|Correct citation:||nn. (1997), "Editorial: Different approaches to AIDS research and intervention." Biotechnology and Development Monitor, No. 30, p. 23.|
AIDS is a modern affliction and a worldwide phenomenon. Both its biomedical and socioeconomic complexities bring differing consequences and struggle to many people. This issue of the Monitor includes two articles about AIDS. The first article by Jurriaans discusses the biomedical research developments in AIDS diagnosis and therapy. The second article by Wolffers argues for the importance of social and behavioural intervention in the fight against AIDS. He emphasizes the relevance of these approaches especially for people in marginalized socioeconomic positions.
According to conservative estimates of the World Health Organisation (WHO), every day more than 5000 people become infected with HIV. Developed regions such as the USA, Western Europe and Australia are witnessing death tolls due to AIDS. However, 4000 cases, or 80 per cent of the daily additional rate of HIV infection, occur in the developing countries. More than half of all the HIV infected people are from Africa. They are about 9 million adults and 10,000 children. However, nowhere is the disease spreading at a faster rate than in Asia. By the year 2000, it is estimated that 10 million people in Asia will be infected by HIV. In Latin America, 1.5 million people are estimated to be HIVinfected. The highest incidence occurs in the cities of Brazil, Colombia and Venezuela.
Beyond these statistics, we see AIDS affecting every aspect of people's lives. In Uganda, for example, a study by Barnett and Blaikie points to the age specific characteristic of AIDS victims. The virus spreads mainly through sexual contact among the population aged between 15 to 50 years old. As a consequence, the death toll is highest in the most economically productive age group. This brings a significant decline in the ratio of producers to consumers. There is a decrease in agricultural production, labour force and income. As a result, AIDSorphaned children are forced to leave their school and take over the agricultural production of their parents/guardians. However, the children may not be able to produce as much as the adults. This could lead to severe food shortages at farm level, as well as in national food supply.
While AIDS affects people in a variety of ways, apparently HIV has different strains as well. As Jurriaans points out, the currently available tests are mainly suitable for the HIV variants found only in Europe and North America. This shows that biomedical research and development has not been aimed at the majority of the HIV infected people, Africans and Asians. While the HIV variants show different strains between people from different regions, the focus of research seems dictated by financial differences between regions. Will pharmaceutical companies bother to develop vaccines for those who cannot pay for these products?
The high cost of the diagnostics and therapies, and the lack of research into AIDS vaccines remain very problematic for both developed and developing countries. These biomedical approaches should not be left to market forces alone. Policy interventions at national and international levels need to address the gaps in biomedical research especially for people in developing countries. For example, 'clients' such as HIV and AIDS patients and vulnerable groups could have more influence in research directions. National and international public sectors, in cooperation with pharmaceutical companies, could invest more in the research and development of affordable products, suited for both developing and developed countries.
On the other hand, behavioural and social approaches remain equally important in the fight against AIDS. This is not only due to the overriding economic realities. Just because marginalized people cannot afford the AIDS drugs, does not justify that they be left out in the cold. Moreover, behavioural approaches remain highly significant regardless of financial status; and regardless of the availability of therapeutic drugs. Again, research and development of social interventions should involve more participation of the target groups. After all, there are wide behavioural differences in varying social context. For example, it is very difficult to conduct AIDS education in social settings in which sex remains a taboo subject. Moreover, while wide spread knowledge of condom use may be attained, access to condoms is another issue in many developing countries.
Biomedical and social/behavioural approaches are not mutually exclusive. As in most reallife phenomena, approaches to AIDS should be just as multidimensional. While various institutions have their own fields of specialization, AIDS intervention and prevention requires interdisciplinary approaches and multisectoral collaborative efforts. Who can afford to discuss AIDS in a polarized fashion? It far too complex to approach such a devastating disease as an 'eitheror question'.
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