Monthly Archives: September 2008

They said it

First, this op-ed piece in the Conta Costa Times tells the story of an epidemic spread by political agenda — the world’s most dangerous “risk behavior.”

Then, this piece in the Washinton Post highlights the shame of the continued ban keeping people living with HIV from travelling to — or even through — our country, putting us in the same category as Libya, Saudi Arabia and Sudan

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The next big thing is here

More than 4,000 health workers, government leaders and people living with HIV and AIDS are gathering in Fort Lauderdale this weekend for the U.S.Conference on AIDS which has the sadly uninspired but unavoidable theme of “Looking Back, Moving Forward.”

It was 27 years ago this summer that the growing crisis that was the AIDS epidemic was recognized, a time when not much attention was given on the whole — by government officials, by the mainstream press, by the people who didn’t think they were or would be affected — to either looking back and moving forward.

Back then, the future had to unfold before us, to be clear then — the elusiveness of a vaccine, the epidemic’s seeming jump (as it appeared to people not paying close attention) from one “risk group” to another, as the new patients highlighted old failures in health care systems and social policies, the numbers of new patients ever exceeding by more than half again the numbers put on treatment.

But the past, a history riddled with plagues could have served as a prologue. Then Ronald Reagan wouldn’t have had to wait for the death of his friend Rock Hudson to learn that plagues take tolls that are hard to ignore.

We had learned that already from outbreaks of tuberculosis.

And while AIDS continues to struggle for the spotlight, as attention shifts from national disasters to human-made catatastrophes, the next big thing, lurks, not in the wings but center stage.

And it is, once again, tuberculosis, a disease given new life in the damaged immune systems of untended people with HIV, turning resistant to the modern treatment that chased it out of this country.

Now, in its encore, TB the No. 1 killer of people living with HIV. Still, worldwide only 1 percent of people diagnosed with HIV are tested for TB. As a result people are living with HIV, which remains incurable, and dying of TB. None of the organizations sending money for AIDS relief have required that TB testing be routine for those diagnosed with HIV. In the United States, which claimed about 13,000 new TB patients in 2006, 1,300 with HIV, then, the situation remains unclear.

But, doctors, scientists and public health experts are warning that a worldwide pandemic of extremely drug resistant tuberculosis will be the next big “surprise” to emanate from the AIDS epidemic, if, as we move forward we are not informed by our look at the past.

Bailing out ourselves

On the same day we hear that we and our descendants have taken on the challenge of bailing out yet another failed private business endeavor in the federal handout to insurance giant AIG, the Centers for Disease Control and Prevention has mentioned an emerging need for money for the public sector.

They point out that the emergence of evidence that 40 percent more people than we realized are being infected with HIV each year means we should spend more money than we have to reduce the number of people catching the virus that leads to AIDS.

We thought only 40,000 people each year were getting the virus that would put them on a lifelong need for medication, in addition to a likely need for help with housing at some point, and social services to navigate all of that. In other words, apparently, we thought we had it under control. Unless it was your brother, your daugher, your mother, your son, who had been dealt a permanently damaged immune system though a preventable disease we as a society could have done more to avert. Oh well.

I realize it is easy to criticize those who run things, particularly in the last eight years, during which more than ever, the message of “don’t catch AIDS, and if you do, you did something wrong,” seems to have failed. Until recently, I worked with, and was among a group of people who criticized the management all day long, with may play into why we no longer are there. So I would be the first to say that second guessing the methods of the past is not a constructive path.

Let’s look instead at the hope for the future.

While the bailout of AIG was, apparently, a no-brainer (literally, as a question on it was the only one Successor to Sepatuagenarian Presidential Wannabe McCain Sarah Palin has answered — with the philosophical take that it’s a bad, bad, necessary thing), less straightforward acknowledgment is likely in the question of putting up money to fight the epidemic at home.

The CDC is calling for $4.8 billion over the next five years to reduce the transmission rate by 50 percent over the next 12 years. Leaving aside imagining if one of those spared is yourself, your sister, your grandson, your next great scientist, health officials agree that each new person who gets the virus represents a cost of more than $1 million in treatment and lost productivity, isn’t it time, at long last, to bail ourselves out?

Risky Business

 

I found today that, suddenly, I have reached the end of my tolerance for hearing about “risk groups.”

Perhaps it is because I used it all up listening to Sarah Palin’s speech the other night, in which she found time to tell us about the commonality between herself and pitbulls, and what a character she was for putting a luxury plane on eBay (where oddly it didn’t sell) but didn’t find time to mention the epidemic that she certainly knows poses a risk to her drug-injecting son, and unprotected-sex-having daughter.

