoveries of lamivudine (3TC), didanosine (ddI), stavudine (d4T), and several others drugs. The benefits of these single drug treatments were later discovered to be short-lived (Bozzette et al., 2001, pp.817-823; Farmer et al., 2001, pp.:404-409). There were failures of treatment in months or a number of years, often caused by the evolution of viruses that increased the resistance to the drugs.

A major breakthrough was achieved when it was found out that putting several antiretroviral drugs together would largely delay the showing-up of drug resistance and amount to a more prolonged and profound advantage than a single drug could do. Other classes of drugs, like the non-nucleoside reverse transcriptase and protease inhibitors, made it possible for more stable three-drug antiretroviral procedures (Farmer et al., 2001, pp.:404-409). Such procedures, known as the highly active antiretroviral therapy (HAART), have culminated into a considerable success in reducing the HIV infection levels in the human blood, usually levels that cannot be detected and have significantly enhanced the immune function in individuals infected with HIV (Freedberg et al., 2001, pp. 824-831).

2.13 HIV/AIDS Intervention Assessment

Despite having been discovered more than two decades ago, HIV/AIDS has continued to be a global pandemic. AIDS has caused many deaths and created orphans. Due to ravages caused by AIDS, the United Nations has opened the UNAIDS office to deal with it. Despite the establishment of the UNAIDS office along with other universal endeavors, there has been little efficiency realized in preventing further contraction of HIV/AIDS. Closely-linked HIV subtypes have been the main causes of the many concurrent epidemics that are starting to surface beyond the initial geographic borders (Gupta et al., 2008, pp. 764-75). Infections are taking place each and every day globally. As a result of these trends, the deaths from HIV/AIDS have been thought to surpass those caused by the historical 14th century Black Plague.

The ever increasing trends of HIV/AIDS infections have stirred a lot of fears in many countries. Developing countries are the hard-hit regions (Porter et al., 2003, pp. pp. 1267-1274). Currently, no single nation in the entire world has escaped the HIV/AIDS disaster. The issue of HIV/AIDS has not only disintegrated the fabric that holds the political, economic, and social facets together on the national, regional, and local levels, but also has been a key destabilizer in international relations.

The implementation of structures and procedures that will help mitigate the effects of HIV/AIDS is being actively involved in promoting generic completion, searching for differential drugs’ pricing from global suppliers, utilizing the World Trade Organization to safeguard national legislation and making sure that every law is fully established regarding the same, providing high demand through international procurement and enhancing local production of drugs by transferring and licensing technology (Bozzette et al., 2001, pp.817-823). The assessment of the absolute HIV cost management takes into account drugs and the financial issue, considering the possible fee contribution from the users, government, donors, and the societies providing medical aid.

2.20 Anti-HIV/AIDS Efforts

There has been an active research conducted by the wealthy countries on the poorer regions on the subject of health issues and diseases that possess threats on the global scale. Universal spending on studies in the poor-developing nations has continued to lag behind that of wealthy nations (Halperin & Allen, 2000, pp.15-18). Getting treatments for the diseases that trouble wealthy nations provides a much bigger promise of political and financial returns than the treatment of diseases that are very common in poor nations, such as tuberculosis, malaria, and HIV/AIDS. There are quite a number of ethical challenges posed by the research in poor countries related to the need to prevent exploitation and harm of the participants in the study and to make sure that the suitable stakeholders get a just share of the benefits that accrue. The quality review of ethics is an important endeavor in promoting research partnerships with the developing and poor nations.

2.21 Addressing AIDS

In the recent years HIV/AIDS has been a leading cause of deaths. There was a great scientific breakthrough in the mid-90s through the discovery of highly active anti-retroviral therapy (HAART). With this development the pandemic now became chronic and treatable condition for many people who could reach the treatment (Bozzette et al., 2001, pp.817-823). Out of the HIV-infected people from all over the world, 95 percent come from low-income developing nations. HAART is not accessible to most of them. Emerging economies, including Thailand and Brazil, have got some kind of coverage through effective and bold national policies.

