Notes for Instructors   IGS:   AIDS in Africa Curriculum Module

This exercise was developed in order to provide instructors in multiple disciplines a way to tackle a serious issue requiring a grasp of complex background information without taking up class-time.  The exercise is self-contained, with links to precise and relevant definitions, sites, and supportive materials.  It asks students to interact in discussion, and then to write a more analytic paper.  The paper can vary in length and topic, and is intended to earn a grade in the class.   Weight:  10% to 20%.  

How does the instructor set this exercise up in the class?

• Click on PLAGUES  button on the main page of the exercise, and read Ismail Shariif's "Global Implications of AIDS" and "Economic Impact of AIDS."  Construct  an introduction  to present to students in class to justify the exercise.  
• Ask students to go to the web site, click on AIDS button to get essential background on the disease, to  the AFRICA button to peruse of the African country sites, and to the PLAGUES button and click on the Security Issues and AIDS, and pursue at least one link on past plagues.  These will provide students  with essential background materials.  Give 3 days for them to do these.  
• Assign the exercise itself.   

What IS the exercise?

Six groups ponder  what policy/action their organization should take towards drugs to treat HIV/AIDS in Africa.  Each group has 4-6 members, each with a different role in the organization and a different perspective.    

Just as in the real world, there is disagreement within and between organizations.    The organizations include the Nurses & Doctors for World Health (non-governmental organization or NGO), a pharmaceutical corporation, an African government, the US government, the Indian government,  and a UN body.   The medical NGO stresses the need for treatment (but can only treat 50);   the US  (other states, foundations) who donate the money to the fund  often stress prevention;  the UN is concerned about satisfying those donors to avoid loss of funding; the Indian government wants to promote and protect its own pharmaceutical corporations with their generic knock-off drugs.  The pharmaceutical corporation wrestles with problems of profits, capacity, and image.  

Key issues are debated in most organizations.  

• One is treatment vs. prevention.  
  • If treatment is an option, then the question arises of who should be treated if quantities of drugs are insufficient or distribution system is inadequate:    
    • Critical core to keep society functioning 
      •  Who is in the core?  
    • Vectors of transmission/amplification
    • "Innocent victims"   
    • Most seriously ill on site, as determined by health professionals 
• If prevention is preferred, then should the program emphasize 
  • education about the disease
  • exhortation on abstinence and "safe sex"
  • distribution  of free or inexpensive condoms

  Should family planning centers be central to the program--or avoided because they advocate birth control or abortion (i.e., the US position)?

  What should be the role of Traditional Healers, and of AIDS activist organizations such as People Living With AIDS in prevention (or treatment) programs?  

Another thread is the value of development in general vs a health program for HIV/AIDS.  Should the focus be on building roads and purchasing Range-Rovers, on expanding training programs for health workers and building clinics , on purchasing technological equipment for testing, or on actual treatment/prevention?    The exercise raises  tough questions about the impact of the disease on food production, security and social order as well as fundamental moral and ethical questions  about all these issues. 

But my students don't know much about Africa or HIV/AIDS.  

 The site offers information on HIV/AIDS and its transmission, with a quiz (optional or required), links to articles on HIV/AIDS, and a  clickable map of Africa.  It has short articles on the impact of HIV/AIDS in general, and in specific countries in Africa, with photos.  The site even provides notable art works on plagues.     

What level is this exercise, in terms of Freshmen - Graduate students?

Multiple levels.  To assist multiple instructors, the supportive links  for each "person" and organization are classified as essential (yellow diamond), greater depth (green diamond), and advanced (purple diamond).  

• Freshman-sophomore courses may specify that students follow the yellow essential links;  upper-level might use a mixture of the more advanced. 
• Instructors in Business/Economics for a lower-level course might ask students to pursue the moderate () links for the corporation, and basic () for all others; an upper level might demand advanced () for corporation and US government, and moderate () for others.   
• Instructors in Nursing programs might ask students to pursue advanced () links for the Nurses and Doctors for World Health, and the basic  () for  others.  
• Professors in Politics of Developing Areas might ask students to pursue the advanced () for the African, Indian governments, and the UN, and basic  () for all else.  
• Instructors in various science courses can devise their own mix, depending on whether the question is the biology, the ethics, or administration.  

What do students do?  

The bed-rock assignment is to bring up each organization, and peruse the arguments made by each official, clicking on links (specified by color).  After reading one organization, students should  go to a discussion site--on Blackboard, Web-CT, etc.  One option is to offer their opinion of what policy the organization should choose and why, and respond to at least two-three others.    (Students do disagree, and challenge each other's views.)  Another option is analysis of pros and cons of specific policies. 

