HIV/AIDS: Beyond the Public Health Domain

[Guest guest]

HIV/AIDS: Beyond the Public Health Domain

 

Devendra Kumar Budakoti

 

The problem of health and illness have been mystified to such an extent that

confusion prevails not only in the minds of masses but also among the ‘well

educated’ class. Health and illness is thought to be a prerogative of the

medical sciences and any problem thereof could only be solved by medicine and

medical technology.

This bio-medical approach views disease and illness in isolation of its social

context.  The other perspective, tell us that social factors play a significant

role in the health status of the community and in the aetiology of the diseases.

In this context, we also see the definition of Health by the World Health

Organization (WHO), which defines health as, “A state of complete physical,

mental and social well being and not merely the absence of disease or infirmity

Today even the World Health Organization (WHO) has recognized this fact and has

instituted a Commission on Social Determinants of Health.

A note on the commission reads as, “The social conditions in which people live

powerfully influence their chances to be healthy.

Indeed, factors such as poverty, food insecurity, social exclusion and

discrimination, poor housing, unhealthy early childhood conditions and low

occupational status are important determinants of most of the disease, death and

health inequalities between and within countries.

To improve health for the world’s most vulnerable populations and promote

health equity requires new strategies for action which take into account these

social determinants of health.  According to WHO, “the launch of the

commission in March 2005, occurs at a time of growing awareness of the

unacceptability and injustice of the current levels of health inequity.

The commitment to equity and to addressing poverty is manifested in efforts by

the United Nations and by countries working towards the Millennium Development

Goals.

 

It is now widely known and accepted that, access to safe drinking water and good

sanitary conditions contribute towards better environmental conditions, which in

tern contribute to an improved health status of the community.

 

The National Rural Health Mission has acknowledged these aspects and proposes to

address these issues. 

 

Coming to the question of HIV/AIDS, It is now widely accepted that AIDS is both

a symptom and a cause of underdevelopment. The vulnerability to HIV/AIDS, raises

the issues of poverty, gender, discrimination, stigma, migration,

marginalization and poor social security in the country,

 

Poverty should not be seen only in terms of income and consumption, as it

manifests itself in many forms, such as discrimination and deprivations. This

also has its ramifications on health and education status, awareness level,

control over life and capabilities and lack of opportunities and empowerment.

 

In addition, we need to understand that the three core groups affected and

infected in the HIV epidemic- men having sex with men, sex workers and injecting

drug users, are activities that are criminalized in India. Under such a

situation, any intervention work amongst these groups becomes difficult task.

 

The problem of HIV/AIDS has also opened the Pandora’s box of social evils,

organized crime, social and gender inequality and poor social security in the

third world state and society.

 

In UNAIDS note say, “…There now a ample evidence for the complex linkages

between AIDS and development: development gaps increase people’s

susceptibility to HIV transmission and their vulnerability to the impact of

AIDS; inversely, the epidemic itself hampers or even reverses development

progress so as to pose a major obstacle to the achievement of the Millennium

Development Goals.

The note adds, ‘the growing understanding of this two-way relationship between

AIDS and development has led to the insight that, in addition to development

programmes that specifically address AIDS, there is a need to strengthen the way

in which existing development programmes address both the causes and effects of

the epidemic in each country-specific setting.  The process through which to

achieve this is called Mainstreaming AIDS.

 

In developed countries, the problem of HIV/AIDS was tackled faster as it had a

strong health system and general welfare system in place.

Developing countries are still struggling with basic issue of accessible health

care system, primary education, electrification, water and sanitation and still

to provide social security to people living below the poverty line. The problem

of HIV/AIDS is beyond the domain of public health and unless we don’t

highlighted and address the basic development issue, we would be only paying lip

service to solve the HIV/AIDS problem.

The Author is Development Consultant.

ghughuti.org

Devendra Budakoti

e-mail: <dkbudakoti@...>