Anyway.

When I saw the headline today MSM Remain Most At-Risk Group for HIV in Beijing, Official Says, I  was irritated.

The problem is not the group; it is the situation. This applies to all people who are classified as members of  “most at-risk” groups, whether they be people who sell sex, have sex with men (whether they are men or women), or inject drugs.

It is not they, but their situations: institutionalized social stigmas and discriminatory laws that force people to hide their practices, poverty, and the shortfalls of housing, food, medical care and education that should long have been recognized as human rights,  that are risky. 

The risk group is the one that holds the power and the resources to right the inequities that have led to this epidemic, but continue to point at others.

AIDS and Civil Rights

When presidential candidates and their supporters at both conventions failed to dwell on the HIV/AIDS epidemic their negligence seemed negligible, because in most Americans’ minds, that problem lies a sea away, on the continent of Africa, which, let’s face it, isn’t here, doesn’t collect nuclear weapons, monopolize the world fossil fuel supply, or openly train terrorists, so: so what.

We all like to think better of ourselves than that, so lets not argue the finer points of where the outcry was on the audience floor those nights and on editorial pages the next day, in response to the scant lip service paid to a preventable epidemic that wastes millions of lives each year around the globe, seizes thousands each year in this country, and claims billions of tax dollars.

Let’s instead look at the numbers as broken down in the August Left Behind report from the Black AIDS Institute, showing that if black America was a nation of its own, it would have more people living with HIV than seven of the 15 countries receiving the most money to fight the epidemic.

But those countries are required to have a plan to fight the epidemic.

Now, reminiscent of the civil rights struggle the fight against HIV and AIDS in this country must increasingly look to, a march will begin Saturday in Jackson, Miss., and end Sept. 23 in Oxford, Miss. will draw attention to the need for a national strategy to deal with the epidemic.

History should not be kind to the candidates who stayed silent while people took their struggle to the streets once again.

What Epidemic?

You might wonder how an epidemic that announced itself through agonizing deaths and was quickly determined to be preventable could spread as far and wide as it has in the 27 years since officials discovered a fatal disease was being transmitted through blood transfusions, through sex, from mother to child.

This aside, in a report on McCain’s running mate’s family problems, can help you to understand.
“In 2007, the candidate stumbled when a reporter in Iowa asked his position on funding condoms to fight AIDS. He called on a member of his staff to “find out what my position is on contraception.”

Uh-oh.

At least we know his running mate’s position. 

Others have been impressed, at least by recent numbers showing the American HIV/AIDS epidemic is advancing about 40 percent faster than previously thought. The New York Times today echoed calls at the recent International AIDS Conference for a national policy to address the epidemic.

Still go ahead and count the references to HIV and AIDS in the coverage of either of the recent political conventions. You won’t need more than one hand.

Evidence-Based Methods vs. “Stuff Happens”

The plainer way to say the above is: Believe what your eyes tell you, especially when millions of innocent people’s lives are at stake.

Unfortunately, the lexicon of common sense has become densely complicated in recent years in response to competing lexicons: Bureaucratese, Religious Righteousness, and Doubletalk — the language that requires the skill of talking out of both sides of your mouth.

Which has been the most astonishing response among political operatives to the poignant news that before growing up, before beginning an independent life,

and before making a decision to have the life she is about to have, the 17-year-old daughter of Alaska Gov. and Vice President-select Sarah Palin will have a child, and an accidentally selected husband. At least that’s what the Palin family said they were “proud” to announce.

The response among Republican political operatives, who, it is to be hoped will find jobs waiting for them at greeting card companies when the current campaign season ends, has been the jarringly blasé “Stuff happens.”

The Palin family should be as proud as they want to be, but not of the announcement itself, which validates objections to the “Abstinence Only” form of health and sex education the governor says she espouses.

Objections among those who hope not to see another generation of HIV and AIDS patients after nearly three decades of awareness of this preventable plague to Abstinence Only education is that it is not evidence based. In fact research has shown the opposite — that children exposed only to messages of abstinence, rather than the full body of prevention information available in the 21rst century, are liklier to get sexually transmitted diseases and unplanned pregnancies.

Little Bristol Palin has done nothing shameful. Her mother has, in seeing evidence that the policy she espouses has failed, and seeing it in her own home, and ignoring the ramifications for millions of children who are not as well-placed or as fortunate as her daughter seems to be.