Global Public Health
Global public health initiatives aimed at improving health for all people across the globe by eliminating avoidable diseases, death, disability, and promoting wellness. THE United States federal government plays a crucial role in contributing to the achievement of global public health. Among the many motives that the U.S government has in fostering global public health include protecting the U.S citizens from health threats, advancing its foreign mission of reducing poverty, increasing national security, building a stronger economy, and enabling individuals, communities and families to live more fulfilling lives. Among the global public initiatives that the U.S federal government has been involved in include HIV/IDS.
Since 1981 when the first case of HIV infection was recorded, the disease infection has increased exponentially to pandemic proportions. Currently, the World Health Organization estimates that there are 65 million people infected worldwide with fatalities standing at 25 million. The U.S federal government and other organizations have collaborated through several initiatives to combat the HIV/AIDS pandemic that has plundered the world for over 50 years as of now. One of these programs includes the U.S Agency for International Development (USAID) (McCree et al., 2010). This is an independent federal government agency that was initiated in 1986 and currently has operations in over 100 countries where it enforces PEPFAR programs. This agency’s main objective is focused on empowering primary health care systems to prevent and treat and caring for various communicable diseases such as HIV/AIDS.
The department of state is another U.S program that combats HIV/AIDS. The office of the secretary of state receives a report from the U.S global AIDS coordinator. According to Ingram (2011), this department directs activities under the advisory of the report where various initiatives may be recommended such as providing human resource services, providing office space, IT technology and communication materials, and finally transferring funds to other agencies tasked with the implementation of programs. In addition, the program is tasked with offering interagency coordination channels to ensure there is harmony in the initiatives that each program and agency funded by the U.S government is achieving its objective without the fear of program collision.
Through such initiatives, the U.S government has contributed a lot to combating HIV/AIDS pandemic. A recent report by world health organization indicates that half of the people living with HIV are under the ARV medication program. In 2015, UNAIDS declared that the stipulated millennial development goal pertaining to HIV and AIDS had been achieved, thanks to the efforts that the U.S government had put in place. In addition to this, the rate of new infections has drastically reduced over the years. This can be attributed to the efforts that the U.S government has put in place to increase awareness about the disease. Despite these initiatives by the U.S federal government, HIV/AIDS continues to pose an immediate and long-term threat to people world over and therefore requires undivided attention to ensure its severity that was felt much in the early 1990s and 2000s will not be experienced again. This can be achieved through a continued emphasis on preparedness and protection campaigns specifically in areas that are considered HIV hotspots.
Global case studies of public health policy challenges
Case study 2: Preventing HIV and sexually transmitted infections in Thailand
Following the rapid HIV infections that were being experienced the world over in the early 1980s and 1990s. Thai government’s first awakening to the pandemic rummaging among its citizen came in 1988 after HIV infection rates heightened among injecting drug users. A task force was formed to look into how the government can develop initiatives to curb this menace. The task force came up with an even shocking discovery that indicated HIV infection among the sex workers was on the rise. The report indicated that the number of direct sex workers infected with the virus between 1989 and 1990 tripled from 3.5 % to 9.3 % percent (Park et al., 2010). This figure almost tripled again the subsequent year hitting a record high of 21.6% increase. The number of male conscripts who tasted for the virus on entry to the army recorded an increase from 0.3% to 3% in 1991.
To combat the rising number of infections, the government of Thailand in collaboration with the USAID came up with an innovative program dubbed “100% condom program”. Basically, the program aimed at targeting all the sex workers in sex establishments where they were required to adopt the use of condoms with all their clients at all times. The program was motivated by the fact that most of the infections came from sex workers and therefore curbing it spread from them will curtail its spread significantly. the implementation had several setbacks such as hesitance by some clients to use condoms since they preferred raw sex (Youngkong et al., 2012). However, by insisting that all establishments adopt the use of condoms, the clients seeking sex had no other option but to accept. Men seeking medication for STI infections were required to identify the sex establishment that they had visited. Government officials would then go there and create awareness. Through these initiatives, the spread of HIV reduced significantly such that between 1993 and 2000, approximately 200,000 new infections were averted. The new infections rate fell fivefold from 1991 to 1995. Also, the use of condoms among the sex worker increased from a mere 14% in 1989 to 90% in 1990.
This policy approached the HIV pandemic from a different perspective and achieved recommendable results within a short time. Unlike other initiatives that fail to achieve their objectives, 100% condom program took less than 10 years to record positive results. A report by UNAIDS indicated that the program had contributed significantly to the reduction of HIV on a large scale throughout the country. This study was conducted in 1/3 of all Thai provinces where around 100 sex workers in every province were included in the survey and about 200 young males per province. However, this program is criticized due to the expense burden that it put on the Thai government. since its inception, the program has consumed about 2% of the Thai health ministry budget early which totals about 375 million dollars. Considering that Thai is a poor country, this budget strained other healthcare services. This however does not underrate the achievements that the program achieved in terms of reducing HIV infections.
References
Ingram, A. (2011). The Pentagon’s HIV/AIDS Programmes: Governmentality, political economy, security. Geopolitics, 16(3), 655-674.
McCree, D. H., Jones, K. T., & O’Leary, A. (Eds.). (2010). African Americans and HIV/AIDS: Understanding and addressing the epidemic. Springer Science & Business Media.
Youngkong, S., Teerawattananon, Y., Tantivess, S., & Baltussen, R. (2012). Multi-criteria decision analysis for setting priorities on HIV/AIDS interventions in Thailand. Health Research Policy and Systems, 10(1), 6.
Park, L. S., Siraprapasiri, T., Peerapatanapokin, W., Manne, J., Niccolai, L., & Kunanusont, C. (2010). HIV transmission rates in Thailand: evidence of HIV prevention and transmission decline. JAIDS Journal of Acquired Immune Deficiency Syndromes, 54(4), 430-436.