HIV/AIDS
Authors
News Type
News
Date
Paragraphs

Epidemic infectious diseases have shaped many aspects of ancient and modern history. In an interdependent world, well-known pathogens and new, emerging infectious diseases continue to pose a global threat. At the same time, the biomedical and social sciences have been making incredible progress in the diagnosis, prevention, and treatment of communicable diseases.

Image
1603 small 11headliner

Recent events highlight the importance of emerging infectious agents, including HIV/AIDS in the early 1980s, the introduction of West-Nile Virus in the western hemisphere in the late 1990s, and SARS (Severe Acute Respiratory Syndrome) in 2003, and draw attention to the role of increased travel and global connections in facilitating the rapid spread of infectious diseases.

HIV/AIDS is now the world’s greatest pandemic. It has claimed more lives than the Black Plague of the 14th century. With an estimated 16,000 new infections daily, more than 40 million people worldwide are infected with Human Immunodeficiency Virus (HIV). More than seven out of 10 of the world’s HIV-infected people live in sub-Saharan Africa. The impact of HIV/AIDS on local economies, its potential to contribute to regional instability due to loss of human life, and the moral imperative to address the pandemic has brought prevention and treatment of HIV/AIDS to the forefront. Increasingly, it is clear that a multidisciplinary team approach including social scientists, behavioral specialists, clinicians, researchers, and policymakers is essential to address this global pandemic.

Advances in epidemiology, molecular diagnostics, bio-informatics, and genomics have enriched our understanding of ancient and emerging pathogens and offer new avenues for addressing infectious diseases. Vaccines, pharmaceuticals, and new paradigms of public health have increased our ability to control and even eradicate infectious agents. The control of many formerly common childhood diseases has been effectively achieved through the development of vaccines. Smallpox and measles provide examples of diseases that have been eradicated by the culmination of modern innovative public health approaches and widespread vaccination. In the news today, the potential for a viral antigenic shift resulting in a more transmissible form of the deadly H5N1 influenza virus has led to extensive media coverage and disaster planning at local, state, and federal levels of government, as well as international public health bodies.

Teachers and students need a strong foundation in the biologic and social sciences to place these events and responses in context and to allow transfer of vital information and understanding to the community at large. There have been few initiatives to provide high school teachers with accurate, up-to-date knowledge on infectious diseases. U.S. high school students continue to be exposed to global infectious diseases through sensationalized media coverage including popular films and television.

We have been developing a high school curriculum unit with Stanford students Robin Lee, Michelle Silver, Piya Sorcar, and Jessica Zhang and Gary Mukai of SPICE to allow teachers and students to place news concerning infectious diseases in perspective; appreciate diverse social and economic responses to infectious diseases; and understand infectious diseases in the context of a global, interdependent world. The curriculum will also encourage students to consider issues related to epidemic and pandemic infectious diseases and their own personal risk.

The proposed five-module unit is as follows, with the first module having been completed this summer:

I: Introduction to Virology and Infectious Diseases

II: The Epidemiology of HIV/AIDS in the United States and around the World

III: Science, Economics, and Business in Infectious Diseases

IV: Local and International Politics and Policy in Infectious Diseases

V: Community and Personal Health

Hero Image
infectious diseases cover
All News button
1
Authors
Gary Mukai
News Type
News
Date
Paragraphs

“Preparing the next generation of leaders and creating more informed elementary and secondary students means changing and improving curricula, setting higher standards, and ensuring that content is based on current research relevant to the world’s critical problems and urgent issues.” Coit “Chip” Blacker, FSI Director and Co-Chair, International Initiative

SPICE was established more than 30 years ago and serves as a bridge between FSI and elementary and secondary schools in the United States and independent schools abroad. SPICE’s original mission in 1976 was to help students understand that we live in an increasingly interdependent world that faces problems on a global scale. For 30 years, SPICE has continued to address this original mission and currently focuses its efforts primarily in three areas:

  1. curriculum development for elementary and secondary schools;
  2. teacher professional development; and
  3. distance-learning education.

