Talk:HIV/AIDS in Africa

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This page should be eliminated or completely rewritten. It states as facts assumptions which never have been confirmed. Even the chart which is presented is complete nonsense. If one researches the subject of AIDS in Africa, one will immediately stumble across the following: -- all numbers are based on estimates without any basis. ( there is no scientific study: all what can be found is: an employee of a UN organisation took some local estimates he read, put it in an excel spreadsheet on his microcomputer and calculated an assumed number for all Africa. -- there is a definition of AIDS specifically for Africa; its based on symptoms of well known diseases. -- the total mortality in Africa has not increased ( but rather went down slightly), despite the " extreme high" assumed infection by HIV. The reason is simple: what counted as death by TB or malaria or cholera is now considered AIDS. --

What bollocks. As somebody who has lost a close friend due to AIDS, I find this attempted denial of the existence of the disease insulting. We have enough of a problem dealing with AIDS now and in the future, we don't need idiots hampering our efforts by spreading stuff like this. Impi 20:57, 28 Nov 2004 (UTC)

Contents

[edit] The first post here is rubbish

The fact of increasing death rates in countries with high estimates of HIV prevalence is not in distpute. The loss of life and good health is evident to all who live int these countries. Of course the rates are estimates, but to claim that there are no "scientific studies" is to denigrate the dedicated work of hundreds of researchers who are using advanced statistical methods to extrapolate from limited data that is available in the harsh conditions of these societies.

[edit] References

The comments above, whatever their validity, demonstrate that this article needs to be referenced. 'Scientific studies have suggested that...' — which scientific studies exactly? — mark ✎ 22:18, 27 Feb 2005 (UTC)

Yes this needs a reference: "In the 35 African nations with the highest prevalence, average life expectancy is 48.3 years—6.5 years less than it would be without the disease. For the eleven countries in Africa with prevalence rates above 13%, life expectancy is 47.7 years—11.0 years less than would be expected without HIV/AIDS."

[edit] Bangui AIDS definition? Evidence for half AIDS sufferers not HIV-positive?

I see this has recently been added to the page:

In October 1985, a conference of public health officials including representatives of the Centers for Disease Control and World Health Organisation met in Bangui and defined AIDS in Africa as, "prolonged fevers for a month or more, weight loss of over 10% and prolonged diarrhoea". About half the AIDS cases in Africa based on the Bangui definition are HIV positive.

Colour me suspicious of this addition. Is this "Bangui definition", which is clearly obsolete given that we have far less ambiguous definitions based on the presence of the HIV virus and T-cell counts, still widely used? And where is the evidence for the statement that "half ot the AIDS cases in Africa based on the Bangui definition are HIV positive" (which of course implies that half aren't, thus calling into question the idea that it is HIV cutting a swathe through Africa's adults at the moment). --Robert Merkel 02:36, 24 Mar 2005 (UTC)


I would also like to see a cite for this newly added information. Dewet 03:30, 24 Mar 2005 (UTC)
Me too. The change to the AIDS article leads me to this question as well. JoeSmack (talk) 00:47, Mar 25, 2005 (UTC)
Given the repeated skepticism about this, I'm going to revert the page to the old version until some more evidence is provided. --Robert Merkel 07:05, 25 Mar 2005 (UTC)

My understanding is that the "Bangui definition", remains the basis for most of the AIDS cases in Africa and therefore the world, because testing for HIV virus and T-cell is not widely available in Africa. I would welcome evidence to the contrary. I will cite the numerous studies that half the AIDS cases in Africa, whne tested are HIV negative. The other difficulty is that many diseases that are endemic on Africa but rare in the United States produces antibodies that produce false positive results on HIV tests.

Sci guy 01:39, 26 Mar 2005 (UTC)

This "Bangui definition" most recent work backs up an appraisal of a the definition of AIDS in Africa between 1980 and 1997 - let us just suppose that turns the 620,000 AIDS sufferers into false positives. Past 1997, like, say now, Africa as something like 25 million AIDS sufferers. Any evidence that today we aren't using a more modern definition? 25.0 million - 0.6 million = way more than half of AIDS sufferers...more evidence to the contrary if you want to keep your previous claims up. JoeSmack (talk) 02:44, Mar 26, 2005 (UTC)
Seeing we haven't gotten satisfactory answers from Sci guy, I'm going to repeat my action at AIDS and revert. --Robert Merkel

[edit] The graph used here is misleading

The graph showing average life expectancy in Africa is misleading because it does not have a base of zero. By zooming in on the curved part of the graph, it gives a visual impression of the lines swinging wildly. The shape of the lines is far more dramatic than it would be if the graph started at zero.

