Rethinking the Complexities of AIDS Impacts: A Call for Interdisciplinarity By May Chazan [1,2], Mike Brklacich[1], Alan Whiteside [2] [1] Carleton University, Ottawa, Canada [2] HEARD, University of KwaZulu-Natal, Durban, South Africa XVI International AIDS Conference, Toronto, August 2006

Context AIDS and Climatic Change: 2 major issues of past 25 years Substantive body of research with conceptual overlap Social vulnerability emerging as key theme Some similarities in research evolution and in current limitations Growing dialogue between AIDS and climate change researchers: Southern Africa Vulnerability Initiative (SAVI) Regional Network on HIV/ AIDS, Rural Livelihoods and Food Security (RENEWAL) CIDA Urban Food Security and HIV/ AIDS in Southern Africa (upcoming) XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Presentation Outline: Purpose To examine the parallels and divergences within the two areas in order to address current limitations in AIDS research. Presentation Outline: Review evolution of 2 fields of study Examine parallels and divergences in AIDS and CC research Explore opportunities to advance HIV/ AIDS research XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

HIV/ AIDS: Dominant Research Themes Human rights & causes Public health response Treatment & ‘global threats’ Science & search for cause Re-medicalization & costs 1981 2006 Adapted from Illiffe 2006, Gill 2006 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

HIV/ AIDS: Current Themes Re-medicalization Focus on crisis intervention Polarization of debates ‘Global’ framing of epidemic FROM AIDS ANALYSIS: “In this fanciful world, we’re somehow all bobbing in ‘the same boat’, if not exactly equally than all equally-at-peril...” - Marais 2005, p 7 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Trends in Climatic Change Research Social Vulnerability Equity Human Adaptation Mitigation Future Impacts Climate Science 1989 1995 2001 2007 Based on Four Assessment Reports: IPCC Adapted from Banuri et al 2001, Najam et al 2003 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Climate Change: Current Themes Questioning science ‘Global’ issue vs uneven impacts Techno-fixes vs social change Forward-looking FROM CLIMATE CHANGE ANALYSIS: “The specifically global scaling of climate change …tend[s] to steer attention away from the difficult politics that result from … different interests.” - Demeritt 2001, p313 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Climate Change and HIV/ AIDS: Parallels Getting and keeping root causes and uneven implications at the forefront of the agenda has proven difficult in both research areas WHY? XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Climate Change and HIV/ AIDS: Parallels ‘Global’ framing Depoliticized discourses Data debates & polarization XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Climate Change and HIV/ AIDS: Divergence – Preventive vs Reactive Present-day capacity to respond to future stress Past impact FROM CLIMATE CHANGE ANALYSIS: “The vulnerability of any individual or social grouping … is determined primarily by their existent state… rather than by what may or may not happen in the future”. -- Kelly & Adger 2002 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Emerging Challenges for AIDS Research FROM AIDS ANALYSIS: NOW 30 I) Unevenness/ inequity? II) Root causes? 25 HIV Infection Impacts AIDS Percentage 20 15 Prevalence Change 1st curve to swazi 10 III) Prevention vs Treatment vs Impact mitigation? IV) Future? 5 1990 1991 Time 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Adapted from Whiteside 2004 2002 2003 XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Challenges and Implications for Future AIDS Research I Uneven and differentiated epidemics BUT global responsibility ‘Global’ framing of epidemic XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Challenges and Implications for Future AIDS Research II Social justice orientation Focus on what causes inequalities in HIV prevalence, impact, capacity for response, access to treatment Re-medicalization XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Challenges and Implications for Future AIDS Research III What underlying issues crosscut unequal access to treatment, risk of infection and likelihood of bearing impacts? Acknowledging uncertainty but acting now to reduce present-day vulnerabilities Polarization of debates XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Challenges and Implications for Future AIDS Research IV From reactive to proactive approaches Understanding and reducing present day vulnerabilities in order to reduce future tragedies Focus on crisis intervention XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’

Conclusions Opportunities to address AIDS within interdisciplinary social science context AIDS & CC – parallels and divergences provide hints Emerging AIDS social science agenda: Differentiation in risk and responsibility Social justice approach, inequalities in root causes Beyond polarization to crosscutting drivers Forward-looking proactive approach XVI International AIDS Conference Chazan et al, ‘Rethinking AIDS Impacts’