AIDS and vulnerability: reflections on “long wave” shocks

This background note, for a UNAIDS workshop on AIDS and Vulnerability, considers the research and policy implications and challenges of treating AIDS as a long wave shock. The paper specifically explores: the methodological challenges of studying long wave shocks; the distinctiveness of AIDS; and the policy implications of a focus on long term vulnerabilities. The author compares two other long wave shocks resulting in chronic health conditions: the fall in life expectancy among middle age men after the collapse of the Soviet Union; and the arsenic crisis in Bangladesh. Similar features of these shocks with AIDS include: demographic impacts; injury to social structures; changes in gender relationships; and existential crises.

The author argues that understanding AIDS as a long wave shock opens up the possibility of comparing it to other long wave shocks and learning across them. Consequently, the author calls for a more comparative approach to understand and deal with the vulnerability consequences of HIV and AIDS. Long wave shocks are complex and difficult in policy terms, as they require dealing with multiple dislocations, diverse agencies and very long time lines. The author calls for further research on long wave shocks and policy responses, incorporating a strong citizen participation component. [adapted from author]