This paper seeks to identify the key aspects of the fight against HIV in Australia and also considering the other approaches undertaken by Malawi and China in the fight against the scourge. The main article is the Sixth National Strategy (2010- 2013) in Australia. The main approaches discussed include funding, research, counseling and testing, education of persons and community based approaches. Identified are also the key players in the fight against the scourge and this include; donors, aid agencies, business community, the gay community, government and non-governmental organizations.
The history and nature of the HIV pandemic can be traced to more than two decades since there was a global outcry and massive response by various persons in trying to curb its effects. It can be stated that there has been an increase in mobilization of persons on the epidemic but still its effects are still extensive and the impact is so severe and there is still need to inform the general public of its effects. The major players in the fight against HIV pandemic include; the nongovernmental sector, the government, the health sector, the gay community, state beurocrats, expert in research and international organization.
According to the Sixth National Strategy on HIV (2010-2013) one can positively assert that Australia has been quite responsive to the pandemic as compared to other high income earning countries. This was mainly through sensitization of the gay community, drug users, travelers and the general public. The main aim of the strategy is to ensure that HIV partnership is strengthened, reinvigorate prevention as a cornerstone of the national response, emphasizing on monitoring and accountability, and provision of legal reform to ensure response of it nationally.
Australia has domestically endorsed the United Nations (UN) General Assembly Declaration of Commitment on HIV (2001) and the UN Political Declaration on HIV (2006) including commitments to universal access to HIV prevention, care, support and treatment to ensure that they are at par with global trends in the fight against the scourge.
For instance the media was the first to report on the existence of it on the gay press in 1981 and the first case was diagnosed in Sydney a year later after the press release. An act of community mobilization was witnessed by gay communities of Australia forming AIDS Action Committees (AACs) mainly in Sydney and by Victorian Aids Action Committee (VAAC) in Melbourne in the year 1983. The main functions of these committees were to lobby the government to provide education for the gay community and also to take an action in fighting the scourge. Organization of public forums that were graced by various medical experts on HIV was specifically created to address the rising interest of the disease. Essentially HIV is considered to be a virus and the increase of it in one person’s blood leads to the disease AIDS.
There was a need to encourage persons to listen to the advice of experts to get educated on it. Moreover the Australian government and the federal states were considered to be the greatest funding bodies for AIDS councils enabling the community based organizations to continue to provide educational programmes and services aimed at eradicating and reducing the spread of the virus.
Policy Advisory Structures were created by the government and one such structure was the National Health and Medical Research Council in 1983 and reconstituted in 1984 as the AIDS task force and its main objective was to provide scientific advice to the federal state and minister of health.
The National Advisory Committee on AIDS (NACAIDS) and the Parliamentary Advisory Group (PLG) was also formulated. Screening of blood donations for HIV infection can be attributed to the federal government. It is common knowledge that the transmission of HIV virus is mainly by blood that carries the virus, hence infected blood transferred to another person can be a cause of the virus. Testing for HIV infections is necessary especially through clinical services.
Research is the main method in which key players in the health sector and interested parties can gain knowledge on how to tackle the HIV pandemic and the various aspects revolving around it. Australia has not been left behind either, and various research institutions have been included. Two special entities for research were created in the wake of 1986 and they included Virology Research Unit at Fairfield Hospital in Melbourne and the Epidemiology and Clinical Research Unit at St. Vincent’s Hospital in Sydney. However they were reconstituted as the National Centre for HIV Virology Research (NCHVR) and the National Centre for HIV Epidemiology and Clinical Research (NCECR).
The introduction of the Medicare system of national health care insurance in 1984 has greatly boosted the free access to medical and hospital treatment and also access to subsidized pharmaceuticals. This has provided funding and support and has greatly boosted delivery of services and treatment and also the treatment of resources. Medicare has ensured that HIV infection has enabled access to clinical care for free. The government has continued to fund the provision of HIV test kits and also accessibility to free, universal, HIV/AIDS testing.