AIDS in Africa has had a positively horrifying effect, but this graph distorts the information.

This is from a textbook, "Visual Communication" by Paul Lester: "A serious problem with charts can be the misleading visual representation of data. Although omitting part of a scale to save space is acceptable (as indicated by the zigzag line at the bottom of many charts), constructing a chart from a y-axis point other than zero can dramatically change the visual message and is not acceptable. As printed in a newspaper and reproduced using the Excel program (center), the [changes in the price of oil from '98 to '99] appears dramatic with the zero point set at ten. But with the zero point set at zero, the infographic is more accurate and less visually alarming."

It's also explained pretty well here with figures 2 and 6.

There cannot be a zero point on the y-axis line in this case, because life expectancy has never been zero for as long as mankind has been around. Note please that there is no comparative frequency or amount analysis being done, unlike in the example at rice.edu, instead we're graphing a value that cannot be zero and tracking it over time. The figure is one that comes straight out of alternate statistics, we're not creating it for the purposes of the graph (for instance, the example from rice.edu obtains values by taking the values it gets from alternate sources and then comparing them to get "relative values").
Were you to argue that such a graph might be more accurate if it went further back in time, by perhaps another 50 years, then you would be right, but so far as I know we don't have proper statistics for this part of the world prior to 1958, so such a point would be moot.
I'm removing the note you added to the graph because of the above, and because it's non-sensical. It's simply not possible to have a zero point on the y-axis in this sort of graph. Impi 19:22, 24 Apr 2005 (UTC)

Ah, of course. Well, don't mind me then. Mr. Billion 20:37, 24 Apr 2005 (UTC)

While a zero-axis doesn't make physical sense, as Impi explained, it *does* provide for a visual anchor. I have to agree with the quote that not having a point of reference (zero) can make graphs appear misleading; however, since this one varies between roughly 35 and 60, adding a zero wouldn't have been as useful as if it had varied between, say, 60 and 65. Dewet 03:48, 25 Apr 2005 (UTC)

[edit] The size and quality of this article is a scandal

AIDS is a global epidemic claiming the lives of 8000 people a day. 60% of HIV infections are in Africa. The possible scope for this article is immense, yet it is still barely above a stub! It's these sort of articles being overlooked which allows people to rubbish Wikipedia. TreveX 15:01, 25 Apr 2005 (UTC)

And the reason you don't jump in and make these improvements yourself would be because...? Dewet 16:22, 25 Apr 2005 (UTC)
...because I researching on the UNAIDS website! TreveX 16:37, 25 Apr 2005 (UTC)
Wikipedia is a collaborative community project, and people edit and expand articles according to their abilities and expertise. To attempt to blame somebody for the AIDS in Africa article being weak is ludicrous, because nobody is responsible for making sure it's perfect. Next time, instead of leaving that sort of obvious and clearly irrelevant comment, jump in and make the edits and changes yourself. Impi 18:32, 25 Apr 2005 (UTC)
Don't worry, TreveX is going to work on it, as he said somewhere else but forgot to mention here. — mark ✎ 19:49, 25 Apr 2005 (UTC)
I am very sorry if anyone thought that I was blaming other people for the state of this article. I was merely trying to point out that its depth is, at present, disappointing considering the importance and immediacy of the subject matter. If anyone was offended by this then please accept my apologies. I realise that what I wrote above may not have come across very well, but I was just surprised at the article, that's all. What I really should have said was that this article should be longer but that hopefully it will improve soon as the result of some glorious collaboration.  :-) TreveX 20:16, 25 Apr 2005 (UTC)
Fair enough, the article is rather pathetically weak for such an important subject, and it's great that you're working on it. I might've been a bit quick to jump to conclusions on what you were saying (as there are many people who do nothing but criticise on Talk pages without doing anything to try improve the article), so I apologise. Good luck with the article! Impi 10:41, 26 Apr 2005 (UTC)

[edit] Religious groups in the battle against AIDS

Does someone know the percentage to which religious groups are engaged in the battle against the AIDS epidemic in Africa (percentage of projects, etc.)? 85.124.182.40 13:27, 19 August 2005 (UTC)

What exactly do you mean: the percentage of AIDS projects that is led by religous groups? I think it is hard to tell because many Church-run hospitals or health projects help AIDS patients like everyone else; a prominent AIDS treatment project run by a religious community is the DREAM program run by the Community of Sant'Egidio that I presented on this site.

