The CIA remained a fixture at the heart of Indian civil debate throughout the 1980s. To the very end of the Cold War, the political fortunes of Indira Gandhi, and her son, and successor, Rajiv Gandhi, were intertwined with a series of espionage scandals in which, almost inevitably, the CIA figured prominently. This chapter examines the Reagan administration’s reliance of the CIA as a cold war foreign policy tool and its difficulties in securing Indian support to counter what officials in Washington perceived to be an alarming and unacceptable expansion in Soviet disinformation activity in the subcontinent. It explores the assassinations of Indira and Rajiv Gandhi and how these two tragic events came to be connected by South Asians with the Agency and its earlier CIA involvement in subversion and political assassination in the Global South. As the Cold War approached its end, and Hindu nationalism, rampant corruption, and political violence gripped India, the chapter considers why national powerbrokers in the subcontinent were once again unable to resist urging citizens to ‘look the other way’ and attribute the country’s troubles to a ubiquitous foreign hand?

During the 1980s, the AIDS crisis unleashed a torrent of animosity against gays and lesbians. As hatred rose, so too did physical assaults. Most of the perpetrators were teenagers, who did not just torment queer adults – they also directed their anger and hatred at their peers. As a result, a substantial percentage of gay and lesbian youth dropped out of school, abused alcohol and drugs, and attempted suicide. Two types of violence consequently plagued queer life: violence from attackers and self-harm. Some advocates responded by focusing on preventing attacks on the streets. They worked with police to improve their responses and lobbied legislators to enact hate crimes protections, which helped make antiqueer violence visible. Others, typically teachers and parents of queer children, focused on creating support systems in schools, so that gay and lesbian teens would not give up hope for a better future.

, During the 1980s and early 1990s, as the HIV/AIDS epidemic swept the country, thousands of gay men and lesbians perished from AIDS-related infections. Their same-sex partners quickly discovered that they had no rights because the law did not recognize their relationships. Advocates consequently pressed municipalities to adopt domestic partnership programs, a concept that originated in union efforts to secure benefits for unmarried partners. In the 1980s, cities, towns, and counties around the country began offering both health benefits to their employees as well as registries where all couples could record their commitment. The total number of these programs were small, and the rights they offered were limited. However, they helped produce new debates over the nature and meaning of family. They also inspired queer workers in the private sector to demand domestic partnership benefits from their employers. By the mid-1990s, domestic partnership benefits had become a mainstay of corporate America.

This chapter details the epidemiology, route of spread, prevalence, incubation period and at-risk groups relating to HIV. It gives information on symptoms, laboratory diagnosis, treatment, prophylaxis and infection control.

As a socially and politically engaged composer, Leonard Bernstein created works for the stage that dramatize and explicate the changing status of women, gender relations, and heteronormative sexuality in the society around him. His Trouble in Tahiti (1951), for all its parodic hilarity, constitutes a powerful critique of bourgeois marriage under McCarthyism and establishes the garden as a recurring trope in his subsequent theatrical compositions. The woman-authored Wonderful Town (1953) turns a nostalgic eye on working women in 1930s Greenwich Village, and, elsewhere in Manhattan, West Side Story (1957) both advances the garden trope and gives us Anita, the wise and powerful Latina. In Trouble in Tahiti’s sequel, A Quiet Place (1983) the garden returns musically and textually to prompt a loving reconciliation between non-binary characters and the family patriarch, brokered by a woman.

Health and science diplomacy is the activity of deploying international cooperation in the service of science and public health, and using global health and science efforts to achieve foreign-policy goals. As a bridge between the scientific community and decision-makers in government, a science or health diplomat must understand the work of both and, ideally, how they think. Scientists see a pattern or anomaly in nature and try to gather data and evidence to explain it. They publish their findings in peer-reviewed scientific journals. But those findings also have to be packaged and communicated to nonscientists, because the data rarely speaks for itself. This is where science diplomats come in. They need to understand the evidence and incorporate it into persuasive arguments that can influence policymakers to elevate the potential threat as a priority and take action.

This chapter features the contributions of influential and lesser-known essayists who have written persuasively and engagingly on gender and sexuality in the twentieth and twenty-first centuries. Issues of identity and difference have had a profound effect on the writing of our age, and certainly on the essay, the most elusive of genres. This chapter considers the intersections of the essay, gender, and queer studies/consciousness over the last few decades, first in a general sense, and then through the lens of specific essayists who have had the most significant impact on the direction of the essay since 1970 in the United States. Beginning with second-wave feminism, this chapter discusses the work of those essayists in feminist and LGBTQ+ communities whose foundational writing on gender still resonates today. The chapter examines important essays that emerged from third- and fourth-wave feminism and then pursues the stylistic and thematic innovations brought by lesbian, gay, trans, and queer writers who have explored topics such as gender as performance, HIV and AIDS, misogyny and misandry, intersectionality, discrimination, and the medicalization and mediatization of desire.