SPICE hopes to continue to educate new generations of leaders by addressing five key initiatives of The Stanford Challenge, announced by President Hennessy last fall.

Initiative on Human Health / 1

SPICE is working with the School of Medicine and the Center for Health Policy on a high school curriculum unit that focuses on HIV/AIDS. SPICE is collaborating with Drs. Seble Kassaye, David Katzenstein, and Lucy Thairu of the School of Medicine’s Division of Infectious Diseases & Geographic Medicine. Using an epidemiological framework, students will be encouraged to consider the many issues involved in the pandemic, including but not limited to poverty, gender inequality, and biomedical research and development. Two Stanford undergraduates, Jessica Zhang and Chenxing Han, are working with the physicians on this unit.

Initiative on the Environment and Sustainability / 2

SPICE recently completed a curriculum unit called 10,000 Shovels: China's Urbanization and Economic Development. 10,000 Shovels examines China’s breakneck growth through a short documentary that integrates statistics, video footage, and satellite images. The documentary, developed by Professor Karen Seto of the Center for Environmental Science and Policy, focuses on China’s Pearl River Delta region while the accompanying teacher’s guide takes a broader perspective, exploring many current environmental issues facing China. Stanford’s School of Earth Sciences is helping to promote this unit and documentary.

The International Initiative / 3

All of SPICE’s curriculum units focus on international topics. Two of SPICE’s most popular units are Inside the Kremlin: Soviet and Russian Leaders from Lenin to Putin and Democracy-Building in Afghanistan. Inside the Kremlin introduces students to key elements of Soviet and Russian history through the philosophies and legacies of six of its leaders—Lenin, Stalin, Khrushchev, Gorbachev, Yeltsin, and Putin. The unit includes (on DVD) six lectures by six FSI faculty members, including FSI director Coit D. Blacker; professors David Holloway and Gail W. Lapidus, CISAC; professor and deputy FSI director Michael A. McFaul; history professor Norman M. Naimark; and history professor Amir Eshel, Forum on Contemporary Europe.

Democracy-Building in Afghanistan is a teacher’s guide for a film called Hell of a Nation. The film’s lead advisor and SPICE’s key advisor was former CDDRL fellow J. Alexander Thier. Hell of a Nation documents the lives of two Afghans participating in the political process to develop a new constitution for Afghanistan—illustrating the “human face” of democracy-building and elucidating the complexities and difficulties of democratic construction in a divided and historically conflict-ridden nation.

Arts and Creativity Initiative / 4

Following 9/11, SPICE decided to develop a unit called Islamic Civilization and the Arts, which introduces students to various elements of Islamic civilization through a humanities approach. Lessons on art, the mosque, Arabic language and calligraphy, poetry, and music provide students with experience analyzing myriad primary source materials, such as images, audio clips, sayings of Muhammad, and excerpts from the Quran. In each lesson, students learn about the history, principles, and culture of Islam as they pertain to particular forms of art.

SPICE recently completed a new unit called Along the Silk Road, which explores the vast ancient network of cultural, economic, and technological exchange that connected East Asia to the Mediterranean. Students learn how goods, belief systems, art, music, and people traveled across such vast distances to create interdependence among disparate cultures. This was a collaboration with the Silk Road Project, the Art Institute of Chicago, Stanford’s Cantor Arts Center and Center for East Asian Studies, and the Shorenstein Asia-Pacific Research Center.

The K-12 Initiative / 5

SPICE develops curriculum based on FSI scholarship, conducts teacher professional development seminars locally, nationally, and internationally, and also offers a distance-learning course called the Reischauer Scholars Program to U.S. high school students. At seminars at Stanford, FSI faculty members offer lectures to the teachers and SPICE curriculum writers give curriculum demonstrations that draw upon the content presented in the lectures. Last summer, Stanford professor Al Dien (Asian Languages) and the SPICE staff gave a workshop for 80 teachers in the Chicago Public Schools. World-renowned cellist Yo-Yo Ma performed at the workshop.

