Connecting local responses around the world
The epidemic of HIV is a genuinely cross-cutting issue knowing no real or notional borders in its progression or the adverse outcome(s).
There is no denial of the fact that HIV/AIDS does have a strong biomedical component, say in terms
of laboratory testing for HIV in ICTCs and the blood banks, treatment of
sexually transmitted infections/reproductive tract infections (STIs/RTIs) and
management of AIDS as a chronic manageable disease through the anti-retroviral
therapy (ART) and what have you.
The issues like promotion of condoms, controversial ‘recommendation’ of abortions or otherwise,
facilitation of male circumcision as a proven strategy for prevention of HIV and
other interventions do, however, have many determinants outside the health
The writing on the wall is therefore writ large-take HIV and AIDS outside the exclusive public health domain.
The problem of HIV/AIDS must be perceived from the following perspectives
and the approaches must be designed accordingly (the list is obviously not exhaustive because of
the existence of myriad
determinants of the pandemic)in the presumably decreasing order of
· Public health
· Human rights
· Health care service delivery
· National vs regional/state
This epidemic demands that all the stakeholders work in unison and in complete
synergy so as to ensure an effective response in a mainstreamed manner -requiring
directed and sustained efforts to take HIV and AIDS outside the exclusive domain of just the
medical/public health professionals and the health sector per se for that
A realist review of the activities in preference to clinical/medical approaches towards
development of evidence base, corroborates the same and necessitates the need to
dedicatedly work for a comprehensive approach.