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This is a call for papers for a panel submission to the American Anthropological Association's 2008 annual meeting to be held November 19-23 in San Francisco. If you are interested in participating in this panel, please contact Christian Reed at [log in to unmask] or Marita Eibl at [log in to unmask] off the list, with an abstract of 250 words by March 24th. Offers for discussants are also welcome. 

A Global Solution? Engaging the reality of the international HIV/AIDS treatment scale-up indeveloping nations
 
It has been twelve years since the announcement of the firstantiretroviral medication (ARV) for HIV/AIDS. Since then ARVs have been readilyaccessible in the Western world, but until the start of the global treatment programsin the early 2000s the medications were unavailable in the developing world. Followingin the footsteps of some small-scale treatment projects, the World HealthOrganization (WHO), the United Nations (UN), as well as the United States through thePresident’s Emergency Plan for AIDS Relief (PEPFAR) are now coordinatinginternational ARV scale-ups in partnership with developing nation governmentsand donor organizations. An increasing number of people in the developing worldare now ARV consumers; in 2006 alone WHO claims the number of individuals onARV treatment jumped from 700,000 to 2 million, representing 28% of those estimatedin need of treatment. In spite of this rise, WHO estimates that another fivemillion are in need of the
 medications, meaning that global treatment programs mustintensify efforts to meet demands. As in other aspects of global health, thepolitics of treatment distribution are more complicated than internationalgoodwill and human rights approaches to universal access suggest. This class ofpharmaceuticals, while not a cure, has changed the reality of living withHIV/AIDS for more than 2.5 million people, but little attention is paid to the shiftingrelationships and unintended consequences of such rapid scale-up. As programsexpand, the state and its responsibilities are highlighted, defined, andpossibly internationalized by negotiations with global entities and donororganizations.  
 
Furthermore, individuals eagerly awaiting access to
treatment are redefining ideas of what citizenship means in regards to health
care delivery. While being a member of an HIV positive association or group
often leads to improved access and adherence to drug regimens, only those who
identify themselves as HIV positive receive specialized care. Poor,
marginalized, and uneducated patients, often labeled ‘non-compliant,’ remain
isolated from biomedical health interventions and epidemiological research,
exposing the universal nature of multilateral health care programs as
unaccountable to local contexts and histories. Finally, are global ARV programs
sustainable where weakening prevention efforts have succumbed to approaches
centered on pharmaceutical distribution and consumption? Recent research
suggests that many AIDS patients abandon ARV treatment for reasons that are not
well understood; in some countries more than half stop treatment within two
years. Food and transportation are commonly cited challenges yet are rarely integrated
into ARV services. Are AIDS interventions, specifically for treatment access,
tools of new democratic politics and ethics? As anthropology examines these
phenomena some important questions are raised such as: What are the
relationships among citizens, the state, pharmaceuticals? How are particular
states coordinating efforts with donors? What is the responsibility of civil
society concerning ARV access? How have local communities and contexts adapted
to or resisted the standardized approaches to ARV scale-up in the developing
world? This is a call for papers to explore ways in which ARVs are shifting,
reconfiguring, and crafting relationships among donors, states, companies, and
citizens within the developing world. 

 
Christian Reed, MA, MPH
PhD Student, Medical Anthropology
Michigan State University




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