En Afrique, le sida réformateur

Bibliographic Data

ID15050141
AuthorsM E Gruénais (corresponding author), M Gruénais
Year2001
Volume9
Issue4
Pages9-17
Publication date2001-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueNatures Sciences Sociétés (JOURNAL)
Journal identifiersISSN: 1240-1307 • E-ISSN: 1765-2979
PublisherElsevier BV (PUBLISHER)
DOI10.1016/s1240-1307(01)80095-9
OpenAlexW1983425358
LanguageFR
Citations received4
References cited5

The Fight against AIDS and change in African Health systems. As the HIV epidemics spread in the early 80's, some expected changes in Health systems. In Africa especially, AIDS should have put the light on health systems dysfunction, the limits of medical consultation for a global patient's care, economic difficulties regarding curing chronic patients, the issue to take account of individual behaviour in health projects, the importance of ethic, the role of “civil society” to tackle with health problems. Fifteen years later, we have to face the facts and conclude that expected changes were not very important. The HIV programs have not been really integrated into the national public health strategies. AIDS became de facto the unique responsibility of a chosen few with the result that other public health staff took no interest in HIV risk within the context of their day-to-day activities, meanwhile the burden of HIV infected persons was heavier and heavier for health facilities. The extent of the epidemic, linked with the question of the difficulty to access to a care of quality, led sometimes to consider specific ethic rules for Southern countries which have not universal validity. In certain countries, the People living with HIV/AIDS associations are not independent from HIV national programs; therefore they cannot play an important role in critisizing health care professionals, a role which has contributed to an evolution in care for people with HIV for Northern countries. We can mention also that some topics (like homosexuality) seem still be taboo considering African context. Due to the organisation of the national AIDS strategies and to the general state of health care systems in AFrica, all of the various initiatives run the risk of having a very weak impact because the expected “AIDS culture” is not yet implemented in African countries. En Afrique, le sida réformateur ? L'émergence du sida au début des années 1980 aurait dû avoir une fonction de « révélation å. En Afrique notamment, on attendait qu'elle mette en évidence le dysfonctionnement des systèmes de santé, les limites de la consultation médicale, les problèmes économiques liés à la prise en charge des maladies chroniques, la nécessaire prise en compte des comportements individuels dans les projets de santé, etc. Vingt ans plus tard, cette vertu réformatrice des activités liées au sida, et en particulier les transformations attendues du système de santé ne se sont réalisées que très partiellement. Les préoccupations relatives au sida (à sa prise en charge et à sa prévention) touchent rarement l'ensemble des systèmes de santé nationaux ; une éthique spécifique aux pays du Sud tend à se développer ; et la réflexion sur les comportements des populations vulnérables semble avoir peu évolué. Il apparaît alors qu'il ne s'est guère développé une « culture du sida å qui aurait pu faire progresser la prise en charge des malades en Afrique en général

Context (archaeology · De facto · Developing country · Economic growth · Geography · Health care · Political science · Public health · Taboo · Ethics in Clinical Research · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Law · Medicine · Nursing