In many of the developing nations of Sub-Saharan Africa and other parts of the world that are affected by HIV HAART has not been available. Only about 10,000 out of 25 million patients in Africa have succeeded to get HAART. The situation is alarming (Mishra et al., 2007, S17-28; Fox, 2010, pp. 16-24). For instance, only 30 people out of 800,000 have got access to HAART in Malawi.

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Many nations, especially in the developing world, have endeavored to access the facilities of healthcare and ensured their rights. However, the level of implementation has been thwarted by insufficiency to fund the programs and policies needed to realize these national objectives. There has been a universal urgency to treat AIDS. The extensive discussions of academicians and scholars take place in the world with an aim of investigating how antiretroviral therapy could be an amicable solution to the developing nations (Halperin & Allen, 2000, pp.15-18). The feasibility and effectiveness of antiretroviral therapy in an effort to offer a treatment for AIDS to prolong life can be realized in poor nations.

2.22 HIV/AIDS and Economic Status

There has been a long held belief that the human immunodeficiency virus (HIV) is driven by poverty (Sachs, Mellinger & Gallup, 2001, pp.71-74). According to the World Bank (1997 report), the unequal income distribution and widespread poverty characterizing underdevelopment seemed to catalyze the spread of HIV/AIDS. According to the UNAIDS as well, underdevelopment, poverty, the absence of opportunities, and the incapacity to establish the destiny of individuals fanned the rates at which HIV was spreading globally. Fenton (2004, pp. 1186-7) made a review of the evidence on how poverty contributes to high-risk behaviors among people and made conclusions that poverty reduction could be the only long-term reaction able to counteract the forces of HIV/AIDS. However, this position has been challenged through recent research founded on statistical relationships of socioeconomic and epidemiological data (Chin, 2007, pp. 23-45; Mishra, Assche, Greener, Vaessen, Hong & Ghys et al., 2007, S17-28).

In many African nations the commonness of HIV contraction is positively related to richness (Chin, 2007, pp. 23-45). There was a robust positive link between HIV contraction and household wealth giving a general conclusion that the rates of HIV contraction seem to closely relate to the national gross income amongst Sub-Saharan African countries. This is a trend that was realized since 2000 (Mishra, Assche, Greener, Vaessen, Hong & Ghys et al., 2007, S17-28). Mishra et al. (2007, S17-28) carried out a country-wide survey in Cameroon, Ghana, Kenya, Burkina Faso, Lesotho, Uganda, Malawi, and the United Republic of Tanzania and made conclusions that there was a positive connection between HIV and the economic status of households. However, no correlation was made, as the trends appeared to be disparate based on the national income as a factor of time.

2.23 Methodology

To answer the research question as to whether wealthy nations should be involved in the anti-HIV/AIDS efforts of developing countries, data and information was collected from secondary sources, including scholarly articles, journals, published reports, government sources, and books. Credible sources providing important details regarding the research question aimed at looking at the question from both sides before making conclusions. Basically, it is a social research as it involves matters related to behavior, attitudes, and perceptions of people.

With the increment of biomedical development and research across international borders, policymakers and researchers need to consider various ethical issues surrounding this development. The ethical obligations of the wealthy countries in financing or carrying out research in the developing nations should be clearly stated. Values guiding the research are also very important. The manner in which ethics review will be conducted and who will do it should be thought over as well, considering international disparities in research and medical practices and the legal matters. It would also be important to find the ways to reach an informed consent among the prospective. The safeguards that make the research protect the participants in the poor countries from possible exploitation and harm are impediments that need redress (Voo, Chin and Campbell, 2008, pp. 107-110). Therefore, sources that have met these criteria were considered useful in arriving at a conclusion as to whether wealthy nations should be involved in the anti-HIV/AIDS efforts in poor countries or not.

