This document compares 27 years of research on AIDS and climate change. It finds that both fields have struggled to understand complex phenomena and social vulnerabilities. Early research in AIDS focused on medical and technical responses, but later shifted to social and economic factors. Climate change research also began with a physical sciences focus and integrated social sciences over time. Both fields have grappled with "globalized" discourses that mask uneven impacts, and tendencies toward technical fixes. The document argues AIDS research could learn from climate change's longer term, forward-looking approaches and sophisticated social vulnerability concepts.
This document discusses the role of epidemiology in public health. It begins by outlining the goals of public health as reducing disease, death and suffering. It then defines epidemiology as the study of disease distribution and the factors that influence distribution, making it the basic science of public health. The document goes on to discuss how epidemiology has expanded over time to study non-infectious diseases, the environment, health care delivery, and personal behaviors. It argues that epidemiology needs to consider broader social and political determinants of health like poverty, conflict, and human rights issues to fully understand population health.
This document provides an overview of epidemiology. It defines epidemiology as the study of disease distribution and determinants in populations. It discusses the history of epidemiology, including John Snow's work identifying contaminated water as the cause of a cholera outbreak. The document also covers epidemiological concepts like the epidemiologic triad of agent, host, and environment; the chain of infection; and the tasks of an epidemiologist like surveillance, investigation, and research.
John Snow conducted seminal epidemiological work in 1854 during a cholera outbreak in London. By mapping cases of cholera and determining locations of water sources, he discovered cholera was transmitted through contaminated water from a Broad Street pump. Upon its removal, cholera cases decreased suddenly, demonstrating waterborne transmission. This was a major achievement in epidemiology and earned Snow the title of the father of field epidemiology. Epidemiology involves the scientific study of disease patterns in human populations, including the distribution and determinants of health-related states or events. It aims to describe disease occurrence, identify etiological factors, and provide data to support disease prevention, control, and treatment efforts.
Environmental Epidemiology in Small areasNik Ronaidi
The document discusses using environmental epidemiology to study environmental risk factors and their impact on health in small areas. It describes collecting health and environmental data from various sources to build a geodatabase, identify potential disease clusters associated with environmental stressors, and purify clusters by excluding non-environmental risk factors. Biochemical analysis of tissues may then be used to check for markers of environmental pollutants in affected individuals to help confirm relationships between environmental exposures and health outcomes. Challenges include accounting for confounding factors and incomplete medical data.
Epidemiology is the study of the distribution and determinants of health and disease in populations. It has evolved rapidly in recent decades from focusing only on disease distribution and causation to also examining health events, treatment modalities, and health services. Modern epidemiology identifies risk factors for chronic diseases and evaluates prevention and treatment options to improve population health.
This document discusses epidemiology and how it was used to identify smoking as a cause of lung cancer. It shows that lung cancer rates increased dramatically between 1937-1950 in the US. A case-control study found that smokers were over 20 times more likely to develop lung cancer than non-smokers. A later British study found that lung cancer risk increased with the number of cigarettes smoked per day. Through observational epidemiological studies, researchers were able to establish smoking as a major risk factor and cause of lung cancer.
Introduction to Epidemiology
1. Define epidemiology
2. Describe the history of epidemiology
3. Describe aims and components of
epidemiology
4. Discuss on the uses of epidemiology
This document discusses the role of epidemiology in public health. It begins by outlining the goals of public health as reducing disease, death and suffering. It then defines epidemiology as the study of disease distribution and the factors that influence distribution, making it the basic science of public health. The document goes on to discuss how epidemiology has expanded over time to study non-infectious diseases, the environment, health care delivery, and personal behaviors. It argues that epidemiology needs to consider broader social and political determinants of health like poverty, conflict, and human rights issues to fully understand population health.
This document provides an overview of epidemiology. It defines epidemiology as the study of disease distribution and determinants in populations. It discusses the history of epidemiology, including John Snow's work identifying contaminated water as the cause of a cholera outbreak. The document also covers epidemiological concepts like the epidemiologic triad of agent, host, and environment; the chain of infection; and the tasks of an epidemiologist like surveillance, investigation, and research.
John Snow conducted seminal epidemiological work in 1854 during a cholera outbreak in London. By mapping cases of cholera and determining locations of water sources, he discovered cholera was transmitted through contaminated water from a Broad Street pump. Upon its removal, cholera cases decreased suddenly, demonstrating waterborne transmission. This was a major achievement in epidemiology and earned Snow the title of the father of field epidemiology. Epidemiology involves the scientific study of disease patterns in human populations, including the distribution and determinants of health-related states or events. It aims to describe disease occurrence, identify etiological factors, and provide data to support disease prevention, control, and treatment efforts.
Environmental Epidemiology in Small areasNik Ronaidi
The document discusses using environmental epidemiology to study environmental risk factors and their impact on health in small areas. It describes collecting health and environmental data from various sources to build a geodatabase, identify potential disease clusters associated with environmental stressors, and purify clusters by excluding non-environmental risk factors. Biochemical analysis of tissues may then be used to check for markers of environmental pollutants in affected individuals to help confirm relationships between environmental exposures and health outcomes. Challenges include accounting for confounding factors and incomplete medical data.
Epidemiology is the study of the distribution and determinants of health and disease in populations. It has evolved rapidly in recent decades from focusing only on disease distribution and causation to also examining health events, treatment modalities, and health services. Modern epidemiology identifies risk factors for chronic diseases and evaluates prevention and treatment options to improve population health.
This document discusses epidemiology and how it was used to identify smoking as a cause of lung cancer. It shows that lung cancer rates increased dramatically between 1937-1950 in the US. A case-control study found that smokers were over 20 times more likely to develop lung cancer than non-smokers. A later British study found that lung cancer risk increased with the number of cigarettes smoked per day. Through observational epidemiological studies, researchers were able to establish smoking as a major risk factor and cause of lung cancer.
Introduction to Epidemiology
1. Define epidemiology
2. Describe the history of epidemiology
3. Describe aims and components of
epidemiology
4. Discuss on the uses of epidemiology
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. The key components of an epidemiological model are the agent, host, and environment. Agents can be biological, nutritional, physical, chemical, mechanical, or social. Host factors include demographic, biological, socioeconomic, and lifestyle characteristics. Environments encompass physical, biological, and psychosocial factors. Descriptive epidemiology studies measure disease frequency, distribution over time, place and person. Analytical studies test etiological hypotheses and identify risk factors. Experimental studies manipulate suspected causes to confirm relationships.
This document discusses emerging and re-emerging infectious diseases. It begins by outlining the objectives and key terms. It then provides background on how human diseases have changed as humans migrated and civilization developed. The document identifies several potential contributing factors to new diseases emerging, such as population growth, poverty, human behavior changes, and technological advances. It also discusses challenges like antibiotic resistance and how diseases spread through increased population movement and globalization. Finally, it examines the development of global surveillance networks and international agreements to control infectious diseases.
This document discusses epidemiology and community health. It defines epidemiology as the study of factors that affect the health of populations, including disease frequencies, types, and distributions. Community health refers to the health status and care of community members. The key relationship between the two is that epidemiology provides critical information on disease trends, causes, and factors that inform community health program planning, advocacy, research, and evaluation. The document outlines objectives, definitions, types and uses of epidemiology as well as community health activities.
This document discusses epidemiology and communicable disease control in public health nursing. It provides historical context on epidemiology dating back to Hippocrates and outlines key terms and concepts. The document also describes methods of epidemiological investigation and sources of epidemiological information. It examines global and national trends in communicable disease control and prevention as well as major communicable diseases in the US and emerging infectious diseases globally.
At the end of this presentation the attendant is expected to:
Define Epidemiology.
Identify the main issues in the definition.
Discuss the uses of Epidemiology.
The document discusses modern theories of disease, including the germ theory of disease, epidemiological triad, multifactorial causation, web of disease causation, and socio-environmental model. It also examines current theoretical trends in social epidemiology, including psychosocial theory, social production of disease/political economy of health, and ecosocial theory. Ecosocial theory systematically links social and biological processes. The document concludes that ecosocial and multilevel frameworks may best guide social epidemiological research in the 21st century.
This document provides an introduction to environmental epidemiology for environmental health sciences students. It defines key terms like health, disease, and epidemiology. Epidemiology is described as the study of frequency, distribution, and determinants of diseases in populations in order to prevent disease and promote health. Environmental epidemiology specifically studies the determinants of disease distributions that are exogenous to human beings. The document discusses types of environmental exposures like point sources, line sources, and area sources. It also covers components of epidemiological studies like frequency, distribution, determinants, and application of findings. Exposure levels, timing, measurement, and interaction with other risk factors are explored. The history and contributions of epidemiology to environmental health are summarized.
8 principle of epidemiology 11 community medicineSiham Gritly
Epidemiologic methods are used to identify disease risk factors and determine optimal treatments. There are two main types of epidemiologic studies: observational studies and experimental studies. Observational studies include descriptive studies, which observe disease distribution, and analytical studies like cohort and case-control studies, which analyze associations between exposures and disease. Experimental studies include randomized controlled trials, which randomly assign participants to test interventions, and non-randomized trials.
This document discusses international health organizations and the International Health Regulations (IHR). It provides background on the IHR, stating that they are binding on 194 countries and are intended to help prevent disease spread across borders and ensure countries have response systems. The IHR require countries to quickly notify the WHO of severe disease events that could spread internationally. The WHO then guides a coordinated global response. Four diseases always require reporting. The role of countries is to assess risk while the WHO determines if an event is an emergency of international concern.
Epidemiology is the study of patterns of disease and injury in populations. Epidemiologists conduct research to identify causes of disease and develop prevention strategies. Entry-level epidemiologists conduct studies, develop intervention programs, and communicate findings. Senior epidemiologists supervise others and lead large-scale studies and research programs. Epidemiology is important for monitoring health status, investigating health threats, and researching solutions.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. It uses a systematic and unbiased approach to collect, analyze, and interpret data. Some core functions of epidemiology include public health surveillance, field investigations, analytic studies, evaluation of public health programs and services, linkages with other disciplines, and policy development. Epidemiology provides an evidence base for effective public health action and disease prevention.
Introduction
Uses and aims of epidemiology
Qualification
Jobs included
List of skills
Role of epidemiologists
Specializations
Courses offered
Public health significance
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems. It involves describing disease frequency, identifying causes, and providing data to plan prevention and control efforts. Key aspects include studying determinants like risk factors, the distribution of diseases among populations over time and place, and measuring outcomes like disease occurrence. Historical figures like John Snow used epidemiological methods to map disease spread and identify contaminated water as the source of a cholera outbreak.
Public health aims to improve health through healthy lifestyles, disease prevention, and controlling infectious illnesses. Biosecurity encompasses actions, systems, and policies that protect people from harmful biological agents using risk reduction methods like personal protective equipment, laboratory containment systems, and decontamination techniques. Containment has two types - primary protects personnel through good practices and safety equipment, while secondary protects the external environment through facility design and operational practices.
This document provides an introduction to the course MPH 5101: Epidemiology. It defines epidemiology as the study of the distribution and determinants of health-related states or events in human populations. The document summarizes the historical evolution of epidemiology, from Hippocrates to John Snow. It also lists the key features and uses of descriptive and analytic epidemiology, and components of the epidemiologic triad.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations. It involves the systematic collection and analysis of data related to health problems. The goals of epidemiology are to identify risk factors for disease, prevent incidence, and improve population health. Epidemiology examines the impact of public health programs and can describe disease presence and controlling factors in a population.
This document provides definitions and explanations of key concepts in epidemiology. It discusses epidemiology as the study of health-related states and events in populations, including determinants, distribution, and health phenomena. It also defines important epidemiological terms like incidence, prevalence, outbreaks, transmission, and measures like rate, ratio and proportion used to quantify epidemiological data. The document aims to describe the scope and methodology of epidemiology as a public health discipline.
The document provides definitions and historical background information about epidemiology. It defines epidemiology as the study of disease distribution, frequency, and determinants in human populations in order to control health problems. Some key points mentioned include:
- Epidemiology studies entire populations while clinical medicine focuses on individual patients.