The Reischauer Scholars Program is a distance-learning course sponsored by SPICE. Named in honor of former ambassador to Japan Edwin O. Reischauer, a leading educator and noted scholar on Japanese history and culture, the RSP annually selects 25 exceptional high school juniors and seniors from throughout the United States to engage in an intensive study of Japan. This course provides students with a broad overview of Japanese history, literature, religion, art, politics, and economics, with a special focus on the U.S.-Japan relationship. Top scholars affiliated with the Shorenstein Asia-Pacific Research Center (including Ambassador Michael H. Armacost, Professor Daniel I. Okimoto, and Professor Gi-Wook Shin), leading diplomats, and young professionals provide web-based lectures as well as engage students in online dialogue. These lectures and discussions are woven into an overall curriculum that provides students with reading materials and assignments.

SPICE has for many years focused on the initiatives that have been identified by President Hennessy to be at the core of The Stanford Challenge. By continuing to focus on these initiatives, the SPICE staff hopes to continue to make FSI scholarship accessible to a national and international audience of educators and students, with the ultimate goal of empowering a new generation of leaders with the tools needed to deal with complex problems on a global scale.

Hero Image
1588 small SPICElogo
All News button
1
Paragraphs

Objective
Inadequate adherence to highly active antiretroviral therapy (HAART) may lead to poor health outcomes and the development of HIV strains that are resistant to HAART. The authors developed a model to evaluate the cost-effectiveness of counseling interventions to improve adherence to HAART among men who have sex with men (MSM).

Methods
The authors developed a dynamic compartmental model that incorporates HIV treatment, adherence to treatment, and infection transmission and progression. All data estimates were obtained from secondary sources. The authors evaluated a counseling intervention given prior to initiation of HAART and before all changes in drug regimens, combined with phone-in support while on HAART. They considered a moderate-prevalence and a high-prevalence population of MSM.

Results
If the impact of HIV transmission is ignored, the counseling intervention has a cost-effectiveness ratio of $25,500 per quality-adjusted life year (QALY) gained. When HIV transmission is included, the cost-effectiveness ratio is much lower: $7400 and $8700 per QALY gained in the moderate- and high-prevalence populations, respectively. When the intervention is twice as costly per counseling session and half as effective as estimated in the base case (in terms of the number of individuals who become highly adherent, and who remain highly adherent), then the intervention costs $17,100 and $19,600 per QALY gained in the 2 populations, respectively.

Conclusions
Counseling to improve adherence to HAART increased length of life, modestly reduced HIV transmission, and cost substantially less than $50,000 per QALY gained over a wide range of assumptions but did not reduce the proportion of drug-resistant strains. Such counseling provides only modest benefit as a tool for HIV prevention but can provide significant benefit for individual patients at an affordable cost.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Medical Decision Making
Authors
Douglas K. Owens
-
Former World Bank Tobacco Control Coordinator Joy de Beyer will give her perspective on the tobacco epidemic.

Anthropology, Building 50, Room 51A
450 Serra Mall
(Inner Quad, next to Memorial Church)

Joy de Beyer Former World Bank Tobacco Control Coordinator; Senior Knowledge Management Officer Speaker Human Development Network, Global HIV/AIDS Program with Specialization in the Economics of Tobacco
Lectures
-

Ms. Rees explores the business of sex trafficking in Eastern Europe particularly from the standpoint of her own personal experience. She explains, from her many years in Bosnia, the tragedies of the business, as well as the failures in attempts to stop it. In addition, Ms. Rees looks forward and argues how she feels the problem should be tackled in the future.

Synopsis

Ms. Rees sets the tone for her talk from the start by stating that while our interventions are a response to the phenomenon of sex trafficking, the phenomenon develops as a result of our interventions. Offering a simplified definition, she explains that the sex trafficking business consists of three main stages: recruitment, transfer, and exploitation. Mr. Rees continues by arguing that although there are many different perceptions of trafficking, focusing on only one of them, such as purely the prostitution aspect or solely the migration factor, will lead to eventual failure.