[edit] Prevalence in Southern Africa

The article mentions a lot of, and I think very valid, reasons for the high rates of HIV/AIDS in sub-saharan Africa. Generally all kinds of diseases will be more common and more deadly in poorer countries, in countries with rather basic healthcare systems, poor nutrition etc. Still I'm intrigued by the extremely high prevalence in Southern Africa. The econonomic / health care situation there isn't worse than in many other sub-saharan countries - quite the contarary: in the cases of South Africa and Botswana it is definitely much better. Still those are the places with the highest HIV/AIDS rates. Why? - Of course it is perfectly possible that we just don't know (which, if this is true, should be mentioned). Otherwise I'd be interested in some, at least, tenetative explanations for this phenomenon - in case there are any?

Recent findings which seem (?) to proove that HIV originated in or around Cameroon (cp. [1]) would make the whole thing only more startling.

Just came across the following - no idea, whether there's anything to it - but at least it is an effort to explain the phenomenon. Should it be mentioned here? Any opionions?

--84.188.216.109 00:00, 31 May 2006 (UTC)

[edit] Causes of transmission (NPOV-section)

There has been a recent edit by an anonymous IP that completely reversed the statement about the causes of transmission of HIV. I just placed a NPOV-section tag because I felt this is a point that has to be cleared up by people more competent than myself.--Robin.rueth 13:40, 2 June 2006 (UTC)

Gisselquist is virtually the only scientist who has published papers on this topic. His theories are not widely accepted. International consensus (WHO, UNAIDS, USAID, NIH, major scientific journals, etc.) asserts that the vast majority of HIV infections in Africa result from heterosexual transmission. Trezatium 18:21, 2 June 2006 (UTC)

The validity of Gisselquist's claims are circumspect, this article provides the WHO consensus. Schnarr 04:59, 5 June 2006 (UTC)

  • The CDC says, "Heterosexual transmission is the predominant mode of HIV transmission [in Southern Africa]" (see here).
  • UNAIDS says, "In sub-Saharan Africa, heterosexual transmission is by far the predominant mode of HIV transmission" (quoted here).
  • DHHS says, "Globally, the major route of HIV transmission to women is through sexual contact with men (heterosexual intercourse)" (see here).
  • USAID says, "The hardest-hit regions are areas where heterosexual contact is the primary mode of transmission" (see here). Trezatium 17:17, 5 June 2006 (UTC)

Here's another article about Gisselquist's theories and the WHO's reaction to them. Also it's worth noting that every sub-Saharan African country bases its response to HIV on the assumption that the majority of transmisison is heterosexual. For example, the Uganda AIDS Commission says, "In Sub-Saharan Africa, HIV is mainly transmitted through heterosexual intercourse" (see here). Trezatium 18:28, 5 June 2006 (UTC)

The section removed from the article had been copied verbatim from this web site, perhaps in violation of copyright. Trezatium 18:39, 5 June 2006 (UTC)

[edit] Name

Misleading Either this article should be renamed HIV/AIDS in sub-Saharan Africa, or it should include information about North Africa. -Justin (koavf)·T·C·M 23:17, 1 September 2006 (UTC)


[edit] Sorry

I had to revert the new paragraph it was full of spelling mistakes, two broken links and inappropriate statements ("is another great site") etc, but please do try again, perhaps on the talk page with something along the lines of the content and we can work on it here --BozMo talk 20:21, 30 November 2006 (UTC)




bam —Preceding unsigned comment added by 216.124.238.20 (talk) 14:44, 14 September 2007 (UTC)




[edit] Sorry

I have reverted the paragraph on the human and emotional aspects. I DO think that we need something more like that in the article and will try to rewrite it when I've got time but the paragraph submitted violated so many WP guidelines that we cannot leave it in place as is. --BozMo talk 19:33, 5 December 2006 (UTC)

[edit] Aids research money

Dose anyone know if aids research money raised by charity or given out by governments ever goes to drug companies or dose it all go to researchers in university's. If some of the money dose go to a drug company dose that change the company's patent on new drugs? Maybe this is a question for an IP lawyer but any answers or links are appreciated.