- Important figures in the history of epidemiology include Hippocrates, John Snow, and William Bugg who conducted early studies of cholera, typhoid, and other diseases.
- Epidemiology aims to reduce disease burden and promote population health through describing disease patterns, identifying causes, and informing prevention and control efforts.
Global health is an emerging field that draws from public health and international health. While these fields share similarities like a focus on populations and prevention, global health is distinct in that it addresses health issues that transcend national borders and involve multiple countries and disciplines. The document presents a definition of global health agreed upon by an international panel as "an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide." It emphasizes transnational health problems and solutions, an interdisciplinary approach, and a balance of population-based prevention and individual clinical care.
The document discusses the African Women's Protocol and its potential role in supporting women's reproductive rights and progress toward achieving the Millennium Development Goals in Africa. Key points:
1) The protocol provides a strong framework for women's reproductive rights in Africa, going beyond other treaties in promoting these rights.
2) However, only 29 of 52 African countries have ratified it so far, and barriers remain to implementing its provisions in national laws and policies.
3) If fully implemented and integrated into legislation, the protocol could help create an enabling environment for women's reproductive rights and support progress on MDGs 3, 5, and 6 relating to gender equality, maternal health, and HIV/AIDS.
Newsletters are the one of the most valuable tools you have for keeping donors connected to your work and for showing them the impact of their support. Yet, surveys show that donors aren’t reading them. Why? Because a good newsletter is hard to find. Come hear what makes a newsletter compelling to your supporters, and how to avoid the most common mistakes. You’ll leave with concrete strategies you can put to work right away!
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. The key components of an epidemiological model are the agent, host, and environment. Agents can be biological, nutritional, physical, chemical, mechanical, or social. Host factors include demographic, biological, socioeconomic, and lifestyle characteristics. Environments encompass physical, biological, and psychosocial factors. Descriptive epidemiology studies measure disease frequency, distribution over time, place and person. Analytical studies test etiological hypotheses and identify risk factors. Experimental studies manipulate suspected causes to confirm relationships.
This document discusses emerging and re-emerging infectious diseases. It begins by outlining the objectives and key terms. It then provides background on how human diseases have changed as humans migrated and civilization developed. The document identifies several potential contributing factors to new diseases emerging, such as population growth, poverty, human behavior changes, and technological advances. It also discusses challenges like antibiotic resistance and how diseases spread through increased population movement and globalization. Finally, it examines the development of global surveillance networks and international agreements to control infectious diseases.
This document discusses epidemiology and community health. It defines epidemiology as the study of factors that affect the health of populations, including disease frequencies, types, and distributions. Community health refers to the health status and care of community members. The key relationship between the two is that epidemiology provides critical information on disease trends, causes, and factors that inform community health program planning, advocacy, research, and evaluation. The document outlines objectives, definitions, types and uses of epidemiology as well as community health activities.
This document discusses epidemiology and communicable disease control in public health nursing. It provides historical context on epidemiology dating back to Hippocrates and outlines key terms and concepts. The document also describes methods of epidemiological investigation and sources of epidemiological information. It examines global and national trends in communicable disease control and prevention as well as major communicable diseases in the US and emerging infectious diseases globally.
At the end of this presentation the attendant is expected to:
Define Epidemiology.
Identify the main issues in the definition.
Discuss the uses of Epidemiology.
The document discusses modern theories of disease, including the germ theory of disease, epidemiological triad, multifactorial causation, web of disease causation, and socio-environmental model. It also examines current theoretical trends in social epidemiology, including psychosocial theory, social production of disease/political economy of health, and ecosocial theory. Ecosocial theory systematically links social and biological processes. The document concludes that ecosocial and multilevel frameworks may best guide social epidemiological research in the 21st century.
This document provides an introduction to environmental epidemiology for environmental health sciences students. It defines key terms like health, disease, and epidemiology. Epidemiology is described as the study of frequency, distribution, and determinants of diseases in populations in order to prevent disease and promote health. Environmental epidemiology specifically studies the determinants of disease distributions that are exogenous to human beings. The document discusses types of environmental exposures like point sources, line sources, and area sources. It also covers components of epidemiological studies like frequency, distribution, determinants, and application of findings. Exposure levels, timing, measurement, and interaction with other risk factors are explored. The history and contributions of epidemiology to environmental health are summarized.
8 principle of epidemiology 11 community medicineSiham Gritly
Epidemiologic methods are used to identify disease risk factors and determine optimal treatments. There are two main types of epidemiologic studies: observational studies and experimental studies. Observational studies include descriptive studies, which observe disease distribution, and analytical studies like cohort and case-control studies, which analyze associations between exposures and disease. Experimental studies include randomized controlled trials, which randomly assign participants to test interventions, and non-randomized trials.
This document discusses international health organizations and the International Health Regulations (IHR). It provides background on the IHR, stating that they are binding on 194 countries and are intended to help prevent disease spread across borders and ensure countries have response systems. The IHR require countries to quickly notify the WHO of severe disease events that could spread internationally. The WHO then guides a coordinated global response. Four diseases always require reporting. The role of countries is to assess risk while the WHO determines if an event is an emergency of international concern.
Epidemiology is the study of patterns of disease and injury in populations. Epidemiologists conduct research to identify causes of disease and develop prevention strategies. Entry-level epidemiologists conduct studies, develop intervention programs, and communicate findings. Senior epidemiologists supervise others and lead large-scale studies and research programs. Epidemiology is important for monitoring health status, investigating health threats, and researching solutions.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. It uses a systematic and unbiased approach to collect, analyze, and interpret data. Some core functions of epidemiology include public health surveillance, field investigations, analytic studies, evaluation of public health programs and services, linkages with other disciplines, and policy development. Epidemiology provides an evidence base for effective public health action and disease prevention.
Introduction
Uses and aims of epidemiology
Qualification
Jobs included
List of skills
Role of epidemiologists
Specializations
Courses offered
Public health significance
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems. It involves describing disease frequency, identifying causes, and providing data to plan prevention and control efforts. Key aspects include studying determinants like risk factors, the distribution of diseases among populations over time and place, and measuring outcomes like disease occurrence. Historical figures like John Snow used epidemiological methods to map disease spread and identify contaminated water as the source of a cholera outbreak.
Public health aims to improve health through healthy lifestyles, disease prevention, and controlling infectious illnesses. Biosecurity encompasses actions, systems, and policies that protect people from harmful biological agents using risk reduction methods like personal protective equipment, laboratory containment systems, and decontamination techniques. Containment has two types - primary protects personnel through good practices and safety equipment, while secondary protects the external environment through facility design and operational practices.
This document provides an introduction to the course MPH 5101: Epidemiology. It defines epidemiology as the study of the distribution and determinants of health-related states or events in human populations. The document summarizes the historical evolution of epidemiology, from Hippocrates to John Snow. It also lists the key features and uses of descriptive and analytic epidemiology, and components of the epidemiologic triad.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations. It involves the systematic collection and analysis of data related to health problems. The goals of epidemiology are to identify risk factors for disease, prevent incidence, and improve population health. Epidemiology examines the impact of public health programs and can describe disease presence and controlling factors in a population.
This document provides definitions and explanations of key concepts in epidemiology. It discusses epidemiology as the study of health-related states and events in populations, including determinants, distribution, and health phenomena. It also defines important epidemiological terms like incidence, prevalence, outbreaks, transmission, and measures like rate, ratio and proportion used to quantify epidemiological data. The document aims to describe the scope and methodology of epidemiology as a public health discipline.
The document provides definitions and historical background information about epidemiology. It defines epidemiology as the study of disease distribution, frequency, and determinants in human populations in order to control health problems. Some key points mentioned include:
- Epidemiology studies entire populations while clinical medicine focuses on individual patients.
- Important figures in the history of epidemiology include Hippocrates, John Snow, and William Bugg who conducted early studies of cholera, typhoid, and other diseases.
- Epidemiology aims to reduce disease burden and promote population health through describing disease patterns, identifying causes, and informing prevention and control efforts.
Global health is an emerging field that draws from public health and international health. While these fields share similarities like a focus on populations and prevention, global health is distinct in that it addresses health issues that transcend national borders and involve multiple countries and disciplines. The document presents a definition of global health agreed upon by an international panel as "an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide." It emphasizes transnational health problems and solutions, an interdisciplinary approach, and a balance of population-based prevention and individual clinical care.
The document discusses the African Women's Protocol and its potential role in supporting women's reproductive rights and progress toward achieving the Millennium Development Goals in Africa. Key points:
1) The protocol provides a strong framework for women's reproductive rights in Africa, going beyond other treaties in promoting these rights.
2) However, only 29 of 52 African countries have ratified it so far, and barriers remain to implementing its provisions in national laws and policies.
3) If fully implemented and integrated into legislation, the protocol could help create an enabling environment for women's reproductive rights and support progress on MDGs 3, 5, and 6 relating to gender equality, maternal health, and HIV/AIDS.
Newsletters are the one of the most valuable tools you have for keeping donors connected to your work and for showing them the impact of their support. Yet, surveys show that donors aren’t reading them. Why? Because a good newsletter is hard to find. Come hear what makes a newsletter compelling to your supporters, and how to avoid the most common mistakes. You’ll leave with concrete strategies you can put to work right away!
This study investigated individual and psychosocial factors associated with high educator-learner interactions around HIV/AIDS and sexuality in South Africa. Younger educators and those in lower job categories interacted with learners on these issues more frequently than older colleagues. Favorable interactions were associated with good HIV/AIDS knowledge, personal experience with HIV/AIDS, and low stigmatizing attitudes. However, educators reported a lack of HIV/AIDS training support from the Department of Education. Younger educators also reported higher sexual risk behavior than older educators, undermining their credibility as educators. The findings highlight the need for formal HIV/AIDS training for educators to equip them to provide education and skills to learners.
National HIV/AIDS responses in Eastern and Southern Africa often fail to address the needs of people with disabilities. While many countries have signed conventions supporting disability rights, fewer than half of national strategic plans recognize disability or the vulnerability of people with disabilities. Plans also rarely provide accommodations for people living with HIV/AIDS who acquire disabilities. To fully integrate disability, national HIV/AIDS responses should involve people with disabilities in all aspects and ensure their rights are protected. Health services also need to consider the specific needs of people with disabilities.
This document summarizes a study that evaluated community perceptions of a 3-year project in South Africa that trained and supported volunteer health workers. The study conducted discussions with community members who were both involved and uninvolved in the project. Community members saw benefits from empowering volunteers to provide better home healthcare. However, they felt the efforts may not be sustainable without more support for volunteers within and outside the community, such as stable stipends, commitment from leaders, and support from external health agencies. The authors conclude that projects aiming to increase the role of community volunteers in AIDS care need substantial support structures to ensure sustainability.
This document discusses the history of AIDS exceptionalism over the past 30 years. It begins by providing background on the global HIV/AIDS epidemic, noting its widespread demographic, economic, and political impacts. It then describes how AIDS exceptionalism originated as a response to the initially frightening nature of the virus and its disproportionate effect on certain groups. More recently, AIDS exceptionalism referred to the unprecedented global response and resources dedicated to addressing the epidemic through organizations like UNAIDS. However, there has also been criticism of AIDS exceptionalism and claims that it receives too much funding compared to other health issues. The document aims to situate this debate in historical context by examining the shifting meaning of exceptionalism over time.
This document discusses the relationship between epidemiology and public health. It argues that epidemiology has become too focused on identifying disease risk factors and transmission, and has lost sight of its original goal of improving overall population health. It proposes that epidemiology should adopt a more holistic approach that integrates biological, social, and analytical perspectives to better inform public health interventions and policies. Recent decades have seen the growth of international training programs to develop epidemiologists able to address global health challenges.
This summary provides an overview of an epidemiology paper on respiratory syncytial virus (RSV) infections in children. The paper discusses the epidemiological triangle as it relates to RSV, describing the agent (RSV virus), host (infants and young children), and environment (fall, winter, early spring seasons). It also covers the types of epidemiology (descriptive and analytic) and levels of prevention (primary, secondary, tertiary) for RSV infections.