Behavioral and social research has been singled out to be the most important area of study. This is because the behaviour of a particular person sexually and social interactions of a person all are the keys to unlocking the prevention of the scourge.
In Africa generally, a whole continent the scourge of Aids has the same characteristics in more if not most in all the countries. The fight against HIV is both tedious and very expensive considering it being a third world nation not basically fighting HIV alone but poverty, disease, civil wars and other various vices that exist. Singling out Malawi for instance, having a large population is highly affected by the scourge.
Malawi’s HIV prevalence is considered higher in urban areas as compared to its prevalence in rural areas. The main approach taken by different players is embracing the use of Consultation and trying to imitate it among the various communities, civil society and various players in the fight against the vice.
Fear and discrimination is a peculiar characteristic in the fight against HIV because it is not only the virus that kills but stigma and prejudice from the people we look up to that can kill a person even more. As has been stated AIDS attacks the body; prejudice attacks the spirit of a person. It is considered a taboo subject in the community, however efforts by President Bakili Muluzi revealing that his brother had died of AIDS three years ago has greatly urged Malawians to challenge and fight the stigma.
In Malawi people still cannot touch loved ones even care for them both physically and psychologically because the fear of getting infected is even higher. One can say that this is due to ignorance and lack of adequate information about the virus. Families can go to the extent of severing ties with the person just for fear of their lives.
The information on HIV as regards its causes and effects has led to multiple beliefs and wrong dissemination about the bane. This can be through its causes, transmission and even the fact that some communities considers it as a curse from the gods have all attributed to the poor fight of it in the country. The cultural appropriateness of information is also not taken into account by various actors against the scourge in the country, unlike Australia where forum and awareness programmes are carried out, this are seldom attended to by the populous.
Being a third world country, Malawi has various problems that need major funding by the government such as the fight against malaria, floods, poverty and food and HIV has not been given the biggest allocation of state resources. Malawi mainly depends on donor funding and donations from developed countries in order to adequately fight the vice.
The major donors in Malawi include the World Bank, Global Fund, World Health Organization(WHO) , United Nations Aids (UNAIDS) and Presidents Emergency Plan for AIDS Relief (PEPFAR). This have contributed and disbursed funds to various parts of Malawi to ensure that the global pandemic is prevented.
Policy creation through a five-year National Strategic Framework to combat AIDS was implemented(Averting HIV and AIDS, 2011) however policy has been slow in taking effect as financial and organizational difficulties within the National Aids Control Programme (NACP) has persisted. National AIDS Commission (NAC) was set up in 2001 to supplement the work of NACP and it overseen a number of AIDS initiatives that provide care and also further programmes to provide treatment and to increase testing to prevent the transmission of the virus.
The national HIV prevalence has stabilized between 11 percent and 17 percent since the mid-Nineties, (National Aids Commission of Malawi [NAC], 20003). Chipeta and Bello (2006) assert that HIV prevalence especially amongst women attending antenatal clinics has fallen slightly and urban areas, such as the capital Lilongwe, have witnessed a decline in HIV prevalence, although some rural areas have continued to witness prevalence increase. The UNAIDS (2010) estimates that up to 7 percent prevalence has been noted.
In Malawi however, the majority of infections occur through heterosexual unlike in Australia where the gay communities have reported to be more infected than their heterosexual counterparts. There is no available data or information that it is transmitted in persons of the same sexes as homosexuality is illegal in the country. However there is a higher rate of prevalence in women than amongst the men (UNAIDS, 2008)
Research has been the major area of Australia in tackling the scourge, but perhaps for Malawi this would be challenging. The financial crisis and available human resources is a hindrance in the research sector. Shortage of Medical Staff as estimated by the National Association of Nurses in Malawi (NONM) currently estimates that about for nurses are lost due to HIV related illnesses every month.
