Moving Mountains, the Race to Treat Global AIDS

Abstract

By Anne-Christine D'Adesky

Moving Mountains, the Race to Treat Global AIDS provides a lucid account of global efforts to scale up treatment for HIV/AIDS. As shown in the book, these efforts confront a number of critical challenges at a political, social, cultural and economic level.The book attempts to provide accounts of these challenges by looking at progress made in nine countries – Brazil, India, Cuba, Haiti, Mexico, Morocco, Uganda, South Africa and Russia.These accounts are formulated through interviews with people living with HIV/AIDS, HIV/AIDS activists and health officials. The book is divided into four parts.The first part has three chapters. Chapter 1 outlines what the book is about. Chapter 2 provides a chronology of recent events in the fights against HIV/AIDS. In Chapter 3 Brazil's success in its AIDS treatment programme and in curbing the rate of new HIV infections is presented as a good model for other developing countries with high HIV prevalence to follow. Brazil has implemented a successful and sustainable treatment programme by initially importing generic medicines from India, and currently through its state-run generic manufacturing programme.

In the second part the author takes the reader around the world by describing the fight against HIV/AIDS in nine countries. Chapter 4 describes India's role in the production of generic medicines. Chapter 5 provides a description of Cuba's unique yet controversial fight against HIV/AIDS.According to the author, the country's policy of keeping HIV-positive people quarantined in sanitoriums raises ethical questions. Chapters 6 and 7 highlight the rural and urban differences when it comes to access to treatment or testing in Mexico and Haiti.The author points out that rural communities tend to fare worse with regards to access to health care. Chapter 8 looks at Uganda's efforts at preventing mother-to-child transmission through community mobilisation.The book also draws attention to Uganda's orphan crisis – one in every ten people in the country is reported to be an orphan of AIDS.

Chapter 9 describes how in Morocco HIV/AIDS is still perceived to be a disease of homosexuals and drug users but, as the author notes, heterosexual transmission is very high. In the chapter on Morocco the author highlights the concern expressed among HIV/AIDS activists that the numbers of people living and dying from HIV/AIDS may be higher than what is reported. Chapter 10 looks at the role that the mining industry in Carltonville, South Africa, is playing in providing testing and treatment to its employees. Carltonville is presented as an example of the business sector joining the fight on HIV/AIDS. Chapter 11 deals with Russia's post-perestroika HIV/AIDS pandemic.The author points out that the high number of injecting drug users in the country fuels this pandemic. In Chapter 13 the author looks at the opportunity that AIDS presents for improving infrastructure and introducing new models of care that could impact on other killer diseases. After having gone through some of the challenges and obstacles in the quest to increase access to AIDS treatment globally, the author takes the reader through the progress made thus far, as well as some of the challenges that still need to be overcome (Chapter Fourteen).

Throughout the book the author uses quotes to enhance the perceptions and experiences of the interviewees.The author has done well in each instance not to examine the treatment issue in isolation from the social, cultural, political and even economic issues pertaining to each country.The author demonstrates convincingly that the issue of access to drugs is one that is embedded in the market-driven global economic system. It is a system that she describes as one that emphasises profit gain over equity or corporate social responsibility. She argues that the debate over patents and generic medicines for HIV/AIDS could potentially spill over to other medicines.

The book provides accounts of global prevention, care and support, as well as treatment efforts in selected countries. It is a good introduction to the abovementioned content areas, with specific focus on the area of treatment.The author succeeds in educating the reader about antiretroviral drugs.The appendices also provide useful information on a number of subjects, such as HIV-related metabolic side-effects, studies on factors affecting adherence, and reports on the vulnerability of women to infection.Apart from a few, sometimes irritating, instances in the book where conjunctions were missing, it was well written.The book could be of benefit to a variety of readers, including researchers in the social aspects of HIV/AIDS treatment, public health researchers, scholars in public health and HIV/AIDS activists.