Placing strong emphasis on the fact that sex trafficking is a free market affair and therefore must be treated as such, Mr. Rees begins her focus on the business in Eastern Europe from the perspective of the dire economic situation in post-Soviet states. Discussing primarily her personal experience in Bosnia in the midst of the Balkans conflict, she explains the situation was one where organized criminal activity was for survival. In addition, Ms. Rees reveals that the status of the region both during and after the conflict was perfect for sex trafficking. There were almost no border checks, the 60, 000 peacekeepers provided a large and convenient market, and the police were easily corruptible. Ms. Rees explains that this messy situation lasted until 1999-2000 when the international community finally realized the seriousness of the problem at hand.

Resulting from the stabilization of the region and increased international attention, the crime of sex trafficking and its response was becoming increasingly sophisticated. However, Ms. Rees explains the role of the UN consisted of, in large part, offering clients and doing little to punish their conduct. She also expresses discontent at the UN program of bar raids which shifted the business underground, making it much harder to track. Similarly, Ms. Rees examines the efforts the International Organization for Migration and her concern with the tactics of coercive testimony. Ms. Rees also focuses on the period after 2003, once the UN peacekeepers had left, where the market had shrunk and the business was legitimizing. As women were starting to make money, the law enforcement approach was becoming increasingly messy, and Ms. Rees examines the certain merits of shelters and legal advice for the female victims.

Ms Rees concludes on a more somber note, exposing her belief that Bosnia was a failure in attempts to stop sex trafficking. She emphasizes that it was a failure with considerable economic ramifications. Finally, Mr. Rees finishes by arguing that current approaches do not listen enough to the subjects of the crime, the women. These are who we must base our efforts around.

Ms. Rees also kindly takes the time answer the audience’s various questions, raising a multitude of issues. She explains the inaccuracy and impossibility of estimating the numbers of the sex trafficking industry. Ms. Rees also explores the issues of HIV and pregnancies, as well as immunity for foreign workers such as the UN peacekeepers. Another key point raised was the potential effectiveness of prosecuting clients of the sex trafficking business.

Sponsored jointly by the Forum on Contemporary Europe, Center for Russian, East European and Eurasian Studies, Stanford Law School, and Michelle R. Clayman Institute for Gender Research.

This keynote speech kicks off the Trafficking of Women in Post-Communist Europe conference April 18.

Bechtel Conference Center

Madeleine Rees Head of the Women's Rights and Gender Unit, Office of the United Nations High Commissioner for Human Rights Speaker
Lectures
News Type
News
Date
Paragraphs

For 2009, SPICE has developed four new curriculum units: Examining Long-term Radiation Effects, Interactive Teaching AIDS: A Comprehensive HIV/AIDS Prevention Curriculum, China's Republican Era, 1911 to 1949, and Teacher's Guide to Wings of Defeat.

Hero Image
2009cover
All News button
1
-

In early 2007, CSIS launched an expert task force to examine the growing involvement of the Department of Defense as a direct provider of “non-traditional” security assistance, concentrated in counterterrorism, capacity building, stabilization and reconstruction, and humanitarian relief. The task force set out to shed light on what drives this trend, including the new global threat environment; assess what was happening at the same time in the diplomatic and developmental realms; evaluate DOD performance in conducting its expanded missions; and consider the impact of the Pentagon’s enlarged role on broader U.S. national security, foreign policy and development interests. From the outset, the task force sought to generate concrete, practical recommendations to Congress and the White House on reforms and legislation that will create a better and more sustainable balance between military and civilian tools.

