The U.S. war on AIDS would almost seem like it is encouraging people to become infected. First we give, then we take away.
Certainly, we have to be commended for the money that we are giving. The US is the largest single donor to AIDS programs in the developing world, where the virus is taking its largest toll.
But instead of giving money and allowing it to be used in a way that makes the most sense for a particular nation, we—or should I say the Bush crowd–is attaching hideous strings to it. The strings serve to deny care to populations who are most at risk of infecting themselves and others, but these de facto policies serve to carry out some bizarre crusade of an even more bizarre ideology.
First, there is the question of drugs. One need not be a rocket scientist to figure that one out. The American programs have been buying only expensive brand-name drugs. Kudos to big pharma. This means that the money goes that much faster, buys less drugs, and saves less lives. Our excuse is that the cheap generics are not “FDA approved.” Duh, the FDA does not have power beyond the U.S. They are not a world regulating agency. The AIDS czar insisted that unless they are FDA approved, we “can’t be sure that generics are safe and effective.”
Comments like that just make you want to scream. The World Health Organization has endorsed many of them, and AIDS programs around the world use them with excellent results. Lives are being saved with them. It’s not a question of science, it’s a question of keeping promises to the friends in pharma who donated money to your campaign.
But there may be a tiny light at the end of the tunnel. From the NY Times:
Last week, the F.D.A. approved for overseas use two Indian-made generic versions of nevirapine, a standard ingredient in the triple cocktail, and a generic version of efavirenz, another widely used antiretroviral. That brings the number of approved generic antiretrovirals to seven. While none are yet in use in Washington’s overseas programs, the approvals will eventually allow four times as many lives to be saved for the same amount of money.
Better late than never, but think of the number of people who may have been helped if we had incorporated these drugs to begin with. They’re not still not being used, however, so at the moment, people are dying needlessly–for the sake of greed and stupidity.
Now, moving along. The Bush administration holds out the money, and then gives orders. Brazil turned down the money because the Bush moral police said that it couldn’t be used to treat sex workers. Brazil’s policy has been so successful for that very reason; they refuse to marginalize anyone. Sex workers can spread the disease like wildfire, and they are really one of the primary groups that needs to be addressed. Not ignored and pretend that they’ll just die off or disappear, as the Bush policy believes.
A huge chunk of the Bush money is also designated towards abstinence only educational programs, which is basically the same as just flushing the money down the toilet. At the same time, they want to downplay the condom, which has shown to be one of the most effective tools in fighting AIDS. Great going, guys. What a good way to spend our money.
Any type of educational program has to fit into the culture and society, and has to be something that will be of some use. The abstinence only programs, of course, do absolutely nothing to protect one of the highest risk groups–women who are married to HIV positive men. They are faithful to their husbands, but they need a way to protect themselves. In many countries, women are helpless when it comes to negotiating sex. “Just say no,” doesn’t work.
Or, maybe go tell that 15 year old girl who is about to be sold to an older HIV positive man as his 4th wife. How does she protect herself? Abstinence? And what about that hungry 12 year old, who has no skills in a town with few jobs, but yet must do something to bring money to her family. Prostitution is only the only way. Abstinence? Hardly. That sugar-daddy may be infected but he gives her food to eat and money to keep her siblings from starving.
Let Those Filthy Addicts Die
Anyway, now for the latest folly. And I need to emphasize that the U.S. stands completely alone on this one. Completely. The lone nation in a great big world, embarking on a caustic moral crusade that is designed to dramatically increase the numbers of people infected with AIIDS.
Also last week, however, the administration was on a moral crusade that could lead to a significant rise in AIDS cases in Russia, China, elsewhere in Asia and in the former East bloc. In these places, drug users who inject are a prime risk group for AIDS, and the gateway through which the epidemic will spread into the general population. As many as a third of new AIDS infections outside sub-Saharan Africa are in drug users; in Russia, Unaids estimates that injecting drug users are 80 percent of the infected. Needle exchange programs can help control this part of the epidemic.
But at a Unaids policy meeting this month, a Bush administration official asked that all references to needle exchange be dropped from the group’s governing policy paper.
Can they be for real? Needle exchange is one of the most effective methods to keep AIDS and other bloodborne diseases from spreading among addicts and out into the community in general. Can they really be that stupid? Is the Bush-administered AIDS program that dumb to think that if clean needles aren’t available then addicts won’t shoot up?
American law already forbids United States money from financing needle exchange programs. For Washington to decide that it wants to stop everyone else from doing that as well is a breathtakingly dangerous step.
Is it because our own “War on Drugs” policy is such as disaster, that we just want to cover our embarrassment over it and pretend to the rest of the world that it is a great success? The very idea that clean needles will encourage drug addiction is so profoundly inane that it makes my flesh crawl. Of course, don’t you know that if a needle exchange booth opened by my house, I would just be first in line to sign on. It’s what I’ve been waiting for, you know. That’s the only thing to keep me from becoming an addict, the lack of clean needles. And here’s where I roll my eyes round and round until they pop out of my head.
Or that if a drug addict only has dirty needles, that will convince him to quit. No, sorry guys, not quite the way it works. Addicts kill and steal to get money for drugs. That’s how desperate they get for a fix. If necessary, they’ll slit their vein open with the tip of a rusty can, in order to get the drug inside.
The only thing that this policy will do is increase the infection rate among addicts, and make sure that it continues to spread into the community at large. And yes, addicts don’t live in an isolated vacuum. Even if the Bush administration thinks that this method will just kill off addicts (those immoral swine), they fail to realize that addicts mix and mingle with the public at large.
What the Bush AIDS fund wants to do is basically, is create an AIDS crisis of Biblical proportion. And so the iceman cometh, and he is deadly.