HLT 362V Grand Canyon University Wk5 Epidemiology Discussion.pdfbkbk37
Epidemiology is the study of the distribution and determinants of health-related states or events in populations. It involves collecting and analyzing data to describe disease patterns and determine causes of diseases. An example is given of an epidemiological investigation of a meningitis outbreak where data was collected through surveys. This led to interventions like immunizations and hygiene education to prevent further spread. Reporting of patient safety events and use of electronic systems allows aggregation and analysis of data to identify risks and improve safety. During the COVID-19 pandemic, telehealth has enabled remote triaging and care while reducing transmission risks by allowing patients to stay home.
HLT 362V Grand Canyon University Wk5 Epidemiology Discussion Responses.docxbkbk37
This document discusses epidemiology and provides examples of how epidemiological data is collected and used. It defines epidemiology as the study of the distribution and determinants of health-related states and events in populations. Epidemiologists collect data through surveys, investigations, and statistical sources to analyze disease causes and spread. Findings are then used to design public health interventions like education campaigns, immunization programs, and infrastructure improvements to prevent future outbreaks.
ARTÍCULO_Epidemiology the foundation of public health (Inglés) autor Roger De...Hilda Santos Padrón
Epidemiology is the basic science of public health as it describes the relationship between health, disease, and other factors in human populations. It uses study designs and methods to generate information to develop effective public health programs for disease prevention and health promotion. Unlike other medical fields, epidemiology is a philosophy and methodology that can be applied broadly. Successful application requires creative use of strategies and methods to answer specific health questions. Epidemiology describes disease patterns in terms of time, place, and person to understand causative agents and risk factors in order to suggest interventions.
This document summarizes the key functions and applications of epidemiology. It discusses how epidemiology studies the spread of diseases and allows for the control and prevention of illnesses. Important discoveries are highlighted, such as Semmelweis' finding that handwashing can prevent the spread of infections in hospitals. Epidemiology also researches the causes of diseases and develops vaccines to help control diseases in populations.
This document discusses the debate around AIDS exceptionalism. It argues that AIDS requires an exceptional response in some contexts but not others. Specifically:
- In countries with low HIV prevalence, AIDS should be normalized and treated as a public health issue, while still addressing the human rights and stigma faced by at-risk groups.
- In countries with mid-level prevalence, AIDS can also be normalized except where treatment depends on outside resources, as is the case in most African countries, due to sustainability challenges.
- Countries with high HIV prevalence over 10% still require an exceptional response, due to substantial morbidity, mortality, and challenges providing effective prevention and treatment programs. The impacts on demography, society and development are significant
The document discusses neglected tropical diseases (NTDs), including their origin, features, global burden, and approaches to control. Some key points:
1. NTDs refer to a group of chronic, debilitating diseases that primarily affect the world's poorest people in tropical areas. There are currently over 40 NTDs.
2. NTDs disproportionately impact over 1 billion people living on less than $1.25 per day and result in over 500,000 deaths and 25 million disability-adjusted life years lost annually.
3. Control approaches include mass drug administration, vaccination, and public health measures to help reduce transmission and morbidity of NTDs.
This review summarizes 36 studies on disability and HIV/AIDS in Africa from 2000 to 2008. The studies used qualitative, quantitative, and mixed methods to examine vulnerability to HIV infection and access to prevention and treatment among people with disabilities. Key findings include that people with disabilities perceive themselves as vulnerable to HIV due to limited access to information and health services. However, prevalence data and studies across different disability groups are limited. Most research focused on eastern and southern Africa, with little data from western Africa. [END SUMMARY]
After Madeira Island experienced its first dengue outbreak in 2012, the authors conducted a study to compare community perceptions about dengue prevention before and after the outbreak. They found that more female residents understood key concepts about dengue prevention after the outbreak, but there was no significant difference in the number who achieved a minimum understanding. Additionally, most residents (95.5%) still believed at least one myth about dengue prevention, and some new myths emerged after the outbreak. The experience of the outbreak surprisingly led to both improved understanding of concepts and the spread of new misconceptions.
Commentary _social_epidemiology__questionable answers and answerable questionsBsie
This document summarizes a paper that was presented at the Third North American Congress of Epidemiology in 2011. The paper discusses the changing field of social epidemiology, which examines relationships between health and social factors like socioeconomic status, gender, and social policies. While social epidemiology was once a fringe field, it is now a prominent area of epidemiology. However, some argue that social epidemiology often answers descriptive questions about associations rather than causal questions about interventions, and thus provides "policy-free evidence" that does not directly inform policies to reduce health inequalities. The paper examines studies that have tried to answer more causal questions through alternative study designs like natural experiments and randomized trials.
AIDS - Status & challenges of the epidemicGreenFacts
In just 25 years, HIV has spread relentlessly from a few widely scattered “hot spots” to virtually every country in the world, infecting 65 million people and killing 25 million.
What has been done since 2001 and what can be done in the future to halt the spread of AIDS?
Note: Figures have been updated in 2008.
From diagnosis to social diagnosisAuthor Phil Brown Mercedes Lys.docxshericehewat
From diagnosis to social diagnosis
Author Phil Brown Mercedes Lyson, Tania Jenkins
Abstract
In the past two decades, research on the sociology of diagnosis has attained considerable influence within medical sociology. Analyzing the process and factors that contribute to making a diagnosis amidst uncertainty and contestation, as well as the diagnostic encounter itself, are topics rich for sociological investigation. This paper provides a reformulation of the sociology of diagnosis by proposing the concept of ‘social diagnosis’ which helps us recognize the interplay between larger social structures and individual or community illness manifestations. By outlining a conceptual frame, exploring how social scientists, medical professionals and laypeople contribute to social diagnosis, and providing a case study of how the North American Mohawk Akwesasne reservation dealt with rising obesity prevalence to further illustrate the social diagnosis idea, we embark on developing a cohesive and updated framework for a sociology of diagnosis. This approach is useful not just for sociological research, but has direct implications for the fields of medicine and public health. Approaching diagnosis from this integrated perspective potentially provides a broader context for practitioners and researchers to understand extra-medical factors, which in turn has consequences for patient care and health outcomes.
Highlights
► “Social diagnosis” recognizes interplay between social structures and illness manifestations. ► Case study shows how Mohawk Akwesasne dealt with rising obesity. ► Provides broad context for practitioners and researchers to understand extra-medical factors.
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Keywords
Diagnosis
Risk
Social movements
Environment
Public health
USA
Canada
Reservations
Introduction
Sociological analysis of diagnosis has achieved considerable influence in the last two decades, providing important insight into how we understand health, disease, and illness. It has also expanded how we view the social and cultural influences that shape our knowledge and practice on health and illness. This includes studies of diagnosis that have gone beyond the interaction between physician and patient, to take into account the larger social, structural, and temporal forces that shape diagnosis (see, for example, the categorization of homosexuality as a mental disorder and the role of gay rights activists in the American Psychiatric Association’s deliberations) (Cooksey & Brown, 1998).
Recently we have also seen the emergence of diseases whose etiologies, symptoms, and, therefore, diagnoses, are often contested or uncertain. This combination of medical and social uncertainty leads us to propose a reformulation of the concept social diagnosis as a new way of thinking about the sociology of diagnosis. This paper explores social diagnosis by first, outlining a conceptual framework of social diagnosis; second, discussing the different acto ...
This document discusses the NHLBI's PRIDE program, which aims to increase diversity in the biomedical research workforce by providing mentoring and research skills training to investigators from underrepresented backgrounds. It notes that while issues like health disparities and underrepresentation in research have been recognized for decades, progress has been slow. The PRIDE program addresses these issues by matching mentees with experienced mentors over a two-year period to enhance research skills and facilitate career development. The document highlights positive feedback from mentees about how PRIDE mentoring has helped support their careers. It also summarizes the design of four PRIDE summer institutes focused on cardiovascular disease and related health issues.
On July 1, 1665, the lordmayor and aldermen of thecity of Lo.docxvannagoforth
On July 1, 1665, the lordmayor and aldermen of the
city of London put into place a set
of orders “concerning the infec-
tion of the plague,” which was
then sweeping through the popula-
tion. He intended that these
actions would be “very expedient
for preventing and avoiding of
infection of sickness” (1).
At that time, London faced a
public health crisis, with an inade-
quate scientific base in that the
role of rats and their fleas in dis-
ease transmission was unknown.
Nonetheless, this crisis was faced
with good intentions by the top
medical and political figures of
the community.
Daniel Defoe made an observation that could apply to
many public health interventions then and today, “This
shutting up of houses was at first counted a very cruel and
unchristian method… but it was a public good that justi-
fied a private mischief” (1). Then, just as today, a complex
relationship existed between the science of public health
and the practice of public health and politics. We address
the relationship between science, public health, and poli-
tics, with a particular emphasis on infectious diseases.
Science, public health, and politics are not only com-
patible, but all three are necessary to improve the public’s
health. The progress of each area of public health is relat-
ed to the strength of the other areas. The effect of politics
in public health becomes dangerous when policy is dictat-
ed by ideology. Policy is also threatened when it is solely
determined by science, devoid of considerations of social
condition, culture, economics, and public will.
When using the word “politics,” we refer not simply to
partisan politics but to the broader set of policies and sys-
tems. Although ideology is used in many different ways, in
this case, it refers to individual systems of belief that may
color a person’s attitudes and actions and that are not nec-
essarily based on scientific evidence (2).
Public Health Achievements
Science influences public health decisions and conclu-
sions, and politics delivers its programs and messages.
This pattern is obvious in many of public health’s greatest
triumphs of the 20th century, 10 of which were chronicled
in 1999 by the Centers for Disease Control and Prevention
(CDC) as great public health achievements, and several of
which are presented below as examples of policy affecting
successes (3). These achievements remind us of what can
be accomplished when innovation, persistence, and luck
converge, along with political will and public policy.
Vaccination
Childhood vaccinations have largely eliminated once-
common, terrible diseases, such as polio, diphtheria,
measles, mumps, and pertussis (4). Polio is being eradicat-
ed worldwide. The current collaboration between the
World Health Organization, the United Nations Children’s
Fund, CDC, and Rotary International is a political as well
as biological “tour de force,” and eradication of polio in
Nigeria has been threatened by local political struggles and
decisions. ...
John Snow is considered the father of epidemiology for his work investigating a cholera outbreak in London in 1854. Through mapping the locations of cholera cases and the water sources people used, Snow was able to determine that the source of the outbreak was the Broad Street water pump. Removing the pump handle stopped the outbreak. Snow's use of statistical mapping methods to identify the source of transmission pioneered epidemiological investigation techniques that are still used today.
Baral et al. BMC Public Health 2013, 13482httpwww.biomed.docxjasoninnes20
Baral et al. BMC Public Health 2013, 13:482
http://www.biomedcentral.com/1471-2458/13/482
DEBATE Open Access
Modified social ecological model: a tool to guide
the assessment of the risks and risk contexts of
HIV epidemics
Stefan Baral1*, Carmen H Logie2, Ashley Grosso1, Andrea L Wirtz1 and Chris Beyrer1
Abstract
Background: Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These
factors are representative of social, economic, organizational and political inequities. Associated with an improved
understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV
prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires
epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages.
Discussion: Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or
penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and
structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is
often far more actionable than characterizing individual-level risks. We propose a modified social ecological model
(MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic
HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key
populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The
MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual
HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The
utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM.
Summary: The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV
in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective
integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic
studies has traditionally been on describing individual-level risk factors, the future necessitates comprehensive
epidemiologic data characterizing multiple levels of HIV risk.
Background
There is an increasing recognition of the importance of
the social and structural drivers of acquisition and trans-
mission of HIV [1,2]. While there is no singular defin-
ition, structural drivers can be conceptualized as those
social, economic, organizational, and political power and
domination factors which contribute to social inequities
[2-4]. These structural drivers do not directly cause the
acquisition or onward transmission of HIV; rather they
* Correspondence: [email protected]
...