J. Stephen Morrison joined CSIS in early 2000. He directs the CSIS Africa Program, the CSIS Task Force on HIV/AIDS (begun in 2001) and most recently co-directed a CSIS Task Force on non-traditional U.S. security assistance. In his role as director of the Africa Program, he has conducted studies on the United States’ rising energy stakes in Africa, counter-terrorism, the stand-up of the U.S. Africa Command, and implications for U.S. foreign policy. In 2005–2006, he was co-director of the Council on Foreign Relations Independent Task Force on Africa, ‘Beyond Humanitarianism: A Strategic U.S. Approach Toward Africa.’ Immediately prior to that, he was executive secretary of the Africa Policy Advisory Panel, commissioned by the U.S. Congress and overseen by then–Secretary of State Colin Powell. From 2005 up to the present, he has directed multi-phase work on China’s expansive engagement in Africa. His work on HIV/AIDS and related global health issues has involved multiple missions to China, Russia, India, Vietnam and Africa, and most recently, a series of focused studies on the President’s Emergency Plan for AIDS Relief. He publishes widely, testifies often before Congress, and is a frequent commentator in major media on U.S. foreign policy, Africa, foreign assistance, and global public health. From 1996 through early 2000, Morrison served on the secretary of state’s policy planning staff, where he was responsible for African affairs and global foreign assistance issues. From 1993 to 1995, he conceptualized and launched USAID’s Office of Transition Initiatives, which operates in countries emerging from protracted internal conflict and misrule. From 1992 until mid-1993, he was the U.S. democracy and governance adviser in Ethiopia and Eritrea. In the period 1987 to 1991, he was senior staff member of the House Foreign Affairs Subcommittee on Africa. Morrison holds a Ph.D. in political science from the University of Wisconsin, has been an adjunct professor at the Johns Hopkins School of Advanced International Studies since 1994, and is a graduate magna cum laude of Yale College. He is a member of the Council on Foreign Relations and the International Institute for Strategic Studies.

CISAC Conference Room

J. Stephen Morrison Executive Director Speaker HIV/AIDS Task Force and Director, Africa Program, Center for Strategic & International Studies
Seminars
-
The Honorable Richard L. Armitage served as Deputy Secretary of State under Colin Powell from 2001-2005. His additional public service experience includes serving as Assistant Secretary of Defense for International Security Affairs, Special Mediator for Water in the Middle East, and Special Emissary to Jordan's King Hussein during the 1991 Gulf War. He is a graduate of the U.S. Naval Academy, and has won numerous distinctions, including the Department of State Distinguished Service Award and the Presidential Citizens Medal.

In a telling presentation about the challenges of diplomacy and providing humanitarian aid, Armitage will discuss several examples of U.S. humanitarian assistance, detailing how such actions relate to both policy goals and our nature as a generous nation. He will specifically address both HIV/AIDS assistance and the Millennium Challenge Account, as well as traditional U.S. aid mechanisms, describing his own experiences as the coordinator for U.S. Assistance to the former Soviet Union.

Sponsored by Stanford in Government. Co-sponsored by The Ford Dorsey Program in International Policy Studies, The Freeman Spogli Institute for International Studies, the International Relations Program, the Stanford Journal of International Relations, and the Stanford Roosevelt Society.

Kresge Auditorium

The Honorable Richard L. Armitage Former Deputy Secretary of State, U.S. Department of State Speaker
Lectures
Paragraphs

OBJECTIVES: We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites. METHODS: We collected demographic data and data on comorbid conditions and then conducted blinded, anonymous HIV testing. We conducted a multivariate analysis to determine predictors of HIV infection. RESULTS: We tested 4500 outpatient blood specimens and 4205 inpatient blood specimens; 326 (3.7%) patients tested positive for HIV. Inpatient HIV prevalence ranged from 1.2% to 6.9%; outpatient HIV prevalence ranged from 0.9% to 8.9%. Having a history of hepatitis B or C infection, a sexually transmitted disease, or pneumonia also predicted HIV infection. The prevalence of previously undocumented HIV infection varied from 0.1% to 2.8% among outpatients and from 0.0% to 1.7% among inpatients. CONCLUSIONS: The prevalence of undocumented HIV infection was sufficiently high for routine voluntary screening to be cost effective in each of the 6 sites we evaluated. Many VA health care systems should consider expanded routine voluntary HIV screening.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Am J Public Health
Authors
Douglas K. Owens
Subscribe to HIV/AIDS