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HIV/AIDS is one of the most widespread chronic diseases in the world. Its prevalence peaked in the 1990s and early 2000s. In the past decade, there has been a significant decrease in the new cases of HIV infections across the globe. The progress may largely be attributed to the proliferation and the increased affordability of the anti-retroviral therapies that greatly help in elongating a patient’s life. Despite the fact that the number of infected persons around the world is declining, the rate still is high. It is evident that the fight to eradicate incidences of HIV/AIDS cannot be won solely through the appropriation of anti-retroviral therapies. Global healthcare leaders must identify and address the healthcare issues affecting HIV/AIDS, the patients, treatment, and ethical and moral considerations among others. This paper explores the global health care issues relating to the HIV/AIDS disease. It details the historical perspective of the medical condition, the formalized regulatory guidelines that impact the disease, the moral, legal, and ethical issues concerning HIV/AIDS, the burden of chronic care, and the effect on healthcare productivity.
Historical Perspectives on HIV/AIDS
HIV/AIDS was discovered by scientists on June 5, 1981, and the first case was reported in the Morbidity and Mortality Weekly Report. The scientists had come across a group of five seemingly healthy individuals who exhibited an infection that was only witnessed in patients with substantial damage to their immune system. Incidentally, these five young persons were gay. This informed the narrative during the early days that connected HIV/AIDS with homosexuality (Chattu, 2015). The disease was further associated with persons engaged in varied forms of deviant behavior, including drug users, hemophiliacs, and even people of color. In other instances, HIV/AIDS was conceptualized as a plague or a form of punishment from God. However, as time went by and other cases started arising, it became evident that HIV/AIDS infections transcend sexual orientations.
As the HIV/AIDS infections spread, the attention of the world was gradually drawn to the emerging scourge. Several organizations, governmental and non-governmental, started launching prevention, care, and treatment programs to arrest the dire situation. Research studies were also initiated to invent a cure for the disease. To date, there is no cure (Holtz, 2016). However, substantial progress has been made in suppressing the adverse effects of the disease. In the early 2000s, there was a ground-breaking discovery with the invention of anti-retroviral drugs. They helped ease the verve of the disease and enabled patients to live longer (Deren et al., 2014). No major developments have taken place since. Research and test studies are still being conducted to get a cure. However, meaningful advances have been made in areas of global AIDS activism. Today, people are aware of the disease, its transmission, apt prevention strategies, and treatment interventions (Chattu, 2015). Still, disclosure is difficult. The majority of the people living with HIV/AIDS would rather hide their status. Nevertheless, the disclosure rate is improving.
The access to HIV/AIDS treatment is one of the areas where healthcare disparities are witnessed. It is imperative to document the existent disparities and inequalities in the access to healthcare services, especially HIV/AIDS treatment so that the disparities can be noted and addressed. The core factors that contribute to these inequalities and marginalization in accessing healthcare are social class and gender (Tran et al., 2012). People with higher income have more money to secure better healthcare interventions and enjoy a better quality of life outcome (Tran et al., 2012). The poor do not have sufficient financial resources to purchase the ARVs. Women too do not have the same access to health care, partly because in most societies they are preoccupied with domestic duties. Unlike their male counterparts, women also experience intense stigmatization if discovered that they have HIV/AIDS. This deters them from seeking medical interventions freely.
Formalized Regulatory Guidelines
In most countries, there are no formalized regulatory guidelines that impact HIV/AIDS or the people living with it. Some countries, though, such as the U.S. and Canada have legislated statutes that protect persons living with HIV/AIDS to ensure that they have adequate access to healthcare services and are not being discriminated (Zhang et al., 2016). However, even in countries where such legislations exist, there are still punitive sanctions, overt and covert, that affect persons living with HIV/AIDS. For instance, in the U.S. the law was passed against any form of discrimination against persons living with HIV/AIDS more than a decade ago. However, it is only in 2010 that the U.S. lifted travel restrictions and sanctions targeting people who suffer from HIV/AIDS (Tran et al., 2012). The World Health Organization has institutionalized formal regulatory guidelines with regards to the treatment of people with HIV/AIDS. However, these guidelines are yet to be adopted or ratified by most member countries.
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Moral, Legal, and Ethical Issues
The core moral and ethical issue relating to HIV/AIDS is stigmatization. Even though modern people are much more informed than the 1980s and 1990s lot, there still exists marginalization and stigmatization of people suffering from HIV/AIDS (Zhang et al., 2016). The victims suffer not only psychologically but also, in some instances, physically as they are assaulted. They are routinely subjected to fear, rejection, hostility, and other forms of overt and covert violence (Zhang et al., 2016). The most common legal issues affecting people with HIV/AIDS often relate to discrimination. Some occupations require one to reveal their HIV/AIDS status or else they may lose an employment opportunity. It is a subtle form of discrimination which can be challenged in court of law. In other instances, people lost their housing and even insurance coverage because being infected with HIV/AIDS presents an enhanced risk.
The Burden of Chronic Care
HIV/AIDS is one of the chronic diseases with the heaviest burden of care. Studies have long ago established a link between HIV/AIDS-related mortality and morbidity and undesirable income mobility (Deren et al., 2014). Its prevalence has implications in many sectors including the healthcare and development sector. First, people who were infected with HIV/AIDS experience reduced productivity. Research studies indicate that in countries with high prevalence rates, HIV/AIDS reduces the population’s productivity by 3% (Catumbela et al., 2015). Apart from curtailing productivity, incidences of HIV/AIDS also necessitate redirection of resources to cater for medical care. An average person requires $800 per annum on HIV drugs, provided that there are no other health complications (Chattu, 2015). Premature adult deaths compromise household stability as they reduce household incomes, burdening the remaining partner, and, in the worst-case scenario, increase the number of orphans.
HIV/AIDS, just like many other chronic diseases, has high economic costs. It is virtually impossible to ascertain the exact economic impact it has on population. However, the general trend is that it reduces the economic growth through reducing the availability of human capital (Holtz, 2016). Healthcare productivity, just like in other sectors, decreases with each case of infection. Some studies have established that high prevalence of HIV/AIDS reduces income by between 1% and 4% per capita (Catumbela et al., 2015). It also affects economic productivity because a substantial part of budgetary allocation is channeled towards the purchase of ARVs and implementation of prevention and care programs for people living with HIV/AIDS. In 2013, for instance, an upwards of $ 427 billion was invested in HIV/AIDS-related treatments and intervention programs (Catumbela et al., 2015). These are monies that could have been invested elsewhere to improve the welfare of the population.
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It is evident that HIV/AIDS is far from being eliminated. HIV/AIDS remains one of the chronic illnesses with dismal mortality and morbidity rates. For the HIV/AIDS pandemic to be addressed, leaders in global healthcare must factor in the HIV/AIDS-related issues and employ a holistic approach towards eradicating the menace. Among the core global healthcare issues that need addressing are the unequal access to healthcare services and stigmatization of people living with HIV/AIDS. The ARVs should be available to everyone for free. Public education should also be intensified to reduce stigmatization, to enhance coping with the issue, and maintain high productivity levels. So long as the cure has not been invented, addressing these global healthcare issues coupled with the use of anti-retroviral therapies remain the best intervention methods to address the HIV/AIDS scourge.
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