This document discusses disease surveillance research. It explains that disease surveillance involves the ongoing collection, analysis, interpretation, and dissemination of health data to monitor disease trends and improve public health. A reductionist approach looks at isolating variables to find cause-and-effect relationships, while a complex systems approach considers adaptive and multilevel systems in context. The document also discusses the roles and competencies needed for nurses to participate in surveillance and investigation activities.
Intensive Healthcare Facilities and Rooms.pdfbkbk37
1) Pandemic preparedness in healthcare facilities is important to minimize the impact and spread of pandemics.
2) Current healthcare facilities are often underprepared with inadequate equipment, supplies, and training to effectively respond to pandemics.
3) Developing comprehensive pandemic preparedness policies and strategies can help healthcare workers obtain necessary resources to fight pandemics and save lives.
Similar to Rethinking the conceptual terrain of aids scholarship 1744 8603-5-12 (20)
- Child and adolescent marriage is common in many developing countries, with over 30% of girls married by age 18.
- Married adolescent girls have little power to negotiate safe sex and are often in unions with much older husbands, increasing their risk of HIV.
- Data from 29 countries show that the majority (over 80% in most) of sexually active adolescent girls who had unprotected sex recently were married.
- HIV prevalence tends to be higher among married adolescent girls than sexually active unmarried adolescents in some settings, highlighting marriage is not always protective against HIV risk for adolescent girls.
This document summarizes the history and current understanding of the AIDS epidemic. It discusses how AIDS has become one of the most studied diseases and our understanding of its medical and social drivers has deepened over time. However, the impacts are still unfolding over generations and varying significantly between places. While early models predicted severe economic impacts, some hard-hit countries have maintained growth. Understanding the social impacts remains challenging given the epidemic is only 25 years old.
Young women in South Africa are disproportionately affected by HIV/AIDS, with infection rates four times higher than young men. Researchers conducted a study examining how poverty, orphanhood, and social isolation relate to risky sexual behaviors. They developed a pilot intervention program to enhance life options for at-risk youth through safe social spaces, financial literacy training, and HIV/AIDS education. Preliminary findings show the intervention was associated with improved knowledge, attitudes, and behaviors regarding self-esteem, finances, and HIV prevention among participants.
1. The document summarizes a case study of an HIV/AIDS impact assessment conducted on a South African contract cleaning company with 500 employees.
2. Key findings include that 31% of employees tested were HIV positive, with the highest levels of infection among women aged 35-40.
3. The estimated average cost to the company for each newly infected employee is 9,007 Rand, which is 63.2% of the average annual salary. However, the overall financial cost of HIV/AIDS to the company is projected to decrease over time from 1999 to 2015.
The document discusses challenges in linking health research to policy in Ghana. It describes how the Research and Development Division of the Ghana Health Service used a collaborative approach to build consensus on research priorities related to orphans and vulnerable children affected by HIV/AIDS. Through stakeholder consultations, gaps in understanding this issue were identified and a research study was undertaken to assess the situation of HIV-affected children. The study informed policy by providing evidence on how to best support these children within their communities rather than institutions.
This document discusses how the conceptualization of HIV as a "long-wave event" needs to be revisited given increased access to antiretroviral therapy (ART). Originally, HIV was seen as involving three curves: an HIV curve, an AIDS curve, and a societal impact curve. However, widespread ART has shifted HIV from a terminal illness to a chronic condition for many. This prompts reconsidering disability as a new form of the second curve, representing transition from HIV infection to HIV-related disability for those on long-term ART. At a population level, experiences of disability are expected to become common for people living with HIV in coming decades, with implications for health and social services.
The document summarizes a project in KwaZulu Natal, South Africa that aims to build assets and reduce vulnerability among youth. It describes the socioeconomic challenges in the region like poverty, unemployment, and HIV. The project uses participatory learning with boys and girls to prepare them for opportunities and risks. Students are randomized into groups receiving different combinations of HIV education, social support, and financial capability training. Evaluations assess changes in knowledge, behaviors, and economic outcomes through surveys, interviews, and diaries. Preliminary findings show improvements in areas like budgeting skills, savings, and social networks.
The document summarizes a study that assessed the impact of a 2007 report titled "Reviewing 'Emergencies' for Swaziland." The report analyzed socioeconomic data to portray the HIV/AIDS epidemic in Swaziland as a humanitarian crisis and call for an emergency response. To evaluate the report's influence, researchers conducted interviews and distributed questionnaires. They found the report initially raised awareness and shifted perceptions of the crisis. In the long-term, it influenced policy by contributing to changes in funding and emergency classifications. While attribution is difficult, the assessment demonstrated research can provide insights into maximizing future impact.
This study investigated the psychosocial and behavioral correlates of attitudes towards antiretroviral therapy (ART) in South African mineworkers. 806 mineworkers at a large South African mine participated. Despite high HIV testing rates and generally favorable attitudes towards ART, temporary employees and contractors were found to be more vulnerable in terms of HIV risk, testing behaviors, and knowledge/attitudes about ART. Employees with more positive ART attitudes had greater ART knowledge and more positive views of the mine's HIV/AIDS treatment program. The findings are discussed in relation to the mine's low ART uptake rates and recommendations are provided.
The document discusses challenges in linking health research to policy in Ghana. It describes how the Research and Development Division of the Ghana Health Service used a collaborative approach to build consensus on research priorities related to orphans and vulnerable children affected by HIV/AIDS. Through stakeholder consultations, gaps in understanding this issue were identified and a research study was undertaken to assess the situation of HIV-affected children. The study informed policy by providing evidence on how to best support these children within their communities rather than institutions. The experience highlights the value of engaging multiple stakeholders to ensure research meets social needs and informs policymaking across sectors.
This document discusses how organizations can act as "boundary organizations" to promote evidence-based policymaking. It uses the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL) as a case study. RENEWAL aims to enhance understanding of the links between HIV/AIDS and food security in Africa. It builds networks between researchers and policymakers to identify policy-relevant research topics and facilitate communication. The document analyzes RENEWAL's experiences networking with South African government officials to encourage use of research evidence in policy. It draws lessons on effective strategies for engaging policymakers and getting research into policy and practice.
1) The document summarizes a report on the impact of HIV/AIDS in Swaziland, which has the highest HIV prevalence rate in the world at 42%.
2) The report used socioeconomic indicators to build a comprehensive picture of how HIV/AIDS has created a humanitarian crisis in Swaziland comparable to a conflict or natural disaster.
3) An evaluation found that the report raised awareness of the crisis and challenged international perceptions of Swaziland as a "middle income country" not requiring significant support for its HIV epidemic.
- Explicit insurance does not offer a panacea for HIV/AIDS service coverage on its own. Where insurance systems already exist, they can be expanded to include HIV/AIDS services.
- Introducing social health insurance is complicated and will take time to cover all people. The process should not be rushed and existing mechanisms should continue in the meantime. Some people will remain inadequately covered and should not be forgotten.
- Political commitment is indispensable for including HIV services in any coverage mechanism. A political-economy analysis will be useful. Financial feasibility is also key, and external funding may be needed initially before being replaced by government funds over time. Not all people will be able to contribute to insurance schemes
This document provides an overview of mental health promotion initiatives for children and youth in contexts of poverty in South Africa. It discusses:
1) Critical risk influences on early childhood development like poor nutrition, maternal depression, and lack of early childhood services in South Africa and evidence that mental health promotion programs can help mediate these risks.
2) Examples of mental health promotion programs in South Africa that have shown benefits for early childhood development, including a home visitation program and programs to reduce alcohol use in pregnancy.
3) Risk influences on middle childhood development in South Africa and how mental health promotion programs may help mediate risks like poor family environments and schooling.
This document summarizes a study that examined how gender and socioeconomic status interact with peer norms and attitudes to influence sexual risk behaviors among youth in a poor, urban community in South Africa. The study uses a social cognitive approach to measure attitudes, beliefs, intentions, and perceived control related to sexual behavior. It reviews literature on factors that influence HIV risk for South African youth, including socioeconomic status, gender-based violence, and psychosocial factors like peer norms. The findings of this study provide insight into how interventions can address the complex ways gender interacts with these other issues to impact youth sexual health outcomes.
This document summarizes a mixed methods study conducted in KwaZulu-Natal, South Africa to design and evaluate an intervention program aimed at improving the health, economic, and social capabilities of adolescents at high risk for HIV/AIDS, teenage pregnancy, and other issues. The intervention incorporated life skills education into the school day and was evaluated using longitudinal surveys, focus groups, and interviews with participants, guardians, and facilitators. The mixed methods approach allowed for iterative improvement of the program and instruments as well as triangulation across data sources. Preliminary results were promising and the Department of Education was interested in scaling up the program.
The document summarizes a program called Siyakha Nentsha in KwaZulu-Natal, South Africa that aims to build capabilities among adolescents threatened by HIV/AIDS. It describes the socioeconomic challenges in the region like poverty, unemployment, early pregnancy and school leaving. Research found these factors associated with higher HIV risk behaviors. The program provides evidence-based, multi-session curriculum on HIV prevention, resource management, and future planning to empower participants. Preliminary feedback suggests it improves attitudes, knowledge, aspirations, and agency. The goal is to scale it up through the Department of Education.
This document summarizes findings from a pilot program in South Africa that aimed to address social and economic factors influencing HIV risk among youth. Formative research found that youth living in poverty, lacking social connections, being orphaned, or not enrolled in school were more vulnerable. The pilot program provided weekly sessions for groups of 10-20 youth to reduce social isolation, increase financial literacy, and teach about sexuality/STIs/HIV. Emerging findings showed participants had larger increases than comparisons in discussing contraception, HIV/AIDS, and gender-based violence, and greater improvements in savings behaviors. Participants reported the program was an "eye-opener" and helped them understand health issues not covered in school. Next steps include a full evaluation and
The Siyakha Nentsha program in KwaZulu-Natal, South Africa aims to improve the capabilities and well-being of adolescents at high risk for HIV, teenage pregnancy, school dropout, and more. The program was developed using formative research that identified structural factors associated with adolescent HIV risk behaviors such as poverty and lack of social connections. It provides knowledge and skills for pregnancy and HIV prevention, economic empowerment, and social support. Evaluations found that participants had increased discussion of sensitive topics, financial literacy, condom use confidence, and ability to open a bank account compared to non-participants. The program is being considered for scale-up in partnership with the Department of Education.
Swaziland has the highest HIV prevalence in the world, with prevalence among pregnant women rising from 3.9% in 1992 to 42.6% in 2004. Every sector of Swazi society is struggling to cope with the impacts of the epidemic, which include rising mortality, mass orphaning, and declines in agricultural production. The situation has been exacerbated by gender inequality, drought, insufficient financial resources, and a lack of accountable domestic governance and ill-suited policies from international organizations. Without greater support from the Swazi government and international donors, community-led interventions may be undermined.