2.30 Findings and Discussions

The global response to the spread of HIV/AIDS in developing nations over the last twenty years has focused on the prevention of HIV basically due to the increasing treatment cost and the lack of resources in these nations. Despite modern scientific prevention tools, the lack of effective vaccines made anti-HIV/AIDS attempts insufficient to deal with the disease. Donor agencies seem to have shied away from the mention of HIV/AIDS treatment, especially in the developed and wealthy nations. The reason has been the fear of high expectations that would largely increase the operational and fiscal demands upon them and detract from the efforts aimed at disease prevention. The differences in accessing effective treatment, especially between the wealthy nations and the developing world, cannot be justified either ethically or scientifically.

The current state of affairs concerning HIV/AIDS treatment is alarming. Therefore, the extension of effective medical healthcare to people in the developing countries is an urgent need. HIV transmission prevention programs and the delivery of effective medical treatment to the people affected by AIDs must be done simultaneously.

2.31 Prevention and Treatment in a Combined Effort

The prevention of AIDS is a prudent idea; nonetheless, the treatment of HIV infected individuals is equally important. While the focus is currently on the prevention, it is important to realize the need of treatment for those already affected by the disease (Gupta, Parkhurst, Ogden, Aggleton, Mahal, 2008, pp. 764-75). This is the immediate response needed on humanitarian grounds to provide a rationale for the efforts of treatment. Treatment is very crucial as it optimizes the efforts of prevention. When treatment cannot be accessed, there is little incentive for a person to carry out a HIV test because a positive status of illness is associated with the social stigmatization and is equivalent to a death sentence. It is only through the effective treatment of HIV that individuals receive an incentive to get tested. This makes it possible to get a logical response to HIV/AIDS: elementary prevention for people who are not infected with the disease and the antiretroviral therapy for the people who are already infected with HIV. The effective antiretroviral HIV treatment helps to lower the viral load in the lives of the infected people. This in turn produces a huge effect in cutting down the chance that there will be a transmission of HIV infection to other people.

Most importantly, then, the suitable treatment of infected people could end up being a big development in the prevention of AIDS. Treatment is extremely necessary in saving the young ones and acts as the fabric that holds communities together. The absence of treatment has led to an increase in the number of deaths caused by AIDs in the recent years. This has also led to many orphans, which might result in a socially destructive phenomenon in the future. Family support is very important for children. The ravages of AIDS deprive the children of this kind of support, making them susceptible to school dropout, malnutrition, poverty, sexual crimes, and violence (Sachs, Mellinger & Gallup, 2001, pp.71-74). All these tendencies put the children in an environment prone to AIDS expansion. It is a big threat and can mire the children in desperate conditions.

The absence of treatment in the developing countries caused a huge demographic shift, especially in the regions of Africa. In such areas the young people outnumber the elderly (Bozzette et al., 2001, pp.817-823). This demographic shift can contribute to an increased instability in the political arena and increased violence. Developing countries are in need of well-established treatment facilities for AIDS for continued economic development (Greener, 2002, pp. 49-55). The absence of treatment will turn people who are able to work into dependants. Their knowledge and skills will drain, hence, affecting the economic and human development in the entire nation. It is a very devastating picture. The loss of skilled and trained workers due to AIDS infection is expected to hamper the anticipated future growth of the economy in many developing countries. The objective of merely preventing the HIV infections without providing treatment to lengthen the lives of the infected individuals is insufficient to significantly lessen the devastating effects caused by the disease. While the need is evident, the developing countries still lack the antiretroviral therapy.

2.32 Framing HIV/AIDS Issue

According to Voo, Chin, and Campbell (2008, pp. 107-110), there has been an absolute mismatch between the global health needs and the investments into the research in the health sector. This was commonly known as the “10/90 gap” in the 1990s. Only 10% of the universal spending on medical research was directed towards the health issues affecting the poor countries and causing about 90% of the global preventable deaths. To date, the gap seems to have somewhat narrowed. Nonetheless, the mismatch is still essential, as there are many challenges remaining with regard to the funding of HIV/AIDS treatment and other health care needs of the developing nations. The treatment of HIV/AIDS and other problematic health conditions have greater promise of political and financial returns than carrying out researches that produce the cures against the common diseases of the developed countries.