[edit] Country by country articles

There seems to be a fair bit of information spread around on the different pages for african countries. What do people think about me consolidating them all in this article? JimmyDodger 10:53, 3 May 2007 (UTC) JimmyDodger

Yes, if its accurate. The article itself isn't terribly accurate at present and needs more citing for data it includes. --BozMo talk 10:54, 3 May 2007 (UTC)

[edit] Contradiction

The section on prevalence in West Africa lists the countries with the lowest and highest prevalence. Why is Burkina Faso on both lists? I don't know the answer myself to correct it. Mapjc 14:21, 3 June 2007 (UTC)

[edit] New Edit

I removed the section at the start of the article that stated that a citation was needed for the assertion that over 60% of the world's HIV cases were in Africa. The source is clearly stated in the table below the statement.

[edit] Please update this article with the 2007 UNAIDS numbers

UNAIDS has come out with 2007 numbers, which are much lower than the previous ones. The new estimate for sub-saharan africa is 20.9 million and 24.3 million people infected. The AIDS pandemic page has the updated numbers in the table at the top, however the body of the article still contains older numbers in places. Gigs (talk) 08:27, 26 December 2007 (UTC)

[edit] Destroyed article

someone has ruined this page. please fix.

thanks. —Preceding unsigned comment added by 71.103.20.232 (talk) 04:44, 17 January 2008 (UTC)

[edit] AIDS in Africa: Key Articles

The three articles excerpted below are essential for understanding AIDS in Africa, and Mbeki's dissent from the Western corporate line that everyone has been force-fed. These articles are long, detailed, well-documented, and very illuminating about many things, not least the racism combined with Puritanical, anti-sex attitudes inherent in most conceptions of AIDS epidemiology in Africa. Great fun, and rewarding reads, IMO. A well-informed reader will note that the principal causes of the "AIDS epidemic" in Africa are the same as the causes of the low-I.Q. "epidemic". They are: malaria, impure water, parasitic infections, malnutrition (micronutrients and macronutrients), tuberculosis, etcetera, which are in turn caused largely by grinding poverty. The articles cited below are essential for understanding contemporary AFRICA, period -- not just AIDS or I.Q. These articles explain the proximate causes of Africa's backwardness.

The three articles are below, tagged:

DOCUMENT #1: Misconceptions About AIDS in Africa (Geshekter)

DOCUMENT #2: Mbeki's AIDS Orthodoxy Critique (Geshekter et al)

DOCUMENT #3: Nutrition, Parasites, and HIV/AIDS (Stillwaggon)

Just a taste:

"After the distinguished Harvard physician Paul Farmer found himself at conferences where professional colleagues went 'practically purple with rage discussing Mbeki,' even accusing him of genocide, he decided to look dispassionately at the controversy. Farmer concluded, quite sensibly, that Mbeki's message was that 'poverty and social inequality serve as HIV's most potent co-factors, and any effort to address this disease in Africa must embrace a broader conception of disease causation.' Farmer acknowledged, 'this is precisely the point many of us have tried to make... and we haven't been branded as AIDS heretics.'"

I highly recommend the full texts, at the URLs, not just these excerpts. But if you don't have time for that, and would prefer an "easy-listening" version, try the following video of Dr. Charles Geshekter on AIDS in Africa:

http://www.youtube.com/watch?v=7qUBagW-xWs -- Part 1
http://www.youtube.com/watch?v=mZkrCm9wMKI -- Part 2
http://www.youtube.com/watch?v=8l5IDC9bJyE -- Part 3

Here's Geshekter, from Part 2 of that video (at about 1.5 minutes):

"What AIDS has become in Africa is a great distraction. It distracts us from the questions of better food, better clean drinking water, more appropriate ways of getting rid of waste. It puts the burden back on Africans and their alleged promiscuous sexual activities. To that extent it is a wonderful shortcut to avoid the harder, stubborn issues about why is Africa so poor, why are its people suffering so badly."

Enjoy.

Alan

DOCUMENT #1: Misconceptions About AIDS in Africa (Geshekter)

http://www2.units.it/~etica/2007_2/GESHEKTER.pdf

Etica & Politica / Ethics & Politics, IX, 2007, 2, pp. 330-370

Myths and Misconceptions of the Orthodox View of AIDS in Africa

CHARLES L. GESHEKTER

Department of History

California State University, Chico

chollygee @ earthlink.net

"Nothing in life is to be feared. It is only to be understood." --- Marie Curie

"To kill an error is as good a service as, and sometimes even better than, establishing a new truth or fact." --- Charles Darwin