More from ABBA RPC (Addressing the Balance of Burden in HIV/AIDS) (20)
2. Globalization and Health 2009, 5:12 http://www.globalizationandhealth.com/content/5/1/12
Likewise, some AIDS researchers and advocates point to This conceptual paper is suggesting that conceptual over-
the limitations inherent in popular "techno-fix" responses laps and differences within AIDS and climate change
(e.g. the focus on microbicides and circumcision at the research may provide insights into future HIV/AIDS schol-
2006 International AIDS conference), noting the contin- arship. It does not seek to study AIDS and climate change
ued challenges involved in understanding and changing together in any substantive way, nor does it argue for links
the underlying social structures that fuel the uneven between HIV spread and climate change or vice versa.
spread and burden of AIDS epidemics [3,4]. This paper
specfically addresses these and other key conceptual limi- Discussion
tations through a novel comparative analysis of historical HIV/AIDS Research and Response: Over 25 Years
trends and contemporary debates within HIV/AIDS and To understand the central limitations within contempo-
climate change scholarship. rary AIDS scholarship and, ultimately, suggest ways in
which climate change research could inform these, a basic
Research on AIDS and on climate change share certain historiography is required. The history of AIDS research
similarities. Scholars in both areas are struggling to under- and response can be divided into the early years (1981-
stand phenomena that are unprecedented, complex and 1996) and the later years (1996-2008). This is not an all-
highly dynamic, and that have different impacts on differ- inclusive review (for lengthier and more comprehensive
ent people and places. In both, "social vulnerability" is accounts, see [7]); rather, based on key research papers,
emerging as a key scholarly theme (e.g., [5,6]). Research policy documents, international responses, and major
on these two major world issues has followed similar tra- conferences, this section aims to anchor the major con-
jectories, starting from a physical or life sciences perspec- cepts examined in this paper within their historical, intel-
tive and working to integrate social sciences. There exist lectual and political foundations. The dominant research
conceptual overlaps, similar limitations, and the begin- themes from 1981 to 2008 are summarized in Figure 1
nings of a dialogue between development practitioners [adapted from [7,8]].
and researchers in these two fields. This is especially true
in southern Africa, as evidenced by partnering of climate The early years 1981 - 1996
change and AIDS specialists in such research initiatives as The unusual clustering of the disease that make up AIDS
Southern Africa Vulnerability Initiative (SAVI) and was first recognised in 1981 in the USA, and growing
Regional Network on AIDS, Livelihoods and Food Secu- numbers of similar immune deficiency diseases were soon
rity (RENEWAL). identified in Europe, Australia, New Zealand and Latin
America. In central Africa, health workers were observing
This paper compares and contrasts the evolution of cli- ailments not previously seen: reports of deaths from wast-
mate change and AIDS research, suggesting that scholars ing in Uganda [7]; Kaposi's sarcoma (a cancer) in Zambia
can learn from a comparative analysis of key debates and [9] and cryptococcosis (an unusual fungal infection) in
trends within climate change and AIDS scholarship. It Kinshasa [10]. In July 1982, the disease was officially
addresses four conceptual limitations in the AIDS field: named Acquired Immune Deficiency Syndrome (AIDS),
(1) the "globalization" of AIDS discourses and the associ- and in 1983 the cause, the human immunodeficiency
ated masking of uneven vulnerabilities to infection and virus (HIV), was identified.
impact; (2) the highly medical framing of AIDS and ten-
dency to seek technical solutions; (3) the polarization of Early research was dominated first by the medical/life sci-
debates within the field; and (4) the crisis-orientation that ences, and then by public health and epidemiology. Sci-
has characterized AIDS research and response. entists sought to understand what was causing the disease
and how it was transmitted in order to prevent its further
The paper outlines the evolution of, and current trends in,
each area of study. It explores parallels and divergences
Human rights &
between AIDS and climate change research, noting espe- causes
cially the forward-looking and longer-term focus of cli-
mate change research and the sophistication of social Public health Treatment & ‘global
response threats’
vulnerability concepts in this field. It ends by suggesting
opportunities for advancing AIDS research. (It is notewor- Science & search for Re-medicalization &
cause costs
thy that this is largely a one-way analysis looking at
extending AIDS research. While a similar analysis examin- 1981 2008
ing the ways in which AIDS scholarship could provide
insights to climate change scholars would be equally Figure 1
Dominant Research Themes in HIV/AIDS
worthwhile, this is beyond the scope of this paper.) Dominant Research Themes in HIV/AIDS.
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3. Globalization and Health 2009, 5:12 http://www.globalizationandhealth.com/content/5/1/12
spread, alleviate symptoms, prolong lives and, ultimately, deaths, however, there was little focus on broader
eradicate the virus. Early responses were scientific and social and economic impacts.
technical (and prevention-oriented): improving blood
safety, providing condoms, encouraging safe injection The later years: 1996 - 2008
practices, and searching for potential treatments and vac- By 1996, there were major changes in response to HIV/
cines. AIDS, reflecting and reflected in much of the scholarship.
There was a shift from the previous "science-epidemiol-
It quickly became apparent that medical/technical ogy" focus to a proliferation of scholarship and institu-
approaches were insufficient, as no cure or vaccine could tional interest around understanding the social and
be readily developed, and providing condoms did not economic dimensions of epidemics. The new UN agency
lead to the widespread adoption of safer sexual practices. charged with co-ordinating the response to the epidemic -
Thus, by the 1990s, AIDS research began to shift away UNAIDS - began operations in Geneva in 1996, acknowl-
from its initial medical, scientific and technical founda- edging the need for comprehensive responses to AIDS epi-
tions: there was growing scholarly interest in the individ- demics, and recognizing that such multi-faceted (social,
ual, social, and economic milieu that lead to vulnerability economic, behavioural, developmental, medical)
to HIV infection, and a recognition that social justice, pov- responses reached beyond realm of "health."
erty and equity issues were driving the uneven spread of
the virus within and between communities and societies This shift away from the medical/technical focus did not
[11,12]. last long, however. The same year, at the XI International
AIDS Conference in Vancouver, it was announced that
Among the pioneers of this shift was Dr. Jonathan Mann, effective new drugs to treat AIDS had become available.
head of the Global Programme on AIDS in the World The result was a swell of interest in medical interventions;
Health Organisation (WHO). In 1986 he began deploying but with costs running at $12000 per patient per year con-
teams to developing countries, to start national AIDS pro- cerns around unequal and inequitable access emerged. By
grammes [13]. This was the first sign of international insti- the XIII International AIDS Conference in Durban in
tutional focus on the social (and equity) dimensions of 2000, these issues were squarely on the agendas of all
the epidemic. It is noteworthy, however, that outside of involved in HIV/AIDS.
the WHO, AIDS was not yet placed on the agenda of any
United Nations (UN) agencies; indeed, international Responses to AIDS have since been dominated by new ini-
responses between 1986 and 1996 were characterized by tiatives for making treatment accessible, especially in
denial, underestimation, and over-simplification (i.e., developing countries. This led to a re-medicalization of
conceptualizing HIV/AIDS solely as a medical issue)[14]. HIV/AIDS and increasing international pledging of
It was not until the end of this period that the work of Dr. resources (see Figure 1). The development of generic
Mann gained wider ascendancy, and social scientists, drugs meant the price of medicine had fallen to about
activists, and international advocates called heavily upon $100 per patient per year by 2008. In 2001, UN Secretary
human rights approaches in understanding and respond- General, Kofi Annan called for spending on AIDS to be
ing to the epidemic (see Figure 1). Interestingly the recent increased ten-fold in developing countries, the Global
WHO report on the social determinants of health reflects Fund for AIDS, TB and Malaria was established, and Pres-
this thinking, which is ignored in HIV[15]. ident George W. Bush pledged $15 billion toward his
Presidential Emergency Programme for AIDS Relief (PEP-
Thus the first 15 years of the epidemic may be summa- FAR). In 1996 there was about $300 million for HIV/AIDS
rised as follows: in low and middle income countries; by 2008 this
increased to $13.7 billion[16]. Among this international
• The first response, combining an epidemiology and mobilization, concerns for social drivers and underlying
public health perspective, aimed at understanding vulnerabilities were largely subsumed by renewed hope
transmission, who was at risk, and how the spread for medical solutions.
could be prevented.
With the turn of the millennium, discourses around AIDS
• Once the virus was identified, science sought treat- also became increasingly "globalized" (that is the impacts
ments and biomedical answers. Alongside this were of AIDS in developing countries were deemed an issue of
attempts to prevent the spread by promoting safer sex "global concern"). The globalization of AIDS discourses
and injecting practices. and the impetus for global response were further pro-
pelled by an international trend toward securitization and
• By the end of the period, human rights approaches a language of "global threats". In 2000, United States vice
were gaining ascendancy; attention turned to why peo- president, Al Gore said: "it (HIV) threatens not just indi-
ple are exposed to HIV. Despite growing numbers of vidual citizens, but the very institutions that define and
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4. Globalization and Health 2009, 5:12 http://www.globalizationandhealth.com/content/5/1/12
defend the character of a society. ... It strikes at the mili- (be they among homosexual, intravenous drug users or
tary, and subverts the forces of order and peacekeeping." African populations) toward concerns for the "global
The US National Intelligence Council then produced its AIDS pandemic". This globalized discourse, however,
"The Global Infectious Disease Threat and Its Implica- misses the differentiated nature of both the spread of the
tions for the United States"[17]. Six months later, the UN epidemic and its impact. There remains a tension faced by
Security Council passed Resolution 1308, stating: "the those working in the field of AIDS: finding a balance
HIV/AIDS pandemic, if unchecked, may pose a risk to sta- between overstating the case (and potentially homogeniz-
bility and security"[3]. ing what is a very uneven and differentiated 'threat') and
the risk of understating it (or limiting who feels com-
Whether based in sound evidence or not, this dialogue pelled to take responsibility) and risking getting fewer
marked an important shift in thinking about HIV/AIDS as resources [18].
an epidemic that could potentially have widespread
implications among even the most affluent and powerful. Theme 2: Re-medicalisation and scientisation
Most recently, with the continued pledging of large sums Also discussed above, with the development of effective
of money, this "globalization" in the conceptualization of treatments in the mid-1990s, the tendency towards a (re)-
AIDS impacts and responses has extended into concerns medicalisation of the epidemic gained momentum. This
over "global governance" (to be discussed further in the was further propelled by the decline in drug prices and the
section that follows). increased flow of resources. Besides the initial focus on
antiretroviral treatment (ARV), the re-medicalization of
The hallmarks of the past 12 years were: AIDS research and response saw renewed hope placed on
other potential medical and technological "solutions",
• Treatment became available and prices of drugs such as vaccines, microbicides and circumcision.
plummeted. With this, scholarly concerns with social Although there has been continual expectation of break-
drivers and underlying vulnerabilities were largely throughs, there are still no solutions. Resources keep on
overtaken by enthusiasm for treatment and renewed being poured into scientific/medical research through
hope in medical intervention. new avenues such as the International AIDS Vaccine Initi-
ative and by the new philanthropies such as the Gates
• The level of resources grew rapidly and new global Foundation marking an overwhelming international
initiatives were announced. desire for a scientific or technological "fix" to HIV/AIDS.
• The language of security and threat to global order Theme 3: The polarization of debates
was used, resulting in a further globalization of AIDS Throughout the history of AIDS research and response,
response and discourse. there has been a tendency toward polarized debates,
depicted by a series of "either-or" framing of responses
• However, the number of infections continued to rise, (i.e. debating the need for treatment versus prevention, as
especially in southern Africa. has happened among multilateral institutions, or the
need for drugs versus nutrition, as has been the case in
HIV/AIDS: Current Themes many African contexts, most notably in South Africa
The particular orientation of AIDS response and scholar- [19]). In addition, among an international contingent of
ship outlined above has in turn prompted a multidimen- "dissident" scientists and politicians, there has been a
sional and vibrant field of research and scholarly debates. questioning of both the data collected on HIV/AIDS and
Four current trends are outlined below; these will be revis- the science itself [20].
ited at the end of the paper in order to suggest future direc-
tions for AIDS research. Theme 4: Focus on crisis intervention
The evolving response of the AIDS field has focussed on
Theme 1: Tendency toward "globalized" discourses intervening in developing crises. As new clusters of dis-
As discussed above, in HIV/AIDS arenas, discourses have eases emerged, the emphasis was on understanding the
become "globalized". This manifests in the language of epidemiology and biology. As the syndrome began to
"global threats" which is still used (e.g., the 2006 AIDS, spread, prevention and behaviour came into focus. As
Security and Conflict Initiative (ASCI)). Issues of "global issues of equity and discrimination emerged, human
governance" have become central as large sums of money rights were placed on the agenda. As treatment became
are pledged. Moreover, in AIDS research the "globalized" available, discussion around costing, access and patenting
language is clearly captured in a shift that took place in the grew. Most recently, as the magnitude of illness and death
1990's - the majority of international organizations in parts of Africa is beginning to have society-wide effects,
shifted gear from an earlier focus on isolated "epidemics" attention is turning toward understanding impacts. The
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overarching trend is that AIDS research been reactive, his-
Social Vulnerability
torically - it has focused predominantly on crisis interven-
tion, not on understanding the complex and place- Equity
specific drivers of infection and impacts. Notable excep-
tions include Campbell and Stillwaggon [21,22]. Human Adaptation
Mitigation
Despite this tendency, some scholars have identified AIDS
as a "long-wave event" recognizing that AIDS epidemics Future Impacts
can take over 100 years to work through society[23]. Thus,
Climate Science
impacts from the current epidemic will last decades. The
notion that AIDS is a long-wave event and the conceptual 1989 1995 2001 2007
implications of this for social vulnerability research will
be discussed in subsequent sections. Based on Four Assessment Reports: IPCC
Figure 2
Trends in Climatic Change Research
An Evolution of Climate Change Research Trends in Climatic Change Research. 1989, 1995, 2001,
Climate change research has also matured considerably 2007.
over the past 27 years, although until very recently there
have been limited interactions between climate change
and HIV/AIDS communities. This section provides an Figure 2 also indicates that, as with the HIV/AIDS field,
overview of key concepts that have framed climate change the IPCC's foundations are based in science, in this case
research. The existence of anthropogenic climate change is physical climatic sciences including the reconstruction of
now well established (for example, see [24,25]) thus we past climates, the understanding of current climates, and
do not attempt to summarize this research here. Instead, the projection of future climates. The first two reports
we purposefully review the evolution of four major were dominated by climate sciences, reflected in the rapid
themes within climate change research. evolution of broad-scale modelling throughout the 1980s
and 1990s.