This chapter extends the consideration of the changing global burden of diseases and discusses what is required to mount an effective response to public health challenges, particularly in countries where people are living in extreme poverty. It considers the role of international development assistance and the responsibilities of the international community in improving the health of poor people.

Human immunodeficiency virus (HIV) pathophysiology is driven by the degree to which the patient is immunocompromised reflected by the CD4+ count roughly stratifying into three groups: > 500 cells/µL, 200–500 cells/µL, and < 200 cells/µL.

In the Emergency Department, patients present with diverse infectious diseases. Some diseases require a keen eye from the clinician to diagnose and prevent transmission and progression. HIV and TB are two conditions that are easily overlooked in the ED, yet are the two deadliest infectious diseases in the world. The HIV/AIDS epidemic has been a challenge to the United States health system since the 1980s and continues to represent major health and economic burden. TB cases in the US had been down trending in the 1950s, but since 1985 cases began to rise in urban areas where large communities of immigrants are present. The HIV and TB pandemics are largely intertwined because TB is a major cause of death in HIV patients. Most cases in the US are concentrated in urban areas of low income. Individuals of color, those experiencing homelessness, engaging in high-risk sexual behavior, and those with substance use disorder are the most likely to be affected. Advances in therapeutics as well as the development of screening modalities have made significant progress. The Emergency Department is the major point of contact for diagnosis and linkage to long-term care.

In South Africa in the 1990s Prof. Robert Pattinson asked the minister of health to establish a CEMD based on the UK model. The first Report appeared in 1998. During the AIDS epidemic the president and officials were denialists and tried to alter the Reports. The Enquiry developed a system to report 'great saves'. Politicians were supportive and maternal mortality fell to 97/100,000 in 2019. In India, Dr VP Paily is the coordinator of Kerala’s Confidential Review of Maternal Deaths. The KFOG was founded in 2002 and the Review began in 2003, stimulated by the WHO. The government authorised hospitals to give the KFOG anonymised records of maternal deaths. Quality standards were developed, helped by NICE International. In 2019 the maternal mortality rate was 28/100,000. In the USA Prof. Elliott Main is the medical director of the California Maternal Quality Care Collaborative (CMQCC), established when mortality rose in the 2000s. It produced toolkits to tackle the leading causes and in 2012 established the Maternal Data Center, combining social and hospital data. Severe maternal morbidity is scrutinised. Mortality fell and similar initiatives have spread across the USA.

The revelation that David Foster Wallace voted for Ronald Reagan caused surprise among Wallace’s readers, many of whom had seen Infinite Jest’s Johnny Gentle as an excoriating parody of Reagan’s persona and politics. While Gentle is undoubtedly a partial caricature, Wallace’s connection to Reagan, and indeed the concept of political leadership, is more complicated than it might first appear. In his essay on John McCain, Wallace uses Reagan to outline a difference between two political personae, suggesting that the first figure, a “leader,” whatever their moral foibles, has the ability to “help us overcome the limitations of our own individual laziness and selfishness and weakness and fear and get us to do better, harder things than we can get ourselves to do on our own.” The second figure is a “salesman,” whose “ultimate, overriding motivation” (despite having the charisma of a leader) is “self-interest.” During Wallace’s career, his position on Reagan’s status gradually changes from the former to the latter, and this transition illuminates an important shift in both Wallace’s politics and the subjects of his writing, one particularly evident in the increased focus on “civics” in the later fiction.

Central to this shift is the short story “Lyndon,” which I argue is partially an analogy for Reagan’s second term and his response, or lack of response, to the AIDS crisis. The story is also, crucially, a dramatization of the death of “New Deal” politics and the steady encroachment of neoliberalism, this latter famously becoming the subject of intense critique in Wallace’s later writing, especially The Pale King, which is itself set in Reagan’s second term. Through a discussion of “Lyndon,” Infinite Jest, The Pale King and the McCain essay, and concluding with an analysis of Wallace’s unpublished short story “Wickedness” that features a dying Reagan, I argue that Reagan comes to stand as perhaps the figure of single widest-ranging importance to understanding the politics of Wallace’s writing.

Key Learning Points

1. 1. There are four stages of human immunodeficiency virus (HIV) infection: primary HIV infection with a CD4 count of >500, chronic asymptomatic infection with a CD4 count of >350, symptomatic infections with a CD4 count of <350 and acquired immune deficiency syndrome (AIDS) accompanied by a CD4 count of <200.

2. 2. CD4 T-helper cell lymphocytes are responsible for both adaptive and cell-based immunity, and are active against both infectious disease and neoplasms.

3. 3. There are 27 AIDS-defining clinical conditions specified by the Centers for Disease Control and Prevention.

4. 4. Recent evidence suggests improved outcomes for intensive care patients treated with highly active anti-retroviral therapy (HAART).

5. 5. Intensive care patients not already treated with HAART, with a low CD4 count and an opportunistic infection, are at high risk of immune reconstitution inflammatory syndrome.