Despite the overwhelming challenges, the research community has shifted attention to the developing world. With the international threats of health issues and diseases, public, non-profit, and private sectors are realizing good reasons to fund and carry out the research in vaccines and diagnostics, to save the lives in poor countries. Switzerland’s Global Forum for Health Research report of 2006 showed that countries with high levels of income had ultimately set a goal to increase the percentage of gross national income committed to the development assistance from 0.47% to 0.7%. The Bill and Melinda Gates Foundation has raised the funds exceeding $10.5 billion since its inception in 2000 to help deal with health issues in poor countries (Voo, Chin & Campbell, 2008, pp. 107-110). The medical research sponsored by industries in the Eastern Europe, Asia, and Latin America has drastically increased as well.

The increased study on poor countries has been plagued by ambiguous ethical challenges. Potential participants in such studies fear exploitation as a result of socio-economic situations, limited access to healthcare, and minimal experience in research. Pharmaceutical organizations that depend on the researches conduced on the poor countries pursue their own interests: poor nations impose lesser regulatory and financial burdens and provide quick recruitment opportunities to the subjects.

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2.33 Anti-HIV/AIDS Efforts by Wealthy Nations in Poor Countries

The efforts of the wealthy nations against HIV/AIDS in the poor countries have been perceived with much criticism. There have been mixed feelings regarding the possible harm and assistance from the wealthy nations, which shift the focus away from other significant things that wealthy nations must be involved in to enhance the development. There is a belief that governments of poor nations must come up with the medium-term strategies to combat HIV/AIDs and reduce their dependency from the wealthy countries (Greener, 2002, pp. 49-55). Similarly, wealthy nations are expected to shift from conventional support-giving to the provision of universal goods, such as vaccinations, clean energy, and security by other means.

The involvement of the wealthy nations in the affairs of the poor countries has raised many issues. Wealthy nations have started feeling that they are over-generous. However, this shouldn’t be perceived as an attack on the support given by wealthy nations, but as an enhancement of the project per se. The overall idea, however, is that people from wealthy countries should show solidarity with those from the developing countries facing challenges of injustice and hardships, usually caused by the actions of the wealthy nations.

Presently, HIV/AIDS is a major natural killer in sub-Saharan Africa and other regions of the developing world (Mishra et al., 2007, S17-28). The effective management and control of this epidemic requires suitable procedures and the use of proven drugs. The drugs are not available in this region, while they are widely used in other, richer nations. Due to the expensiveness of the treatment there is a huge potential for counterfeit products in the market. The implementation of anti-HIV/AIDS actions is a very delicate process that has united the efforts of the global community. In poor nations the urgency for routine evaluation of drug concentrations is surpassed by the need to cut down therapeutic costs. The wealthy nations have made huge strides in addressing those issues, and, therefore, the interdependence among nations will be well perpetuated through their common goal to fight against HIV/AIDS.

With the desired changes in the universal landscape, both geopolitical and natural, there is a lot more that the donor community can endeavor to create a foundation that ensures sustainable and lasting HIV/AIDS funding and is ready to solve the anticipated future challenges. These challenges include increased coordination both at the national and donor levels and between the NGO and private sectors, maintaining attention and funding for important innovation and research, cementing connections with Millennium development goals and the bigger development and health agenda, building the physical numbers and capacities of health workers who are very skilled in the developed and developing countries, and promoting strong leadership in the healthcare at all levels.

The challenges of getting help from the wealthy nations can be solved amicably if the recipient poor nations have access to flexible and predictable financing in line with the priorities set by the respective countries to guarantee sustainable and efficient use of the aid. It is very important to ensure that the necessary actions are taken to deal with the exorbitant sum of overhead expenses that are related to program initiatives skimmed off to encourage flourishing donor establishments.

