Aveneu Park, Starling, Australia

Introduction to continual global development’. (Held and

Introduction 300

explain the question and how you will answer it

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Much research has been conducted into the virus HIV, human immunodeficiency virus, (NHS, 2017) is a virus that
weakens the immue system, therefore weakening the ability to fight off
infections and diseases. (Gillespie, 2014) HIV doesn’t always show symptoms and
can be passed on numerous different ways such as through bodily fluids, sharing
needles, from mother to child (NHS, 2017) sexual partners and certain
behaviours (HIV Gov, 2017) such as gay/bisexual men, intravenous drug users
(drugabuse.gov, 2012) and sex workers. (FH1360, 2011)

And say why it is global issue – a pandemic –
explain what MDG targets are, and summarise progress made

Peter Piot, the
head of the joint united nations programme on HIV/AIDS (UNAIDS), said HIV/AIDS
is ‘the single greatest threat to continual global development’. (Held and
McGrew, 2010) in 2000 alone 5 million people were infected with HIV, at a rate
of 15,000 per day. Depending on access to anti-retroviral drugs, those people
are likely to die within 5 – 10 years, joining the 17 million people who have
already died since the early 1980’s. (UNAIDS and WHO, 2001) In 2000 a set of 8 goals, the millennium development goals,
were announced and adopted by 198 countries and set to be achieved by 2015 (Mellis,
2015) The millenium development goals aimed to improve the lives of people
worldwide. (WHO, 2018) Among these goals was ‘to fight HIV/AIDS and other
diseases…’. (SDGF, 2017) UNAIDS conducted research into the number of people
living with HIV/AIDS in 1999, which was 34.3 million. (UNAIDS, 2000) Further
research states the number of people living with HIV/AIDS in 2013 was 35.5 million.
(AIDS2014.org, 2014) in 2016 the number of people living with HIV/AIDS was 36.7
million. (UNAIDS, 2016) As a result of HIV/AIDS, countries all over the world
are witnessing a deterioration in child survival rates, reduces life expectancy
and overloaded health systems. (Held and McGrew, 2010)

Understanding global phenomena – key debate on
globalization prosses – SHOW CRITICAL UNDERSTANDING – Held and McGrew (2002)
identify two main groups in the debate – globalists and sceptics

David Held and Anthony McGrew identify two main
perspectives of globalisation, the globalists and the sceptics. They state
globalists are believers of globalisation. (Schirato and
Webb, 2004) Globalists (optimist) believe that globalisation is a positive
process allowing economic growth, increased wealth and democracy. (Steger,
2017) Feachem argues we must not allow the potential risks of globalisation to
stop the benefit it may have. (Feachem, 2001) Sociologist Ronald
Robertson stated globalisation brings the world together and creates a global
culture (Robertson, 1992) His theory is supported by sociologists Featherstone
and Lash, as they agree globalisation is the expansion of culture and allows
goods to be traded around the world. (Featherstone and Lash, 1999)
Additionally, economist Bhagwati stated globalisation is beneficial to all. With
the trading of goods and knowledge, Bhagwati states globalisation is the answer
to the world’s problems. (Bhagwati, 2003) Freidman agrees globalisation is beneficial,
he suggests dire results on the economy and technology from any attempts to
resist globalisation. (Freidman, 2008)

Whereas for sceptics (Pessimist), globalisation is ideological.
(Schirato and Webb, 2004) Sceptics believe globalisation
is another form of American imperialism, they believe it is a way of
controlling other countries. (Steger, 2017) The neo-liberal theory of world
order proposes globalisation is driven by greed and the need for control. However,
this theory suggested by Meyer, Boli, Ramirez and Thomas assumes European
values are to be held worldwide. (Meyer et al, 1997) Krasner agrees
globalisation is simply another name for American imperialism. He suggest the
international system is doomed. (Kranser, 1995) Kellner’s work suggests
globalisation will destroy local traditions with the enforcement of European values
worldwide. (Kellner, 1997)

When it comes to goals,
optimists think they will achieve whatever goal they set. Whereas pessimists,
lack motivation as they believe their goals are out of reach and they are
unable to achieve them. There is much debate around whose view is better,
optimist or pessimist. Evidence suggest optimists are less distressed when
times are tough, they cope in ways that create a better outcome for the, and
they are better at taking steps to ensure that the future continues to be
bright. Although there are situations where optimists re better of than
pessimists there is likely to be cases in which they have no advantage, however
there is little evidence to suggest this. (Snyder, 1999) Many have suggested
that optimism could possibly be damaging. Too much optimism could allow a
person to ignore a threat until it is too late, sometimes not putting their own
wellbeing first. (Tennen and Affleck, 1987) Goodman, Chesney and Tipton studied
a group of adolescent girls at risk for HIV infection, those who were
optimistic were less likely to seek help and information about HIV testing and
were less likely to actually get tested to see if they were infected than those
lower in optimism. (Goodman, Chesney and Tipton, 1995)

