Transcript Social and Political Aspects of (ARVs)
Slide 1
M AKERERE UNIVERSITY
C h ild He a lt h an d Devel o pme n t Ce n tre
P. O. Bo x 6 71 7 Ph o n e: 0 4 1 4 5 41684/53
0 32 5, F ax 53 167 7 K a m pa la (U )
Em a il : m ut u m b a @ chd c -m u k .c o m W e b s i t e: w ww .ch d c-mu k. co m
Social and Political Aspects of
(ARVs)
Politics, Pills and People
Lisa Ann Richey, Ph.D.
Roskilde University, Denmark
Slide 2
The Politics of Access to
Antiretrovirals in the Treatment of
African AIDS
Supported by the Danish Development Research Council
• The Western Cape Province of
South Africa-a township AIDS
clinic
• from June until December 2005
• The Central Region of Ugandaan urban low-income AIDS
clinic
• Aug-Sept. 2007, Dec-Jan 2008
• Research assistance and
collaboration with Elizabeth
Seabe, Lara Knudsen
Slide 3
Lisa Ann Richey (Roskilde University)
and
Stefano Ponte (DIIS)
BETTER (RED)™ THAN DEAD:
‘BRAND AID’, CELEBRITIES AND
THE NEW FRONTIER OF DEVELOPMENT ASSISTANCE
download at http://www.diis.dk/sw27885.asp
Slide 4
ARVs: Sustainable support
or trendy international
development?
Slide 5
AIDS Treatment
• Global political economy, race/ethnicity,
gender, regionalism, religion, nationalism
and politics will all impact the way that the
ubiquitous “roll-out” of ARVs will take
place in developing countries.
Slide 6
Comparing AIDS treatment
in South Africa and Uganda
from the policy level
•
•
•
•
•
•
‘Good’ State vs. ‘Bad’ State
Political will-- national vs. Subnational
Public health system
Openness
Diversity
Leadership
Slide 7
Lessons from the clinic
level
• Taking care of yourself (more than just
taking pills)
• Adherence as a process
• Returning to life (being a person means
being able to reproduce)
• The importance of community links
Slide 8
How do patients demonstrate
adherence? Medical, empirical and
social, interpretive
•
•
•
•
•
•
•
•
Pill counts
Biomedical markers (CD4, Viral Load)
Use a condom
Inform the clinic before traveling
Apply for government grants
Eat well
Do not use traditional medicines
Plan pregnancies with doctor
Slide 9
A common conversation on
reproductive health from a popular
Ugandan AIDS clinic
•
•
•
•
•
•
Doctor – “Do you and your wife use condoms?”
Patient – “Yes.”
Doctor – “Is your wife pregnant?”
Patient – “No.”
Doctor – “Would you like some free condoms?”
Patient – “No.”
Slide 10
Politics, Pills and People
• Political priorities have both intended and
unintended local level impact
• Global remedicalization of AIDS as a problem
that can be solved by treatment
• Nutrition and food security, sexuality, mental
health and gender relations would benefit from
prioritization among mainstream researchers and
policymakers
M AKERERE UNIVERSITY
C h ild He a lt h an d Devel o pme n t Ce n tre
P. O. Bo x 6 71 7 Ph o n e: 0 4 1 4 5 41684/53
0 32 5, F ax 53 167 7 K a m pa la (U )
Em a il : m ut u m b a @ chd c -m u k .c o m W e b s i t e: w ww .ch d c-mu k. co m
Social and Political Aspects of
(ARVs)
Politics, Pills and People
Lisa Ann Richey, Ph.D.
Roskilde University, Denmark
Slide 2
The Politics of Access to
Antiretrovirals in the Treatment of
African AIDS
Supported by the Danish Development Research Council
• The Western Cape Province of
South Africa-a township AIDS
clinic
• from June until December 2005
• The Central Region of Ugandaan urban low-income AIDS
clinic
• Aug-Sept. 2007, Dec-Jan 2008
• Research assistance and
collaboration with Elizabeth
Seabe, Lara Knudsen
Slide 3
Lisa Ann Richey (Roskilde University)
and
Stefano Ponte (DIIS)
BETTER (RED)™ THAN DEAD:
‘BRAND AID’, CELEBRITIES AND
THE NEW FRONTIER OF DEVELOPMENT ASSISTANCE
download at http://www.diis.dk/sw27885.asp
Slide 4
ARVs: Sustainable support
or trendy international
development?
Slide 5
AIDS Treatment
• Global political economy, race/ethnicity,
gender, regionalism, religion, nationalism
and politics will all impact the way that the
ubiquitous “roll-out” of ARVs will take
place in developing countries.
Slide 6
Comparing AIDS treatment
in South Africa and Uganda
from the policy level
•
•
•
•
•
•
‘Good’ State vs. ‘Bad’ State
Political will-- national vs. Subnational
Public health system
Openness
Diversity
Leadership
Slide 7
Lessons from the clinic
level
• Taking care of yourself (more than just
taking pills)
• Adherence as a process
• Returning to life (being a person means
being able to reproduce)
• The importance of community links
Slide 8
How do patients demonstrate
adherence? Medical, empirical and
social, interpretive
•
•
•
•
•
•
•
•
Pill counts
Biomedical markers (CD4, Viral Load)
Use a condom
Inform the clinic before traveling
Apply for government grants
Eat well
Do not use traditional medicines
Plan pregnancies with doctor
Slide 9
A common conversation on
reproductive health from a popular
Ugandan AIDS clinic
•
•
•
•
•
•
Doctor – “Do you and your wife use condoms?”
Patient – “Yes.”
Doctor – “Is your wife pregnant?”
Patient – “No.”
Doctor – “Would you like some free condoms?”
Patient – “No.”
Slide 10
Politics, Pills and People
• Political priorities have both intended and
unintended local level impact
• Global remedicalization of AIDS as a problem
that can be solved by treatment
• Nutrition and food security, sexuality, mental
health and gender relations would benefit from
prioritization among mainstream researchers and
policymakers