Then students go to another organization, etc., and to another discussion forum. 

How long does it take? It takes about 45 min - hour to peruse one organization at basic () level.  It takes about 15 minutes to post a position in discussion, and respond to two others.  It will take longer if students are utilizing the moderate or advanced links.  

Because of the need to get vigorous discussion, it is important to have a relatively short time-frame of two-three weeks for that part of the exercise.  In a pinch students could do one organization a day, and at the end of the week be done with the discussion on all of them.   The instructor could assign three organizations for one week and the remaining three for a second week.    

Because of the need to examine the introductory materials on HIV/AIDS, etc., plan on 2-3 more days at the beginning.    Given pressures of other academic work, add a few more days.  That would be about 3 weeks.  You can set a deadline for the discussions to be completed.    

After the discussion ends,  students write a paper to be graded, based on the exercise, but going beyond it.  This is where gradations for level can occur.  

• A Freshman-Sophomore paper analyzing the issues raised and conflicts on options  can be written in a few days.  Lower-level students can hand in papers three to three-and-a half weeks from the date the exercise started.  
• An upper-level paper requiring additional research, whether analysis of conditions in, or policies adopted, or preparing an administrative strategy for one or more African states, or exploring disciplinary issues, will need more time for research.   How much time partly depends on the weight of the exercise in the grading for the course (35% vs 10%).  

The exercise was designed to supplement not dominate your course.   But if an instructor wants to make it prominent  in the course, then that is possible.    

  What questions can be posed in each discussion forum?  

The political scientist asked these questions of freshmen-sophomores in a general liberal arts multi-disciplinary course including biology, geography and political science:

African State: 

 If you were a key decision-maker in this African state, what do you think this African government should adopt as policy?  Be specific about alternatives, and justify them.  

Indian Government:  

What are the prime concerns on the Indian Government on the issue of AIDS in Africa?  What policy do you think Ram Raj Tripathi should place before the Prime Minister?

Millennium Pharmaceutical Corporation

1.  You are J. Worthington Black, CEO.  Now that you've listened to different options, what policy pertaining to AIDS and Africa should you propose?    Give how much to whom, and why?  Explain your response. 

2.  What are the most important factors that the Millennium CEO should take into account in making a decision? 

Nurses and Doctors For World Health (NGO)

You are Janet Stansky and must now put forward a program detailing what NDWH should do in Africa.  What is your plan?  What type of program?  Defend your proposal.

United Nations committee

The Global Fund received only 1/10th of what they had hoped.  What standards and rationale should the UN Global Fund on AIDS  utilize in evaluating requests for funding?    What kind of programs should get precedence and why?   

Alternate:  The Global Fund received only 1/10th of what they had hoped.  What policies should the UN body adopt on HIV/AIDS policy in order to maintain and enhance the level of donations? 

US Government

Do you see a compromise policy that the  US Deputy Chief Of Staff  could take to the President?  (In other words, what should the US do and why?) Take up issues of what assistance should be given, to whom; what should the emphasis of program be.)

The questions that could be posed for a paper:

from Nursing:

1. Who do the different board members propose to treat with anti-retroviral therapy and what rationale do they provide? Do you agree or disagree? Why? Would you suggest treating any other groups?

2. How are HIV treatment and prevention related? Can programs that focus solely on preventing the transmission of HIV successfully halt the spread of AIDS? Why or why not?

3. In their presentations the board members identify several factors that complicate prevention and treatment, what are they? 

4.  Using the information provided in the Online NewsHour reports on Botswana and Malawi compare and contrast the factors that would complicate or facilitate AIDS treatment and prevention efforts if Nurses and Doctors for World Health operated clinics in those nations.

From Political Science (lower level course)

1.   Identify and briefly explain why a particular policy position taken by one organization either

•  would not be effective in Africa, or 

• could not be accepted by another organization.    

• Give   x number of examples for each

 2.      What issues are likely to be the most  controversial in developing a policy to address HIV/AIDS in African states? Why?  (Utilize your discussion board debates to help answer this question. ) 

 3.     Take one of the African countries covered under the "Africa" button, and one specific item. Choose one of the following: 

• If the link describes and analyzes the problem in the country,  suggest what might be the most appropriate policy to adopt to counter the HIV/AIDS epidemic.  Explain your reasoning.

• If the link describes a plan of action proposed or being followed, critique the policy in terms of its likely effectiveness.   Explain your reasoning.