The
case for globalists/optimists 750

An ‘HIV free generation’ is a real possibility
– set out global visions and strategy. UNAIDS – WHO strategy other NGOs Bonos
ONE, Bill gates foundation – optimism

In 2015, 17 sustainable development goals where announced
based upon the success of the millennium development goals. These goals aim to
be reached by 2030, all with the intention of benefitting people lives. (United
Nations Sustainable Development, 2017) Sceptics suggest the goals are too
ambitious and unrealistic; their main weakness is the large scale of them.
David Miliband, British labour party politician, stated the extent of the goals
should not be an excuse for them to not be fulfilled however, the fear of not
wanting to miss anything out has potentially made the goals slightly out of
reach. (Worley, 2015)

On the other hand, Optimists suggest that MDG’s where not
the only thing responsible for the improvement of health and well-being around
the world, but they did put global issues firmly on the agenda. The SDG’s have
done the same thing and have created much talk about the effectiveness of the
policies and programmes which have came from them.(Worley, 2015) Ban Ki-Moon,
south Korean diplomat, (United Nation, 2018) stated the SDGs are beneficial to
all and no area has been left out. (Worley, 2015)

What is the extent of the HIV pandemic? i.e.
what does current global data tell us? (What, who, where)

Current data confirms a lot of work is needed around
eliminating HIV. In, 2016, 36.7 million people were living with HIV, 1.8
million were children and 30% of these same people are unaware they have the
virus. In 2016 alone, 1 million people died of AIDS related illnesses and there
was around 1.8 million new infections, a decline from 2.1 million new
infections in 2015. (Sidibé,
2017) However, despite the progress UNAIDS warned progress is
not happening fast enough to meet global targets. (UNAIDS, 2017) Michel Sidibé, executive director of UNAIDS, confirmed
the target of 15 million people to be receiving treatment for HIV, was achieved
in 2015. Despite many challenges, new global efforts have increased treatment
dramatically. In 2016, more than half the people living with HIV, 19.5 million
people, had access to treatment, leaving them on track to hit the target of 30
million people receiving treatment by 2020. (Sidibé, 2017)

Take global action / campaigns – Identify who
is at risk and target action – MDGs

78% of young people living
with HIV live in sub-Saharan Africa. Asia and the pacific have the second
highest number; estimated around 550,000. In 2011, young people
aged 15-24 accounted for 40% of new global HIV infections in people aged 15
years and older. The number of young people living with HIV is around 5
million. (United Nations, 2017) Young women are
especially at risk, 59% of new infections are among young people ages 15-24. (Sidibé, 2017) According to,
among others, ongoing research in Botswana and Zambia, older men select younger
girls to have sex with as they are seen as ‘clean’, unlikely to be infected
with HIV. (Poku and Cheru, 2001) However, out of 2400 teenager interviewed in
Botswana, only 25% admitted to being sexually active. These studies are similar
to studies from other parts of Africa. For example, in Kismusu, 23% of girls
aged 15-19 were living with HIV, however 29.9% of this age group has never had
sex. (Buve et al, 1999) These figures tell us girls who are already sexually
active at this age are more likely to be infected with HIV and given their age
are likely to be at the beginning of their sexual lives, therefore they have
probably been infected with HIV recently, further increasing their contagion
rates. (Held and McGrew, 2010)

The
case for sceptics/pessimists 750

What do the notion of an ‘HIV free generation’
really mean?

A ‘HIV free generation’ starts
with the elimination of the transmission of HIV from mother to child. With the
aim of eventually having no babies born with the virus. (Sidibe and Birx, 2016)
The overall goal is to eliminate and control the spread of AIDS.
The goals are to have virtual no babies born with HIV and for those who do
carry the virus to have access to treatment to prevent the HIV developing into
AIDS and to stop them from passing it on. This will create a decrease in new
infection rates, as there would be a far lower chance of people getting
infected. (Kerry, 2013)

Is there agreement on the meaning between NGOs?