The creation of an international agency to address climate
change occurred about eight years, prior to the creation of Although social science contributions lagged behind the
UNAIDS. With growing evidence that human activities development of the physical sciences, there has been a
were altering the Earth's climate throughout the 1980s, proliferation of this research recently. In the first two IPCC
the Intergovernmental Panel on Climate Change (IPCC) reports, the social sciences focused on climate mitigation
was created in 1988 by the World Meteorological Organi- options - looking at how to reduce greenhouse gas (GHG)
zation (WMO) and the United Nations Environment Pro- emissions or recapture and sequester carbon generated by
gram (UNEP) with the mandate to assess scientific, human activities[36]. By the mid-1990s, research into cli-
technical and socio-economic information. IPCC is mate change impacts (i.e., how climate change is affecting
employed in this paper as a window into climatic change and will affect different communities) and human adapta-
research; its four assessments, in 1990, 1995, 2001 and tion (i.e., how people are able to respond to various
2007, provide an effective mirror of research trends in this stresses in their environments) was underway. The uncer-
field [24,26-30]. Note that although IPCC is highly influ- tainties associated with future impacts on a wide range of
ential in both research and policy (e.g., has been co- economic activities were featured in the 1989 report,
awarded the Nobel Peace Prize), and although it employs while the technical feasibility of both mitigation (reduc-
a meticulous peer review process (David Suzuki Founda- ing/limiting greenhouse gases (GHG)); and adaptation
tion[31]), its assessments remain controversial among (finding ways to reduce potential impacts through techni-
some scientists [32,33]. Nevertheless, given the compre- cal means or by changing where and how certain commu-
hensiveness of the IPCC assessment process (one for nities live), only began to emerge by 1995.
which there is no parallel within AIDS research), we have
selected to draw heavily on this in our review of climatic Since the mid-1990s, multiple calls to refocus social sci-
change research; this is not intended as a commentary on ence contributions have sparked considerable research,
IPCC as an institution or on its major findings. especially in the areas of equity [37,38] and social vulner-
ability [5,39]. Equity issues have emerged in at least two
Figure 2[34,35] summarizes the progression of key related ways: first, attention to achieving more fair repre-
themes within the four IPCC reports. As this schematic sentation within the science communities participating in
indicates, the IPCC has always adopted a forward-looking climate change research (so that research coming out of
approach; understanding the potential impacts of future non-Western institutions are given voice in international
climate change has been a central theme since 1989. assessments); second, increasing awareness about the dis-
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location between countries which are contributing to cli- potential "techno-fixes" like switching from coal-fired
mate change and countries that will be adversely impacted power to renewable energy sources, improving energy effi-
[40-42]. ciency in buildings, and introducing more effective eco-
nomic incentives to support mitigation efforts. Full-out
These trends within the IPCC has directly contributed to reduction in consuming fossil fuels, particularly among
the growing awareness that those most responsible for affluent communities, remains rather silenced in current
causing climate change are not the ones who are most discussions.
likely to bear the greatest negative consequences. Indeed,
a key finding from the Small Island States chapter in 2001 Moreover, the "globalness" of climate change - the global-
was as follows: "The small island states account for less scale nature of the science and the discourses of global-
than 1% of global GHG emissions but are among the scale threats - was a major factor leading to IPCC's crea-
most vulnerable of locations to the potential adverse tion in 1989 and remained a primary concern in 2007.
impacts of climatic change and sea-level rise" [41]. This is evident in the most recent report, which assesses
the extent to which "impacts may change at larger
With growing concerns around the inequitable distribu- increases in global mean temperature," focusing on world-
tion of potential impacts, came the need to better under- wide impacts that may occur as average temperatures rise
stand what makes certain groups and places particularly [46]. By focusing on "the global", however, the chapter
vulnerable and determines how effectively they respond follows much of the popular and academic climate
to potential stresses. While the underlying (and uneven) change discourse: it obscures the regional variability that
social, economic, political and geographical factors driv- is expected to characterize future changes in climate as
ing what has become known as "social vulnerability" were well as the unevenness in response capacities across and
virtually absent from the first two IPCC assessments, this within nations. Climate change is a global phenomenon,
has now emerged as a central issue in the field. This is but the preoccupation with this perspective diverts atten-
reflected in a number of ways: the recent chapter title, Cli- tion away from the unevenness in GHG emissions and the
mate Change Impacts, Adaptation and Vulnerability [29]; social and political inequities that undermine the
each regional chapter in the third assessment included a response capacities of the most vulnerable communities
vulnerability subsection; and the third report concluded and regions.
with a chapter on Vulnerability to Climate Change and Rea-
sons for Concern [43]. In summary, the research is based on science; and climate
change research has always been forward-looking. Early
Vulnerability is defined in the third assessment as "the social science contributions focused on mitigating (pre-
degree to which a system is susceptible to, or unable to venting) climate change itself, while understanding how
cope with, adverse effects of climatic change" [44] In the communities might adapt to change took longer to come
most recent report, social vulnerability concepts are onto the agenda (at times with some polarization
expanded - vulnerability is understood to be exacerbated between these positions); in both cases, recourse to
by the presence of other stresses (such as entrenched pov- "techno-fix" solutions continues to dominate. Several
erty and weak governance) and to be affected by the extent new issues have emerged over the past decade with the
to which future development efforts are equity-oriented, most notable being:
sustainable and culturally-sensitive [45]. The most recent
report concluded that poorer communities (some of • Understanding the uneven capacities of human systems
which are more dependent on climate-sensitive resources to adapt to climate change, and recognizing North-South
such as local water and food supplies) tend to have lim- equity issues; and
ited adaptive capacities, and therefore are disproportion-
ately vulnerable [29]. • Focusing on understanding and addressing underlying
social vulnerabilities that put some individuals and com-
Although contemporary climate change science has not munities in "harm's way".
abandoned its physical science roots, it has clearly begun
to recognize that a full understanding of climate change Climate Change: Current Themes
requires careful consideration of the interaction of human Some commonalities and differences between climate
and climate systems. Nevertheless, even with growing change and HIV/AIDS scholarship clearly begin to emerge
attention to equity and social vulnerability in the research from the above discussion. Before turning specifically to
arena, the trend in climate change response continues to an examination of these, this section highlights four cur-
lean toward technological solutions. The section in the rent themes within the climate change field. As in the dis-
most recent report entitled Mitigation of Climate Change cussion around HIV/AIDS, we will revisit these themes in
[30] focused on the application of existing technologies - the analysis and conclusion sections of this paper.
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Theme 1: Science and uncertainty Attempts to alter human behaviours which underly the
The uncertainty inherent in understanding climate change problem (e.g., urban North Americans driving large vehi-
has important research, response and political implica- cles and other overly consumptive indulgences), or to
tions. Given the complexities involved, it is unreasonable enhance communities' capacities to adapt to climate
to expect firm predictions of future climates and climate- change (e.g., by finding strategies to make them less
society relationships. It is in this context that climate dependent on fragile, resource-dependent economies),
change research is gradually placing more emphasis on have received less attention and are more controversial
living with uncertainty. For example, there has been a pro- from a public policy perspective. As discussed in the HIV/
liferation of "scenario" exercises designed to articulate AIDS field, technical solutions continue to dominate;
future uncertainties about how human activities will alter however, attempts to bridge what has been a polarization
GHG emissions and climate regimes [47]. Among a small between mitigation (ie technical solutions) and adaption
but growing group of researchers, there has also been (ie social solutions) is giving way to a more balanced
emphasis on understanding vulnerabilities to environ- approach which does not pit mitigation against adapta-
mental changes broadly, and on intervening to reduce tion.
these vulnerabilities now, regardless of debates around
future climate scenarios [48]. Theme 4: Focus on the future
As discussed above, climate change research has tradition-
The uncertainty around climate change has also been used ally been framed in a forward-looking context (and here
towards political ends - deploying it as a delaying or diver- we are beginning to see a departure from the crisis-orien-
sionary tactic to deter response efforts. This "denialism", tation that has characterized HIV/AIDS research and
not unlike the AIDS denialism discussed earlier (i.e., response). For example, paleoclimatology investigates
recourse to data debates and pseudo-scientific "evidence" past climates, but it is routinely framed as basic research
that HIV does not cause AIDS), includes well-constructed into Earth system processes which provides a window into
arguments denying human activities are contributing cli- future climates. In addition, the use of scenarios to depict
mate change, as well as calls for more science to determine a range of futures has been and continues to be standard
the extent to which the climate change reflects natural or practice in climate change research and recognizes human
human-induced variability. Denialism invariably com- activities are bound to change to many stimuli.
mences with reference to the Earth's climate as dynamic
(i.e., that it has alternated between warm and cool periods Moreover, more recent social vulnerability research
for over 500,000 years) and suggests that climate science attempts to understand what present-day conditions
is in need of further development [32,33,49]. While deni- cause certain people to be hardest hit by environmental
alism is steadily losing ground, it does continue to exist changes and to be the least able to respond to these
and is often employed to protect large emitters of GHGs. stresses. This too is forward-looking, in that it aims to find
ways to prevent future climate change impacts by reduc-
Theme 2: "Global" versus "local" and equity perspectives ing present-day vulnerabilties.
The "globalness" of climate change lies at the heart of the
issue: even more so than HIV/AIDS, climate change is Conclusion
overwhelmingly framed as a "global threat." The prevail- Summary and Ways Forward: Parallels, Divergences and
ing belief that no one will escape its consequences has Directions
indeed prompted many affluent leaders to take action. The above discussion reveals a number of the parallels
Climate change is clearly a global issue requiring global and divergences in how researchers and practitioners have
solutions. Much like in the AIDS field, however, the con- responded to and conceptualized HIV/AIDS and climate
tinued globalized discourses around climate change stand change. In this final section, we will explicitly summarize
in contrast to, and can even serve to mask, the uneven and these key parallels and divergences, and then extend these
inequitable vulnerabilities that are emerging as key con- points so as to suggest future conceptual directions for
cerns. AIDS research.
