The Political Economy of HIV/AIDS in Developing Countries
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The Political Economy of HIV/AIDS in Developing Countries

TRIPS, Public Health Systems and Free Access

Edited by Benjamin Coriat

The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.
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Chapter 8: HIV Prevalence Estimates: The New Deal in Sub-Saharan Africa Since 2000

Joseph Larmarange


Joseph Larmarange HIV prevalence and incidence data are necessary at different levels, for monitoring the epidemics, understanding their dynamics, determining priorities of actions, modelling AIDS impact on population and so on. In macro-economy, HIV prevalence is often an important parameter of the models. HIV prevalence data are often used for evaluation, planning and advocacy and so their uses are very political. Since 2000, changes in UNAIDS estimates have reflected improvements in the methodology used. For example, the estimated number of persons living with HIV worldwide in 2007 was 33.2 million (30.6–36.1 million) (UNAIDS, 2007), a reduction of 16 per cent compared with the estimate published in 2006 (39.5 million (34.7–47.1 million)) (UNAIDS, 2006). This difference is largely due to more accurate data and assumptions about HIV epidemics. So, UNAIDS estimates from different reports cannot be directly compared and apparent trends do not reflect HIV epidemic trends. This chapter will review and discuss the different sources of HIV data and the estimation methodology used. BRIEF HISTORY OF HIV SURVEILLANCE Initially, sentinel surveillance of specific populations was developed in SubSaharan Africa in the 1980s to identify the emergence and spread of HIV epidemics. Nationally representative seroprevalence surveys have not generally been conducted,1 largely due to cost concerns. So efforts were focused on the surveillance of specific populations, this system becoming generalized in Sub-Saharan Africa in the 1990s. The HIV/AIDS Surveillance Database was developed and has been maintained since 1987 by...

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