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South Africa has been hailed as possessing one of the most progressive and visionary Constitutions in the world. It recognizes the right of everyone to have access to health care services. It also recognizes, in detail, various rights of accused, arrested and detained people, including the right to adequate medical treatment. However, despite the constitutionally entrenched rights, we (as civil society) are painfully aware that this does not magically transform the social conditions of the poor and marginalized amongst us. In fact, we have learnt that it is not only food, shelter and healthcare that cost money, but rights also. For without access to legal services in order to enforce one’s rights, they often remain not much more than paper ideals. This is recently demonstrated in the case of EN and Others v Government of the Republic of South Africa and Others , more commonly called the Westville Correctional Centre case (WCC case). This article will examine this case, and the implications of the right to adequate medical treatment for prisoners in South Africa, by addressing the factual background to the litigation, the legal and policy framework, the key issues that arose and the legal remedy.

Sociologists have tended to construct theories of identity based on unitary notions of social location which avoid conceptualizing disjunction and contradiction and which therefore fail to capture certain characteristics of the postcolonial condition. This paper engages in a postcolonial re-reading of sociological theories of practice (in particular, Pierre Bourdieu's notion of habitus). It does so through an analysis of the historical development of the field of health and healing in South Africa. From the beginning of the colonial enterprise, biomedicine resisted amalgamation with other forms of healing and insisted on a monotherapeutic ideology and practice whereas indigenous healing accommodated not only biomedicine, but invited pluralism within and across cultural and ethnic differences. As such, a bifurcated and parallel system of healing emerged, whereby Black South Africans practiced pluralism and white South Africans utilized biomedicine in isolation. This disjuncture became acrimonious in the post-apartheid era as the state attempted to forge a united health system and battle the AIDS epidemic. Despite the historical and contemporary bifurcations within the field of health and healing, people living with AIDS continue to subscribe to a hybrid health ideology. There is, therefore, a structural disjuncture between the realities of consumption within the field of health and healing and the logic of the field as it is articulated in the symbolic struggle raging in the field of power. The field of health and healing is characterized, therefore, by a simultaneous bifurcation and hybridity – which is reflected in HIV-infected South Africans’ beliefs and practices. In order to make sense of this puzzling disjuncture and its impact on subjects’ trajectories of action, this paper draws insight from Pierre Bourdieu's theory of habitus and Homi Bhabha's conceptualization of hybridity – transforming each of them through their synthesis and application to the postcolonial context.

Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.

The authors conducted a randomized, double blind pre-/post-intervention trial with 201 HIV-positive children (six to 15 years) in Botswana. Eligibility included CD4 cell counts < 700/mm3 (a marker for the severity of HIV infection), documented treatment with antiretroviral (ARV) drugs, and no reported evidence of taking supplemental food products with one or more added nutrients in the six-month period prior to the study. The intervention (12 months) consisted of two food supplements for ethical reason, one with a higher protein content, bean (bean-sorghum based) group (n=97) and a cereal (sorghum) group (n=104) both of which contained added energy- and micro- nutrients. Anthropometric and biochemical nutritional status indicators (stunting, wasting, underweight, skinfolds for fat and muscle protein reserves, and hemoglobin levels) were compared within and between the bean and the cereal groups pre- and post-intervention separately for children six to nine years and ten to 15 years.

Older children (ten to 15 years) fared worse overall compared to those who were younger (six to nine years) children in anthropometric and protein status indicators both at baseline and post-intervention. Among children six to nine years, the mid arm circumference and blood hemoglobin levels improved significantly in both the bean and cereal groups (p < 0.01 and p < 0.05, respectively). Although the BMI for age z-score and the triceps skinfold decreased significantly in the bean group, the post-intervention subscapular skinfold (fat stores) was significantly higher for the bean group compared to the cereal group (p < 0.05). Among children ten to 15 years, both the bean and the cereal groups also showed improvement in mid arm circumference (p < 0.001), but only those in the bean group showed improvement in hemoglobin (p < 0.01) post-intervention.

Similar significant nutritional status findings and trends were found for both food interventions and age within group pre- vs post-comparisons, except hemoglobin in the older children. Post-intervention hemoglobin levels for the type food supplement was higher for the “bean” vs the “cereal” food in the younger age group. The fact that all children, but especially those who were older were in poor nutritional status supports the need for nutrition intervention in conjunction with ARV treatment in children with HIV/AIDS, perhaps using a scaled up future approach to enhance desired outcomes.

Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and middle-income countries. The effective and efficient operation of HIV supply chains is critical to tackle this problem. The purpose of this paper is to give an introduction to HIV supply chains in low- and middle-income countries and identify research opportunities for the operations research/operations management (OR/OM) community.

First, the authors review a combination of the scientific and grey literature, including both qualitative and quantitative papers, to give an overview of HIV supply chain operations in low- and middle-income countries and the challenges that are faced by organizing such supply chains. The authors then classify and discuss the relevant OR/OM literature based on seven classification criteria: decision level, methodology, type of HIV service modeled, challenges, performance measures, real-life applicability and countries covered. Because research on HIV supply chains in low- and middle-income countries is limited in the OR/OM field, this part also includes papers focusing on HIV supply chain modeling in high-income countries.

The authors conclude this study by identifying several tendencies and gaps and by proposing future research directions for OR/OM research.

To the best of the authors’ knowledge, this paper is the first literature review addressing this specific topic from an OR/OM perspective.

In January 2005 Dr. Mean Chhi Vun, director of the Cambodian National Center for HIV/AIDS, Dermatology and STDs (NCHADS), needed to decide how to control the spread of HIV/AIDS and save the lives of thousands of Cambodians who were dying from it each year. In the seven years since Dr. Vun had been appointed director, NCHADS had built an organization that was transparent and efficient, had implemented a nationwide 100 percent Condom Use Program, had established a system that allowed individuals to voluntarily seek confidential counseling and testing, and had instituted a set of guidelines and procedures for staff at health facilities to refer HIV-positive patients to treatment clinics and link them with NGOs providing financial and psychosocial support. Now, however, Dr. Vun faced decisions about three initiatives that were critical to expanding care and treatment programs in his country. First, he needed to decide how to quickly and cost-effectively improve the national HIV/AIDS laboratory support infrastructure. Second, Dr. Vun needed to improve logistics and supply management in order to get the best prices and ensure patients had access to life-saving medicines. Finally, he needed to figure out how to provide sustainable care and treatment to the thousands of Cambodian children living with HIV/AIDS.

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Objective – To present the challenges arising from the double burden of disease in developing countries, focusing on the case of Mexico, and to propose a strategy for addressing these challenges.

Methodology/approach – Mortality and morbidity data are presented for selected countries and groups of diseases. Specific examples of the pressures faced by the public health services in Mexico to provide and finance treatment for communicable and non-communicable diseases are used to illustrate the extent of the challenges in the context of a country with limited resources.

Findings – Public health systems in developing countries face strong pressure to provide and finance treatment for both communicable and non-communicable diseases, inevitably producing competition among diseases and conditions and requiring trade-offs between equity and efficiency goals.

Implications for policy – In developing countries, addressing the challenges presented by the double burden of disease requires a multidisciplinary approach to develop and strengthen the policymaking process. This involves the use of analytical tools applied to each stage of the planning cycle, in particular the use of an explicit priority setting process together with monitoring and assessment to strengthen decision making under limited resources.

The purpose of this paper is to analyze poor management of tuberculosis (TB) prevention and treatment and explore parameters and causes of this problem drawing on qualitative interviews with former prisoners and medical specialists in Kaliningrad Oblast in Russia.

The authors undertook a qualitative study, to explore access to HIV and TB treatment for people who inject drugs in Kaliningrad. The authors interviewed (outside of prisons) 15 patients and eight health specialists using a semi-structured guide. The authors analyzed the accounts thematically and health consequences of imprisonment emerged as a major theme.

Prisons are overcrowded and lack basic hygiene and infection control. Demand for medical services outstrip supply, HIV and TB prevention lacking, HIV and TB treatment is patchy, with no second-line drugs available for resistant forms. The prison conditions are generally degrading and unhealthy and many respondents perceived surviving prisons as a miracle. Cooperation with medical services in the community is poor.