ABSTRACT

This article rebuts conventional claims that AIDS in Africa is a microbial problem to be controlled through sexual abstinence, behavior modification, condoms, and drugs. The orthodox view mistakenly attributes to sexual activities the common symptoms that define an AIDS case in Africa - diarrhea, high fever, weight loss and dry cough. What has really made Africans increasingly sick over the past 25 years are deteriorating political economies, not people's sexual behavior. The establishment view on AIDS turned poverty into a medical issue and made everyday life an obsession about safe sex. While the vast, self-perpetuating AIDS industry invented such aggressive phrases as "the war on AIDS" and "fighting stigma," it viciously denounced any physician, scientist, journalist or citizen who exposed the inconsistencies, contradictions and errors in their campaigns. Thus, fighting AIDS in Africa degenerated into an intolerant religious crusade. Poverty and social inequality are the most potent co-factors for an AIDS diagnosis. In South Africa, racial inequalities rooted in apartheid mandated rigid segregation of health facilities and disproportionate spending on the health of whites, compared to blacks. Apartheid policies ignored the diseases that primarily afflicted Africans - malaria, tuberculosis, respiratory infections and protein anemia. Even after the end of apartheid, the absence of basic sanitation and clean water supplies still affects many Africans in the former homelands and townships. The article argues that the billions of dollars squandered on fighting AIDS should be diverted to poverty relief, job creation, the provision of better sanitation, better drinking water, and financial help for drought-stricken farmers. The cure for AIDS in Africa is as near at hand as an alternative explanation for what is making Africans sick in the first place.

[...snip...]

DOCUMENT #2: Mbeki's AIDS Orthodoxy Critique (Geshekter et al)

http://www.altheal.org/africa/aidspapergeshekter.doc

AIDS, Medicine and Public Health: The Scientific Value of Thabo Mbeki's Critique of AIDS Orthodoxy

Charles L. Geshekter

Department of History, California State University, Chico, Chico, California 95929-0735 chollygee@earthlink.net

Sam Mhlongo, M.D.

Department of Family Medicine, Medical University of South Africa, P.O. Box 222, Medunsa, South Africa smmhlong@iafrica.com

Claus K”hnlein, M.D.

24103 Kiel K”nigsweg 14, Germany Koehnlein-Kiel@t-online.de

Presented at the 47th Annual Meeting of the African Studies Association

New Orleans, Louisiana

11 November 2004

NOT FOR QUOTATION WITHOUT PERMISSION

1. Introduction

In his installation address at the University of Witwatersand in 1998, Vice Chancellor Colin Bundy reminded the audience that a university "must encourage its academics and students never to take knowledge as given, as fixed: they must recognize that knowledge is `socially sustained and invested with interests and backed by power'."1

This advice was forgotten when scientists and activists gathered in Durban for the 13th International AIDS Conference in July 2000 - then again in Barcelona/2002 and in Bangkok/2004. They ignored the many paradoxes and contradictions that arouse serious concern about the reliability of African AIDS research. In the United States, where AIDS was first identified, an imprecision about the definition of the syndrome and its causation (abetted by a lack of journalistic and social science scrutiny) still clouds the public's understanding of HIV and AIDS.2

This paper evaluates how the assumptions and claims that turned "AIDS is everywhere" into an American clich‚ are being perpetuated in Africa. It scrutinizes the predictions of increased numbers of AIDS cases in Africa to show how conceptual flaws and questionable statistics mar conventional studies. It suggests that western stereotypes, poorly designed research and racist claims about African sexuality have created the untenable conclusions about AIDS now proliferating in Africa.

In a critique of armchair empiricism that applies to much AIDS research, Margo Russell and Mary Mugyenyi showed how analysts often squeeze "African data into inappropriate Western categories" and "international agencies, with their passion for international comparison...exert a strong pressure for just the kind of standardization that sociologists should be well-placed to reject."3

In many ways, AIDS has become a great diversion. The belief that behavior modification will cure poverty disguises the endemic conditions that cause the appearance of the "symptoms" in the first place. Many AIDS activists and researchers ignore the complexity of historical forces that propelled parts of Africa into a downward economic spiral beginning in the late 1970s that set the stage for the appearance of "AIDS."

In the Reagan Era, a "Washington Consensus" dominated official thinking about economic development in the U.S. government, the IMF, the World Bank and private banks and foundations. It called for sharp cutbacks in government spending, financial liberalization, privatization of state-owned enterprises, deregulation and the supremacy of the market over all other values, policies that contributed mightily to the demise of Africa. According to Joseph Stiglitz, an economist formerly with the World Bank, during the 1990s, the number of people living in extreme poverty (less than $2 per day) increased by nearly 100 million, world-wide, with the disproportionate amount being found in Africa.