3.0 Conclusions

The international community needs to provide financial and scientific leadership for the treatment of fast spreading HIV/AIDS in the developing nations of the world. This should be done on social, medical, economic, and moral grounds. The initial developments must focus on the ones already infected with HIV. Wealthy nations have been called upon to establish bigger development and research to pledge to purchase vaccines for diseases in developing countries. HIV/AIDS is one of them. Globally, the poorest nations do not have enough resources to carry the healthcare costs. Countries in Sub-Saharan Africa have an average budget amounting to approximately one dollar per day. Investments by poor countries in health care are apparently unattainable. There cannot be enough savings for investments based on this level of per capita income (Fox, 2010, pp. 16-24). The savings cannot be sufficient to control the HIV/AIDS pandemic either. Successful endeavors at an international level would require good economic policies in the developing countries and financial support from the wealthy nations to assist them in overcoming HIV/AIDS and the related consequences. Increased donor funding isbelieved to make great progress to reduce HIV/AIDS contraction and help in the treatment procedures while increasing productivity among the poor nations.

The international AIDS crisis is affecting many nations. It is a global challenge, affecting not only the developing economies, but also the developed nations. There has been a public outcry over the disturbing rates of deaths caused by HIV/AIDS. This phenomenon has continued to spur efforts to cut down prices on medical treatment and prompted to political action. There are numerous challenges to getting access to the effective treatment for the HIV-infected people in the poor countries. The absence of political and financial commitment from both the poor and wealthy nations, the lack of sufficient delivery systems in a number of areas, as well as the debate concerning the economic feasibility of enhancing treatment against the investment in vaccine-research are a number of challenges hampering efforts to deliver the much needed care to the HIV/AIDS patients in the poor countries.

Former initiatives related to HIV/AIDS emphasized the prevention of the disease. Powerful costly antiretroviral therapy drug cocktails were drastically improving and extending the lives of individuals infected with HIV/AIDS, but only in wealthy nations. At the same time, the infection rates increased drastically in the poor nations (Freedberg et al., 2001, pp. 824-831). Measures of prevention alone did not solve the situation. It is unacceptable and unethical to send patients home to die just because the invented and tested medicines were very costly. The issue is not about the way to treat HIV/AIDS in poor nations, but about the involvement of wealthy nations in the treatment of the disease. Such efforts and development are vitally important.

The experience across borders has proved that providing treatment is a feasible engagement even in settings that have limited resources, like in the developing countries. The treatment of HIV/AIDS has shown that it is a good incentive for people to be tested and a very significant move for effective prevention. The hope to get treatment assists in breaking the vicious cycle of defiance of this pandemic and of social stigma linked with HIV. Providing treatment has been a motivating factor to the developing nations to put together resources and to strengthen the infrastructures of healthcare. While this progress has been realized, the participation of the wealthy nations is much needed to propel these efforts.

The support of the wealthy nations in combating the challenges posed by HIV/AIDS is desperately needed. The need in the operational study to establish the best ways of providing and monitoring antiretroviral administration in resource-poor countries can be fulfilled by the engagement of the wealthy nations. A reliable antiretroviral medicines’ supply offered at an affordable price is required to promote the compliance of patients, effectiveness of treatment, and hampering the resistance to drugs. Another important need is the substantial investment in the delivery of healthcare in terms of supplies, personnel, equipment, diagnostics, and facilities to maintain and sustain the care for longer periods until they become fully established. Therefore, the input of the wealthy nations is essential.

The treatment for HIV/AIDS requires pulling up the resources by seeking international access to drugs and other crucial medicines. Therefore, any serious international endeavor will need the massive financial resources mobilization from the developed and wealthy nations along with genuine political commitment on the side of the poor nations to fully implement all-inclusive programs that offer a care continuum with an entirely integrated treatment and prevention efforts. Research on HIV/AIDS has provided a lot of support for interdependence between nations despite their socio-economic status. HIV/AIDS is a global challenge and cannot be left in the hands of a few nations. The effects of this disease in one nation can triple out to others, that is why combined efforts to stop HIV/AIDS would benefit everybody. Therefore, wealthy nations should promote the anti-HIV/AIDS efforts in poor nations.


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