The authors used qualitative research methods, which do not rely on a representative sample. However, many of the structural barriers preventing effective TB treatment and prevention highlighted in this paper have been noted elsewhere, suggesting that findings are likely to reflect conditions elsewhere in Russia. The authors tried to include all possible points of view, as of the medical staff and the patients. However, due to resistance of the officials the authors were unable to conduct interviews with employees of the FCS. Since all the interviews are recalling past experience, the situation may have changed. This does not undermine importance of the findings, as they shed light on particular treatment experiences, and development of prison health system.

The paper contributes to the literature on prisons as a contributor to TB epidemic, including drug resistant forms. An urgent penitentiary reform in Russia should focus on HIV and TB prevention, case detection, availability of medications and effective treatments. Key to decreasing prison population and improving health is political reform aimed at introduction of effective drug treatment, de-penalization and de-criminalization of drug users and application of alternatives to incarceration.

Almost 10 years ago, attention was drawn to the many pitfalls involved in the treatment of tuberculosis (TB) in prison settings, based on field experience from the ICRC (International Committee of the Red Cross) (Coninx et al., 1995). Since that time, the ICRC has continued working in the field of TB in prisons, either directly or by supporting the local programmes in different countries. Further experience gained since then has, if anything, confirmed and reinforced the worries caused by the specific problems posed both by the prison environment and by “prisoner‐patients” for the treatment of TB. Medical staff working in prisons need to be familiar with these issues if tuberculosis is to be managed and treated successfully. With the menace of drug‐resistant TB no longer merely a marginal problem but arguably becoming a direct menace to public health, it becomes all the more important to be aware of these pitfalls. This paper addresses the following: * why prison settings are especially difficult for TB detection and management; * why prisoners can be particularly difficult patients; * how different resistant strains of TB are produced or enhanced in prisons; * added difficulties in treating MDR‐TB in prisoners; and * how and why the association of TB and HIV complicate TB, and MDR‐TB, treatment in prisons even further. The photographs and additional illustrations are from the author’s collection. Permission was obtained from all persons photographed for reproduction.

The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW).

It examined changes in condom use, lubricant use, HIV testing and counseling (HTC) uptake and sexually transmitted infection (STI) screening uptake, as well as how and why changes did or did not occur. The study applied mixed methods of both quantitative and qualitative approaches.

There were 16,539 MSM, and TGW reached at least three times in the program during October 2011‒September 2012. The program was found to affect changes in condom use with steady partners (p<0.000), condom use with casual partners (p<0.000), water-based lubricant use (p<0.000), HTC uptake (p<0.000) and STIs screening uptake (p<0.000). Age and province of outreach are associated with HTC uptake and STI screening (p<0.000), slightly as well as gender identity (p<0.1). Gender identity and province of outreach are associated with condom use with steady partners (p<0.000). Gender identity (p<0.000) and sex work (p<0.05) are associated with the use of lubricant. The qualitative results showed that the program had an immediate effect on HTC and STIs screening due to successful bond between the outreach workers and their clients, leading to trust and influencing behavior change.

HIV prevention by peer educators continues to be proved the most effective method, assuming its program consistency. TGW are more vulnerable to MSM to protect themselves, and they have steady partners. Future program for MSM can be replicated and scaled up, but more empowerment component and self-esteem building should be integrated to target TGW.

The global spotlight is increasingly shone on the situation of women in the male-dominated prison environment. Africa has observed a 24% increase in its female prison population in the past decade. This year is the 10-year anniversary of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules) adopted by the General Assembly on 21 December 2010.

Using a legal realist approach, this paper examines South Africa’s progress in adopting the Bangkok Rules. This paper documents the historical evolution of the penal system since colonial times, focused on the development of recognition, protection and promotion of human rights of prisoners and an assessment of incarcerated women’s situation over time.

The analysis of the human rights treaties, the non-binding international and regional human rights instruments, African court and domestic jurisprudence and extant academic and policy-based literature is cognizant of the evolutionary nature of racial socio-political dimensions in South Africa, and the indeterminate nature of application of historical/existing domestic laws, policies and standards of care when evaluated against the rule of law.

To date, there has been no legal realist assessment of the situation of women in South Africa’s prisons. This paper incorporates race and gendered intersectionality and move beyond hetero-normative ideologies of incarcerated women and the prohibition of discrimination in South African rights assurance. The authors acknowledge State policy-making processes, and they argue for substantive equality of all women deprived of their liberty in South Africa.