Countries in east and southern Africa became so indebted to and dependent on international financial institutions that they were no longer free to make basic decisions about which goods and services could be allocated.4 Beginning in the late 1970s, corruption and decay in the public health field, sharp decreases in the prices of exported commodities, severe restrictions on social services due to the IMF and World Bank strictures of "structural adjustment," savage civil wars, declining rates of immunization, and crowded refugee camps were among the major forces afflicting Africa as the 20th century ended. None of these forces were related to sexual promiscuity.

2. Definitions

[...snip...]

DOCUMENT #3: Nutrition, Parasites, and HIV/AIDS (Stillwaggon)

http://www.ifpri.org/events/conferences/2005/durban/papers/stillwaggonWP.pdf

The Ecology of Poverty: Nutrition, Parasites, and Vulnerability to HIV/AIDS

Eileen Stillwaggon

HIV/AIDS continues to spread throughout the developing world, in transition countries, and among poor and marginalized populations in industrialized countries. In some countries the epidemic is still spreading rapidly. And today, in its third decade, even with increased resources, global AIDS policy is still failing to stem the epidemic. HIV prevention fails because it ignores the fundamental causes of the epidemic, it is unscientific, and it attempts to intervene at the last minute with programs limited to behavior change.

The HIV epidemic is not an isolated event. It is the predictable result of declining economies, insecure food systems, and inadequate investment in water and sanitation. The crisis of sustainable agricultural systems, most notably in sub-Saharan Africa but elsewhere as well, has aggravated the health crisis in developing countries and favored the spread of HIV/AIDS. The collapse of agricultural economies caused rapid urbanization, unemployment, and increasing inequality. The AIDS literature addresses, to some extent, the effect of economic crisis on behavior through the disruption of relationships and pressures toward unsafe sex, in particular in the form of commercial sex for survival. Little emphasis, however, has been placed on the direct, biological effects of malnutrition and unsanitary conditions on the vulnerability of individuals and societies to HIV.

The epidemic of HIV cannot be explained by behavioral factors alone, even though a necessary condition is contact through sex, needles or other medical instruments, or mother to child. Scientific evidence demonstrates the role of biological cofactors - malnutrition and parasitic and infectious diseases - in enabling the transmission of HIV. Although AIDS policy organizations use the phrase, "AIDS is a development issue," they do not incorporate scientific information about the diseases and conditions of poverty into their programming for HIV prevention. Consequently, their policies are limited to programs that address only behavioral factors. This paper integrates analysis of poverty with the epidemiology of infectious and parasitic diseases. Combining medical, economic, and geographical data, it demonstrates the specific disease synergies that promote HIV transmission in poor populations.

How diseases spread

[...snip...]

Conclusion

The same conditions that promote high prevalence of other infectious diseases and parasites are responsible for the spread of the AIDS epidemic in poor populations. Programs to prevent HIV transmission will be unsuccessful unless they address the underlying causes of the spread of AIDS. HIV prevention must be based on scientific evidence regarding cofactor conditions, not on unproven assumptions about the primacy of behavioral factors. Poverty eradication is the most important objective in stopping AIDS epidemics. The establishment of food security and investment in sanitary infrastructure and education are integral parts of a program of poverty eradication. Food security, deworming, schistosomiasis prevention and treatment, and malaria control programs must be incorporated into HIV prevention. Inexpensive means are available for achieving these goals and organizational support already exists that can be integrated with AIDS programming.

The biggest constraint on malaria, helminth, or schistosomiasis eradication has been the lack of adequate institutional framework for implementing control programs. But that is the same constraint that discourages investment in myriad complementary programs. A broad program of investment in public health infrastructure, such as clean water, plus health care centers, and health and hygiene education is the necessary base. Then the additional cost of a program for parasite control or other intervention would be minimal. Numerous analyses of HIV-prevention and treatment programs argue that poor countries cannot absorb the billions of dollars of anticipated expenditures. That is only true in a very narrow and shortsighted view of developing country needs. When the agenda is good health, not only HIV-prevention but including that, there is no problem of absorptive capacity in developing countries. There are ample opportunities for investments - in water, sanitation, nutrition, health-care facilities - with known benefits for a broad array of problems.

--- Alan2012 (talk) 04:48, 22 May 2008 (UTC)