Theme 3: Leaning toward technical interventions Conceptual parallels: summarizing three key trends
Much of the social science-based research has focused on Three parallel conceptual trends in HIV/AIDS and climate
either reducing GHG emissions or sequestering atmos- change research are pivotal for understanding current con-
pheric carbon in order to reduce the magnitude of future ceptual limitations in the AIDS field. The first is the ten-
climate changes. Technical interventions such as carbon dency toward globalized discourses in both areas, which
trading schemes, incentives to encourage a more efficient have often masked the differentiated risks and responsi-
use of fossil fuels, and switching to non-carbon fuels have bilities associated with both HIV/AIDS epidemics and
been thoroughly researched and are routinely included as human-induced climate change. In the AIDS field, the
key components in climate change programs. shift to globalized language took place in the late 1990s,
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coinciding with the ascendancy of "global threats" and lem. It is difficult to understand why this "denialism" has
security discourses. While this "globalization" of AIDS taken place, though perhaps the unprecendented and
discourses served to mobilize international actors, it also uncertain nature of both phenomena, alongside not
functioned to minimize massive inequalities in vulnera- knowing what to do and attempting to protect the status
bilities within and between countries and communities. quo, is partially to blame. The result has been a polariza-
As Marais notes with respect to AIDS, "In this fanciful tion within the debates in both fields, which distracts
world, we're somehow all bobbing in 'the same boat', if from the underlying issues and the associated inequities,
not exactly equally than all equally-at-peril..." [1] The real- and thus hinders mobilization for change that will
ity, however, is that AIDS is not really a 'global' problem - improve the circumstances of those most vulnerable.
at least uniformly so. He illustrates stark inequalities in
who is most vulnerable and who will be most impacted To summarize, three key parallel trends within AIDS and
within the South African context, and he notes that these climate change research include: (1) the tendency toward
inequalities increase manyfold when considering HIV/ globalized discourses and the masking of uneven vulner-
AIDS at an international level. abilities; (2) the dominance of scientific perspectives and
continued grasping for "techno-fixes"; and (3) the polar-
In the climate change arena, we have seen the tendency to ized debates and resulting diversion away from equitable
frame the 'threats' in a similarly homogenizing way. Ref- and comprehensive responses. Together, examining these
erence to the Earth as a unified system reinforces similar parallels begin to elucidate why the task of understanding
images of "all bobbing in the same boat." [50]. As in the the root causes of the uneven impacts of AIDS (and of cli-
AIDS arena, such a globalized discourse does assist in mate change) has not been (or has failed to remain) at the
mobilizing international audiences, however, negative forefront of dominant research or development agendas.
consequences of climate change are not, and will not be, This analysis begins to shed light on one of the central
even, and the problem, again, is that the heavy focus on conceptual limitations addressed in this paper and thus
the "globalness" can mask these very uneven vulnerabili- highlights ways in which scholars and practitioners in the
ties. AIDS field might begin to reorient their approaches - pri-
oritizing the underlying, place- and time-specific drivers
The second important parallel is that both AIDS and cli- of uneven vulnerabilties.
mate change research have developed from scientific per-
spectives: AIDS from life sciences, virology and An extended look at one divergence: toward a forward-looking
epidemiology; and climate change from Earth and paleo- vulnerability approach in AIDS research
climatic sciences. In both cases, this leaning and contin- There are also some obvious differences in the evolution
ued emphasis (or reinvigoration, as in the case of AIDS) of the AIDS and climate change fields. The key divergence
has resulted in tendencies to de-politicize the issues and discussed in this paper offers an important way AIDS
focus on scientific or technical solutions. Just as focussing scholars could learn from the work of their climate change
on vaccines, circumcision, and microbicides does not colleagues. This major difference can be summarized as
delve into the very difficult task of social change that will follows: while climate change research has always been
undoubtedly be required to curb the spread of HIV and forward-looking, attempting to predict and prevent future
mitigate the impacts of AIDS, carbon trading, alternative impacts, AIDS research has tended to be crisis-oriented,
energy schemes, and projects to fortify dams are all part of focusing on understanding impacts as they happened.
a comprehensive response to climate change but still over-
look the key question: who is consuming and who will AIDS research and response has followed the evolution of
pay the price? In both the climate change and AIDS are- the disease and the epidemic. The key issues changed as
nas, there is a tendency to avoid tackling vested interests the epidemic spread and treatment became available. This
(such as removing power from oil lobbies) and difficult approach is retroactive - researchers, health care profes-
issues (such as gender inequalities and sexual violence). sionals and policy makers look backward to understand,
and in some cases intervene in, AIDS impacts. Climate
The third parallel trend is the issue of "denialism". "Data change research, by contrast, has focused on reducing
debates" and "denialism" have taken place in both arenas: future impacts. This has meant not only modeling pre-
around AIDS, debates (especially in southern African con- dicted climate changes, but within a smaller cluster of the
texts where epidemics are most widespread) have often most recent social science research, moving beyond this to
focussed on scrutinizing prevalence levels, questioning understanding present-day vulnerabilities in order to help
the causes of AIDS, and being skeptical of the utility of vulnerable groups respond to future stresses [51,52].
ARVs; in the climate change arena, there has been ongoing
debate as to the amount of change attributable to "natu- This forward-looking vulnerability approach is at the crux
ral" and "human-induced" causes, as well as skepticism of the conceptual reorientation advocated in this paper.
that fossil fuel burning is at the core of the pending prob- Growing in popularity among social scientists in the cli-
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mate change field, the approach places emphasis on takes several years to progress from causing asymptomatic
understanding the specific social, economic, political and infection, to manifesting in acute illness, to killing its
geographical factors that currently make some people and host. Thus, this conceptualization recognizes the need to
groups vulnerable to any new shock or stress in their envi- look forward: given the high levels of HIV infection in
ronment, including, but not limited to those caused by parts of the world, AIDS, like climate change, will have
present-day and future climate change. It recognizes these effects well into the future.
vulnerabilities as exisiting now, before the worst of pre-
dicted climate change has hit; as Kelly and Adger [48] However, the projection depicted in Figure 3 does not
explain, "the vulnerability of any individual or social capture the four key points highlighted on this illustration
grouping ... is determined primarily by their existent and emphasized throughout this paper: (1) the inequities
state... rather than by what may or may not happen in the inherent in AIDS impacts (this projection does not show
future". These existing vulnerabilities therefore afford differentiation in impact within or between societies); (2)
places to intervene, regardless of knowing with certainty the root causes of vulnerabilities to any of the three curves;
how much sea level will rise or where storms will surge. (3) where or how to intervene (are efforts best placed on
This approach strives to be preventative, bypassing polar- preventing HIV spread, lengthening times between infec-
ized debates over future impacts - it also speaks precisely tion and illness through treatment, attempting to mitigate
to the limitation outlined above, seeking to understand impacts, or some combination of these, often polarized,
drivers of uneven vulnerabilities. A lesson for AIDS strategies); or (4) what actions will alter future trajectories
researchers thus emerges: vulnerabilities to HIV infection (they should not be considered fixed or unchangeable).
and AIDS impacts exist now, before AIDS epidemics have Thus, while the projection reveals the start of an impor-
fully run their course; thus, understanding these existing tant shift toward forward-looking AIDS research, taken
context-specific vulnerabilities gives opportunities to alongside certain insights from the climate change arena,
intervene in proactive ways. it also represents and reinforces emerging and continued
challenges in the AIDS field.
Some, but only very few, AIDS scholars have stressed this
need for proactive and preventive measures to understand Conclusion: key challenges for AIDS research
and mitigate potential future impacts [53,54]. As indi- This paper was premised upon the notion that examining
cated earlier, the important temporal dimension of HIV/ certain key parallels and divergences within and among
AIDS has been highlighted by scholars describing the AIDS and climate change research and response could
"long-wave" nature of epidemics (See Figure 3). The three offer new insights for AIDS scholarship. The overarching
curves depicted in Figure 3[3] indicate that in any general- question must now be addressed: what can we really learn
ized AIDS epidemic (such as those spreading through from how scholars have grappled with climate change and
southern and eastern Africa), time lags can be expected AIDS, and what does this mean for AIDS scholarship?
between the points at which: (a) infection levels begin to
climb, (b) there is an epidemic of people exhibiting symp- The four key themes highlighted above, and examined
toms of full-blown AIDS, and (c) society-wide impacts throughout the discussion, are central to answering this
such as orphaning can be measured. This is because HIV question:
1. We have seen parallels in the globalized framing of
NOW
both HIV/AIDS and climate change. Yet, it is clear that
I) Unevenness/
AIDS epidemics (as well as climate change impacts) are
inequity?
II) Root causes? HIV
uneven and differentiated. Nuance is needed: one
AIDS Impacts
Infection approach could therefore be to frame HIV/AIDS epidem-
ics in terms of their unevenness (probing the questions of
who is most vulnerable, who is most affected, who is most
Prevalence
able to respond, and why), while at the same time recog-
III) Prevention vs Treatment nizing that it is in part because of this unevenness (not
vs Impact mitigation? IV) Future?
because of some "real" or otherwise phantom security
threat) that a global response is appropriate.
Time
2. We have also seen a re-medicalization in the AIDS field,
Figure 3
Emerging Challenges for AIDS Research with a focus on treatment, resources and techno-fixes.
Emerging Challenges for AIDS Research. Prevalence, This discussion hence suggests that AIDS scholars take
Time. back on board social justice approaches, which were more
prominent a decade ago but have since been pushed to
the margins of the field. This does not mean moving away
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10. Globalization and Health 2009, 5:12 http://www.globalizationandhealth.com/content/5/1/12
from treatment, as treatment is also a social justice issue mate Change; PEPFAR: Presidential Emergency
(particularly where access is concerned), and certainly Programme for AIDS Relief; RENEWAL: Regional Net-
medical interventions will need to be part of any compre- work on AIDS, Livelihoods and Food Security; SAVI:
hensive response. Rather, drawing on the work of col- Southern Africa Vulnerability Initiative; UN: United
leagues in the climate change arena, this analysis suggests Nations; UNAIDS: Joint United Nations Programme on
looking at what causes inequalities in infection levels, HIV/AIDS; UNEP: United Nations Environment Program;
capacity for response, impacts and access to treatment. WHO: World Health Organisation; WMO: World Meteor-
ological Organization.
3. In both areas we have seen polarization and data
debates. Clearly in the AIDS field there is a need to move Competing interests
beyond treatment versus prevention and other such The authors declare that they have no competing interests.
"either-or" debates. What underlying issues cut across
unequal access to treatment, risk of infection and likeli- Authors' contributions
hood of bearing impacts? Can we intervene in underlying MC conceived of this paper and engaged MB and AW in
drivers common in all of these areas? Perhaps some of dialogue around their respective fields, climate change
these crosscutting root causes are gender inequalities, and HIV/AIDS. MC outlined the study in a presentation
social marginalization or livelihood insecurity? How are format; MB and AW contributed feedback and substantive
such root causes unique to specific places or similar across intellectual input; and MC presented this preliminary ver-
different communities? These complex questions pose a sion at the 2006 International AIDS Conference in
major challenge to social scientists in the field, but are cru- Toronto, Canada. MC then drafted the manuscript; AW
cial to consider in order to devise and implement effective contributed to sections pertaining to HIV/AIDS; MB con-
and comprehensive responses. tributed to climatic change sections. All authors edited
and proofread the final manuscript.
4. Finally, one central lesson AIDS scholars can take from
the climate change literature is a reorientation in the way Acknowledgements
they think about vulnerability and impact. As in recent MC wishes to acknowledge the PE Trudeau Foundation and the Social Sci-
social vulnerability research, it would make sense to push ences and Humanities Research Council of Canada, MB acknowledges the
for an AIDS agenda that looks forward - an agenda that support of Carleton University, and AW acknowledges the support of the
University of KwaZulu-Natal, and the DFID Addressing the Balance of Bur-
seeks to understand present-day vulnerabilities in order to
den of AIDS Research Partners Consortium for support during the prepa-
reduce future impacts, in a preventive rather than reactive ration of this manuscript. None of these institutions have in any way shaped
way. We note AIDS epidemics have not yet run their the process of devising, writing, or submitting this piece.
course, and thus impacts will inevitably continue to
unfold to decades; the magnitude and distribution of References
these future impacts depend, however, on existing vulner- 1. Marais H: Buckling: the Impact of AIDS in South Africa Pretoria: Univer-
abilities; and although major social and structural sity of Pretoria; 2005.
