Week 5: Health risks and transport corridors: information communication technology for health care
The pattern of AIDS infection in the developing world is strongly related to the location of transport corridors with truckers in these corridors playing a major role in the transmission of infection. This seminar explores new transport based approaches to the reduction of AIDS infection piloted by agencies such as the World Bank.
The key readings are:
http://www-wds.worldbank.org/servlet/WDS_IBank_Servlet?pcont=details&eid=000090341_20031117104415
The first reading provides information on World Bank funding of measures designed to tackle the spread and incidence of HIV/AIDS along Africa' transport corridors. The focus on long distance truck drivers and the social networks of this group receives explicit mention though sex workers does not:
The second reading provides a short summary of the transport-targeted World Bank action around HIV/AIDS and makes explicit mention of sex workers:
The project ' s objective is to increase access along the Abidjan-Lagos transport corridor, to HIV/AIDS prevention, basic treatment, support and care services by underserved vulnerable groups. Particular attention is to be given to the transport sector workers, the migrant population, commercial sex workers and the local populations living along the corridor, especially at the border towns. The project has the following three components: Component 1) will support: (a) the implementation of an integrated HIV/AIDS Information, Education, and Communication/Behavior change communication (IEC/BCC) policy along the transport corridor; and (b) the social marketing of condoms in the 8 geographic border communities and along the entire corridor. Both public sector and civil society organizations including NGOs and the private sector will participate in the implementation of both parts of this component. Component 2) will support: (a) strengthening of public and private (where applicable) health care facilities identified along the corridor to provide services in the areas of Voluntary Counseling and Testing (VCT), treatment of Sexually Transmitted Infections (STIs) (with promotion of the syndromic approach) and HIV/AIDS opportunistic infections; and (b) the provision of grants to Civil Society Organizations (CSOs), including NGOs and the private sector, to undertake community based initiatives in HIV/AIDS care and support and; (c) support the disposal of medical waste related to the project. Due to the complexity of the logistical and organizational requirements for anti-retroviral drugs, this project, with its regional nature and type of target groups, will not provide these drugs to the target groups. @ http://www-wds.worldbank.org/servlet/WDS_IBank_Servlet?pcont=details&eid=000090341_20031117104415
In these world bank funded projects, we see a new understanding of the social relationships around transport and, indeed, gender and transport.
Within the research on HIV/AIDS it was recognised that a certain group of sex workers in Kenya appeared to have an immunity to the virus and this group has been researched in the development of vaccines designed to eradicate the disease. WHO reports on this research:
Intervention:
Scientists realized that a group of sex workers in Kenya had a particular resistance to the HIV virus, not developing symptoms despite repeated exposure to HIV over a duration of time. Researched showed that these women did not have any special antobodies in their blood, though many women have leukocytes that destroy HIV. Thus a proposed vaccine has been developed by a collaboration between Oxford University, the University of Nairobi, and a few others groups, and sponsored by the International AIDS Vaccine Initiative. The vaccine contains two parts: a DNA vaccine intended to target immune responses against HIV, and a smallpox vaccine to accelerate that response.
Results:
The sex workers who are used as models for developing this vaccine, are maintaining their resistance against HIV. Results challenge the robustness of natural immunity when some sex workers previously resistant to the virus became infected after taking a break from sex work and returning. Furthermore, immunity to one strain of HIV might not protect against another. Thus, trials are being conducted, and scientists must determine if immunity is natural or due to repeated exposure, or a combination of both. AIDS vaccine work is also being conducted in other African nations, as well as in India.
@ http://www.who.int/genomics/professionals/applications/africa/en/
Further reading:
http://www.transport.gov.za/library/docs/policy/strategy.html
http://www.fhi.org/en/HIVAIDS/pub/guide/corrhope/corrfind.htm
http://htc.anu.edu.au/pdfs/ContinuingHIV/mukodzani.pdf
Click here to return to the seminar course outline.
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