Prevention of mother-to-child transmission of HIV (PMTCT) was initiated since 2004 to ensure that pregnant mothers do not transfer it to their unborn babies during birth. Condom distributions carried out by Non-governmental Organizations (NGOS) to ensure that prevention of transmission of the virus is undertaken. Voluntary counseling and testing (VCT) was introduced in Malawi to provide testing and counseling for both the infected and uninfected persons however, availability of this center is limited in number.
It is estimated that over 740, 000 people living with HIV IN China and at around 2009 more than 26,000 people died from AIDS (UNAIDS, 2010). The first case of infection was reported by a traveler abroad who died in Beijing and mostly was reported amongst travelers and imported blood products. During the 1990s there was an increase in AIDS cases in China attributed to blood donation unlike Australia where it is more prevalent amongst the gay communities.
HIV education in China has taken root as the Chinese Education Ministry formulated the Basic requirements for Health Education as early as 1990 stating that sexual morality and self-discipline should be taught to ensure that HIV is prevented. Mass education campaigns have also been undertaken.
Distribution of contraceptives and condoms was first banned in China however in 2002 during the World Aids Day was lifted because it was considered as a medical device rather than a sexual commodity. China was initially considered a conservative community but the rise of female sex workers necessitated the use of the devices. This is also an approach taken by Malawi because prevention is a key to fighting the scourge.
PMTCT is also a method used by China in fighting HIV as mother-to-child transmission is a major way in which it is transmitted. National guidelines have been adopted. VCT was implemented in China in 2003 and various centers were created throughout the country. This has enabled individuals to request free HIV testing and counseling from a health provider enabling persons to overcome fear of being tested.
Stigma and discrimination is still an issue with the fight against HIV. In almost all countries such as Malawi and Australia fighting stigma is still a challenge. Confidentiality issues and disclosure of a person’s HIV status is still treated with malice as persons are still a little bit ignorant of it.
Access to treatment and care in China especially in antiretroviral treatment and clinical treatment was initially limited. China Comprehensive AIDS Response (China CARES) was launched I 2003 and is community based group for fighting HIV. Moreover, Pilot programmes were initiated in Chinese provinces and has also provided patients with free, locally produced antiretroviral a policy named “Four Frees and One Care” was initiated with the aim of providing free HIV treatment making it available to poor people in urban areas and even in the rural areas.
According to the Chinese Ministry of Health, it is contended that between 2003 and 2007, there was provision of free antiretroviral therapy to people living with AIDS and including 771 HIV positive children. It was then realized that HIV-related mortality declined as antiretroviral drug provision for patients with advanced HIV-infection increased dramatically.
Researchers especially in China have tried to identify the highly risk groups of persons, documented tried to find out the cause of the disease, and successfully observed programmes in other countries and experienced the effectiveness of behavioral and social interventions. The Centers for Disease Control (CDC) has initiated various programmes in research in attempting to fight the scourge.
Funding for the prevention of HIV in China is both preserve of donors, the government and to some extent interested groups of persons. Adequate funding would ensure that HIV is adequately dealt with in the country.
The impediment to preventing numerous people from accessing adequate treatment include; existence of stigma and discrimination, lack of adequate funds to finance the health care system and migratory patterns of the working population.
Conclusion
Essentially HIV can be stated to be the worst global disease or virus that has ever affected humans in a wide area than any other disease. No country either developed or under developed has eluded the scourge and it takes great measures to ensure that it is well dealt with.
Australia being one of the more developed nations through its community based approach and government intervention has ensured that people know about the pandemic and that there is a general concern by different players in how to fight it. Research and education has been one of the most effective ways of fighting the scourge as ignorance is a great disease.
In considering underdeveloped countries such as Malawi in Africa fighting the HIV virus has proved to be a great challenge mainly due to the poverty and other vices that affect them. However this has not affected the way they treat HIV related issues and donor funding and community based approach has proved to be effective.
China a major world power has also has its ups and downs in fighting HIV infections. The large population in its country and the fact that there is always a threat of new infections has proved to be a challenge to the government and even interested parties on the scourge. Generally therefore, it is a global challenge to all countries not only Australia to fight the scourge and save the world more lives.
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