2. Chazan M: Seven deadly assumptions: the implication of HIV/
changes will almost certainly be required, these vulnera- AIDS among grandmothers in South Africa and beyond. Age-
bilities can be reduced now in order to reduce or prevent ing and Society 2008, 28:935-958.
3. Whiteside A: A Very Short Introduction to HIV/AIDS Oxford: Oxford
hardships. University Press; 2008.
4. Quinlan T: Circumcision is not the solution in HIV/AIDS bat-
By examining the conceptual similarities and differences tle. Sunday Times (South Africa) 2007.
5. Adger N: Vulnerability. Global Environmental Change 2006,
within AIDS and climate change research, this paper has 16:268-281.
provided challenges toward an emerging AIDS research 6. Kalipeni E: Health and disease in Southern Africa: a compara-
agenda. Many of the challenges facing the AIDS field are tive and vulnerability perspective. Soc Sci Med 2000,
50:965-983.
not dissimilar to those scholars are grappling with else- 7. Iliffe J: The African AIDS Epidemic: A History Oxford: James Currey;
where. Indeed, there are opportunities to learn from cli- 2006.
8. Gill P: Body Count: How They Turned AIDS into a Catastrophe London:
mate change research, as we have demonstrated. There is Profile Books; 2006.
a need to move beyond what often is constructed as 9. Bayley A: Aggressive Kaposi's sarcoma in Zambia. Lancet 1984,
"issues-based" silos to examine barriers within social 1(ii):1318-1320.
10. Hooper E: The River: A Journey Back to the Source of HIV and AIDS Lon-
inquiry more broadly. don: Penguin Press; 1999.
11. Gruskin S, Hendriks A, Tomasevski K: Human rights and the
response to HIV/AIDS. In AIDS in the World II Edited by: Mann J,
Abbreviations Tarantola D. Oxford: Oxford University Press; 2006.
AIDS: Acquired Immune Deficiency Syndrome; ASCI: 12. Barnett T, Whiteside A: HIV/AIDS and development: case stud-
AIDS, Security and Conflict Initiative; ARV: Antiretroviral ies and a conceptual framework. European Journal of Development
Research 1999, 11:200-234.
Treatment; GHG: Greenhouse gas; HIV: Human Imuno- 13. Mann J, Tarantola D, Eds: AIDS in the World II Oxford: Oxford Univer-
deficiency Virus; IPCC: Intergovernmental Panel on Cli- sity Press; 1996.
Page 10 of 11
(page number not for citation purposes)
11. Globalization and Health 2009, 5:12 http://www.globalizationandhealth.com/content/5/1/12
14. Behrman G: The Invisible People: How the United States Has Slept through the Intergovernmental Panel on Climate Change (IPCC) Cambridge: Cam-
the Global AIDS Pandemic, the Greatest Human Catastrophe of our Time bridge University Press; 2001.
New York: Free Press; 2004. 37. Lonergan S: Human challenges of climatic change. In Hard
15. Social Determinants of Health [http://www.who.int/ Choices: Climate Change in Canada Edited by: Coward H, Weaver A.
social_determinants/en/] Waterloo: Wilfred Laurier Press; 2004.
16. UNAIDS: What Countries Need: Investments Needed for 2010 Targets 38. Tonn B: An equity first, risk based framework for managing
Geneva: UNAIDS; 2009. global climate change. Environmental Change 2003, 13:295-306.
17. US National Intelligence Council: The Global Infectious Disease Threat 39. Liverman DM: Vulnerability to drought and climate change in
and Its Implications for the United States [http://www.fas.org/irp/threat/ Mexico. In Global Environmental Risk Edited by: Kasperson JX,
nie99-17d.htm]. Kasperson R. NewYork: UNU and Earthscan; 2001.
18. Chin J: The AIDS Pandemic: The Collision of Epidemiology with Political Cor- 40. Bijlsma L: Coastal zones and small islands. In Climate Change
rectness Oxford: Radcliffe; 2006. 1995: Impacts, Adaptation and Vulnerability. Contribution of Working
19. Nattrass N: Mortal Combat: AIDS Denialism and the Struggle for Antiret- Group II to the Second Assessment Report of the Intergovernmental Panel
rovirals in South Africa Pietermaritzburg: University of KwaZulu-Natal on Climate Change Edited by: Watson R, Zinyowera M, Moss R,
Press; 2007. Dokken D. Cambridge: Cambridge University Press; 1996.
20. Whiteside A: Is AIDS Exceptional? [http://www.aids2031.org/ 41. Nurse L, Sem G: Small island states. In 2001 Climate Change:
working-groups/programmatic-response?view=papers#105]. Impacts, Adaptation, and Vulnerability: Third Assessment Report, IPCC
21. Campbell C: Letting Them Die: Why HIV/AIDS Prevention Programmes Working Group II Edited by: McCarthy J, Canziani O, Leary N, Dokken
Fail Oxford: James Currey; Bloomington and Indianapolis: Indiana Uni- D, White K. Cambridge: Cambridge University Press; 2001.
versity Press; Cape Town: Double Storey; 2003. 42. Mimura N, Nurse L, McLean RF, Agard J, Briguglio L, Lefale P, Payet
22. Stillwaggon E: AIDS and the Ecology of Poverty New York: Oxford Uni- R, Sem G: Small islands. In Climate Change 2007: Impacts, Adaptation
versity Press; 2005. and Vulnerability. Contribution of Working Group II to the Fourth Assess-
23. Barnett T, Prins G: HIV/AIDS and Security: Fact, Fiction and Evidence ment Report of the Intergovernmental Panel on Climate Change Edited by:
London: LSE/AIDS for UNAIDS; 2006. Parry ML, Canziani OF, Palutikof JP, van der Linden PJ, Hanson CE.
24. Intergovernmental Panel on Climate Change: Summary for policy- Cambridge: Cambridge University Press; 2007.
makers. In Climate Change 2007: The Physical Science Basis. Contribu- 43. Smith J, Schellnhuber H, Mirza M: Vulnerability to climate change
tion of Working Group I to the Fourth Assessment Report of the and reasons for concern: a synthesis. In 2001 Climate Change:
Intergovernmental Panel on Climate Change Edited by: Solomon S, Qin Impacts, Adaptation, and Vulnerability: Third Assessment Report, IPCC
D, Manning M, Chen Z, Marquis M, Averyt KB, Tignor M, Miller HL. Working Group II Edited by: McCarthy J, Canziani O, Leary N, Dokken
Cambridge and New York: Cambridge University Press; 2007. D, White K. Cambridge: Cambridge University Press; 2001:913-967.
25. Steffen W, Tyson P, Eds: Global Change and the Earth System: A Planet 44. McCarthy J, Canziani O, Leary N, Dokken D, White K, Eds: Climate
Under Stress Stockholm: International Geosphere Biosphere Program; Change 2001: Impacts, Adaptation & Vulnerability Contribution of Working
2001. International Geosphere Biosphere Program Science Series, Group II to the Third Assessment Report of the Intergovernmental Panel on
Report No. 4. Climate Change (IPCC) Cambridge: Cambridge University Press; 2001.
26. Houghton JT, Callander BA, Varney SK, Eds: Climate Change 1992: The 45. Sathaye J, Najam A, Cocklin C, Heller T, Lecocq F, Llanes-Regueiro J,
Supplementary Report to the ICC Scientific Assessment Cambridge: Cam- Pan J, Petschel-Held G, Rayner S, Robinson J, Schaeffer R, Sokona Y,
bridge University Press; 1992:205. Swart R, Winkler H: Sustainable development and mitigation.
27. Houghton JT, Meira Filho LG, Callender BA, Harris N, Kattenberg A, In Climate Change 2007: Mitigation. Contribution of Working Group III to
Maskell K, Eds: Contribution of Working Group I to the Second Assessment the Fourth Assessment Report of the Intergovernmental Panel on Climate
of the Intergovernmental Panel on Climate Change Cambridge: Cam- Chang Edited by: Metz B, Davidson OR, Bosch PR, Dave R, Meyer LA.
bridge University Press; 1995:572. Cambridge and New York: Cambridge University Press; 2007.
28. Watson RT, Core Writing Team, Eds: Climate Change 2001: A contri- 46. Schneider SH, Semenov S, Patwardhan A, Burton I, Magadza CHD,
bution of Working Groups I, II and III to the Third Assessment Report of the Oppenheimer M, Pittock AB, Rahman A, Smith JB, Suarez A, Yamin F:
Intergovernmental Panel on Climate Change Cambridge U.K.: Cambridge Assessing key vulnerabilities and the risk from climate
University Press; 2001. change. In Climate Change 2007: Impacts, Adaptation and Vulnerability.
29. Intergovernmental Panel on Climate Change: Summary for policy- Contribution of Working Group II to the Fourth Assessment Report of the
makers. In Climate Change 2007: Impacts, Adaptation and Vulnerability. Intergovernmental Panel on Climate Change Edited by: Parry ML, Can-
Contribution of Working Group II to the Fourth Assessment Report of the ziani OF, Palutikof JP, van der Linden PJ, Hanson CE. Cambridge, UK:
Intergovernmental Panel on Climate Change Edited by: Parry ML, Can- Cambridge University Press; 2007.
ziani OF, Palutikof JP, van der Linden PJ, Hanson CE. Cambridge: 47. Nakicenovic N, Swart R, Eds: Special Report on Emissions Scenarios
Cambridge University Press; 2007. Cambridge U.K.: Cambridge University Press; 2000.
30. Intergovernmental Panel on Climate Change: Summary for policy- 48. Kelly PM, Adger WN: Theory and practice in assessing vulner-
makers. In Climate Change 2007: Mitigation. Contribution of Working ability to climate change and facilitating adaptation. Climatic
Group III to the Fourth Assessment Report of the Intergovernmental Panel Change 2000, 47:325-352.
on Climate Change Edited by: Metz B, Davidson OR, Bosch PR, Dave 49. Plimer I: Heaven and Earth: Global Warming, The Missing Science Victo-
R, Meyer LA. Cambridge. and New York: Cambridge University ria: Connor Court Publishing; 2009.
Press; 2007. 50. Demeritt D: The construction of global warming and the pol-
31. David Suzuki Foundation [http://www.davidsuzuki.org/ itics of science. Annals of the Association of American Geographers
climate_change/science/ipcc/] 2001, 91,2:307-37.
32. Essex C, McKitrick R: Taken By Storm: The Troubled Science, Policy and 51. Huq S, Reid H: Mainstreaming adaptation in development. In
Politics of Global Warming Toronto: Key Porter Books; 2002. An Earthscan Reader on Adaptation to Climate Change Edited by: Schip-
33. Friends of Science [http://www.friendsofscience.org/ per EL, Burton I. London: Earthscan; 2009.
index.php?id=11] 52. Nicholson-Cole S, O'Riordan T: Adaptive governance for a
34. Banuri T, Weyant J, Akumu G, Najam A, Roas LP, Rayner S, Sachs W, changing coastline: science, policy and publics in search of a
Sharma R, Yohe G: Setting the stage: climate change and sus- sustainable future. In Adapting to Climate Change: Thresholds, Values
tainable development. In Climate Change 2001: Mitigation, Contri- and Governance Edited by: Adger N, Lorenzoni I, O'Brien K. Cam-
bution of Working Group III to the Third Assessment Report of the bridge: Cambridge University Press; 2009.
Intergovernmental Panel on Climate Change (IPCC) Edited by: Metz B, 53. Whiteside A: HIV/AIDS and development: failures of vision
Davidson O, Swart R, Pan J. Cambridge: Cambridge University Press; and imagination. International Affairs 2006, 82:327-343.
2001. 54. Whiteside A, Whalley A: Reviewing Emergencies: Shifting the Paradigm
35. Najam A, Rahman AA, Huq S, Sokona Y: Integrating sustainable for a New Era Durban HEARD and Mbabane: NERCHA; 2007.
development into the fourth IPCC assessment. Climate Policy
2003, 3(Suppl 1):S9-S17.
36. Metz B, Davidson O, Swart R, Pan J, Eds: Climate Change 2001: Mitiga-
tion, Contribution of Working Group III to the Third Assessment Report of
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