NGO’s play a large part in addressing the problem of HIV in
developing countries. Their aim is to prevent the spread of HIV, provide
treatment to all who require it, give support to those affected by it, and to
remove the stigma associated with it. (Funds for NGOs, 2018) The stigma being
discrimination, prejudice, negative attitude and direct abuse towards people
living with HIV. Available data shows over 50% of people report having
discriminatory attitudes towards people living with HIV. (UNAIDS, 2015)

are MDGs realistic / achievable? Has progress
been made?

The Millennium development goals for HIV/AIDS where ‘to
have halted by 2015 and begun to reverse the spread of HIV/AIDS’ and ‘Achieve,
by 2010, universal access to treatment for HIV/AIDS for all those who need it’.
(WHO, 2014) UNAIDS provide statistics stating the nobler of people living with
HIV/AIDS in 1999 was 34.3 million. (UNAIDS, 2000) Further research shows the
amount of people living with HIV/AIDS in 2013 totalled 35.5 million.
AIDS2014.org, 2014) UNAIDS stated in 2016, the amount of people living with HIV
totalled 36.7 million. (UNAIDS, 2016) Following the MDGs, new HIV infections
fell from 3.5 million to 2.1 million between 2000 and 2013. By June 2014, 13.6
million people living with HIV were receiving antiretroviral therapy (ART) a
huge increase from only 800 000 in 2003. ART is estimated to have prevented 7.6
million AIDs related deaths between 1995 and 2013. (United Nations, 2015) In
June 2015, Cuba became the first country in the world to eliminate mother to
child transmission of HIV. Following Cuba’s success, Belarus, Thailand and
Armenia also received recognition for their elimination of mother to child
transmission. The elimination of mother to child transmission is defined as
less than 50 babies born with HIV per 100 000 births, mother to child rates of
HIV should be less than 2% per year. (Soares, A. 2016)  Deborah Birx, United States global AIDS
coordinator and special representative for global health diplomacy, stated new
HV infections among children reduced by 60% in 21 of the highest burden
countries in sun-Saharan Africa and 6 countries cut new infection among
children by 75% or more. She also states the work for children, adolescents and
young women not done but so far, it is an incredible achievement. (Sidibe and Birx, 2016)

 

 

Just identifying the risks isn’t enough.

Just identifying the risks
to people worldwide would not be enough to influence Banduras social cognitive
theory emphasizes knowledge alone is not enough to explain or change a person’s
behavior. Based on his theory in order for knowledge to influence the rates of
new HIV infections the individual would have to have increased knowledge around
safe sex and intravenous drug use. They would also need to have self-control
and risk-reduction strategies to prevent any risky behaviors. Bandura would
argue knowledge alone is not enough; individuals would need to uphold their
newly acquired skills in order to use them to their advantage in order to
prevent HIV infections. (Bandura and Jourden,
1991)

 

What about global health inequality?

 

Prostitution

Female sex workers are 13.5% more likely to be living with
HIV than other women of the same age. In Asia, female sex workers are 30% more
likely to be living with HIV. (WHO, 2018) HIV is faster spread around sex
workers due to the lack of consistent condom use, multiple sexual partners and
often injection drug use. (Anh Tuan, 2007) People often
turn to sex work in a desperate attempt to make money. Often sex workers have a
history of homelessness and unemployment. It can also be due to mental health
issues, violence and drug use. (CDC, 2016) Many factors indirectly contribute
to the risk of infection of HIV among sex workers by limiting their access to
HIV and health services. (Rosenheck et al., 2010) The criminalisation of sex
work contributes to the increased risk of HIV infections among sex workers, as
it limits their ability to receive help ad information about safe sex and
treatment. (Nhurod et al., 2010) Other factors include gender inequality,
poverty, discrimination and social exclusion. (Simi? and Rhodes, 2009;
Onyeneho, 2009) The acceptance of sex work has proven to reduce risks to HIV
infections by providing safer work environment and condom promotion. (Reza-Paul
et al., 2008; Shannon et al., 2008; Kerrigan et al., 2003)

Poverty (lack of money for treatment,

Extreme poverty has drastically declined, for example in
2015 14% of the population of the developing world lived off $1.5 a day,
however in 1990 nearly half of the population in the developing world lived off
less than $1.25 a day. On a Global scale, the number of people living in
extreme poverty has more than halved, falling from 1.9 billion in 1990 to 836
million in 2015. (United Nations, 2015)

 

 

Social injustice.

 

 

Why is HIV / AIDS so prelevant in specific
social groups and regions of the world? Consider social, cultural and economic
inequality

East and southern Africa is the region that holds the most
people living with HIV, with 19.4 million people living with HIV, they are home
to more than 50% of the world’s population of people living with HIV. (Aidsinfo.unaids, 2018) Research found many places in east and
southern Africa had sexual relationships between young girls and older men,
increasing their vulnerability to HIV. (UNICEF, 2015) Studies in Zimbabwe and
Uganda also provide evidence that relationships are a major component of HIV
infections, some women struggle to negotiate condom use with their older
partners. (Schaefer et al., 2017) Surveys carried out by UNAIDS in the region
suggest young women endure higher levels of physical or sexual violence from
their partners than other age groups. (UNAIDS, 2014) this increases their risk of
HIV, a study carried out in south Africa found young women who experienced
violence from their partner were 50% more likely to have HIV than women who did
not experience violence. (Jewkes et al., 2010)

Sex workers are also at an
increased risk of becoming infected with HIV. (ARASA, 2014) Often sex workers
do not have access to condoms and in some cases, police are confiscating
condoms found in possession of sex workers. A study in 2012, found evidence of
physical and sexual abuse and harassment of sex workers who try to use condoms,
police were also threatening to arrest on the grounds of condom possession.
(OSF, 2012)

Although limited, data suggest HIV infections among men who
have sex with men (MSM) is high in this region. (UNAIDS, 2014) Research suggest
MSM also have sex with their wives or long time partners. (Beyrer et al., 2010)
Data from 2011 and 2012 estimates only around 50% on MSM use condoms. (UNAIDS,
2013) Most plans to eliminate HIV identify MSM as people most infected, however
data is very limited. It is more forced by common homophobia. (UNAIDS, 2016)

Finally, intravenous drug users are at an increased risk of
HIV. (UNAIDS, 2016) in 2015, it was estimated 19.4% of people who inject drugs
in South Africa were living with HIV. (SANAC, 2015) A study in 2015 also found
32% of men and 26% of women admitted sharing syringes and other injecting
equipment and reused needles. (Scheibe et al., 2016)

https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/overview#footnote15_0mggrwp

 

Discussion

Researching an HIV free generation?  Is it just about access to treatment? More
resources?

Out of the 36.7 million people living with HIV, 30% of
these people are unaware they have the virus. (Sidibé, 2017) This causes problems for the prevention of
HIV, it is clear more testing and awareness needs to be made available to
ensure people who are living with HIV are aware they have the virus in order to
take precaution.

 

What else must change?  

It is clear from evidence; access to treatment is not
enough to meet the HIV free generation goals. There are more issues than just
people being uneducated around the subject.

When use correctly and consistently, condoms have 80%
protective effect against the transmission of HIV and other STDs. They are key
in the prevention of HIV. (WHO, 2009) However, research conducted by Choi and
Holroyd state some clients of sex workers are highly uneducated about condoms,
some associate them with birth control rather than disease prevention, others
have never heard of, nor seen condoms before. Their clients refuse to use
condoms and would rather have an STD than use a condom. The research states the
clients  believe they can judge whether
or not a sex worker has an STD based on their appearance, an d would often
chose younger sex workers as part of their belief they would not have had
chance to catch anything yet, they are considered ‘clean’. (Choi and Holroyd, 2007)  

According to the World Bank, the percent of people in
extreme poverty on a global scale is less than 10%, their aim is to end it by
2030. (WHO, 2018) Ending poverty worldwide is key to reducing the spread of
HIV. As previously stated many women turn to sex work due to poverty, (CDC,
2016) sex workers often would have no mention of condoms if the sex worker were
in desperate need for the clients’ money. (Choi and Holroyd, 2007)

Sex workers, especially women, often feel too much fear to
request a condom due to violence from the client. Due the criminalisation of
sex work, they are unable to acquire help from authority. (Choi and Holroyd,
2007) Studies show legalising sex work could reduce new infections in sex
workers by up to 46% over 10 years and eliminating sexual violence against sex
workers could reduce new infections by up to 20%. (WHO, 2018)

 

What does academic studies and research tell
us?  Some example. See HIV READING LIST
ON BB A gendered problem (LULE et al) 2009 Sexual and gender based violence
(UNFPA) 2005 Bhana 2008 beyond stigma

 

 

 

 

Conclusion

Explain the essay question and summarise key
arguments in answer. Remind marker how question has been tackled and what
conclusons can be made – optimist / pessimist perpectives offer different
understanding of the problem and solutions 

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