Why is AIDS so Sexy?

As I read the next chapter, AIDS and Empire, which describes the recent "global treatment revolution" which began in 1998 and continues to this day, I began thinking about a question that came up in our group discussion on the last day of class. Why HIV? Why has this disease captured the attention of the international community more than any other over the last decade?

Malaria kills more people annually every year. So does Cancer. In 2007, 7.6 million people died of cancer. (American Cancer Society)

Is it because of Bono? Is sex just sexy? Or is it what the book is implying. The late 1990's with the improvement in quality of antiretrovirals combined with increased pressure on Congress by small activist groups led to a tangible, benchmarkable concept that politicians all over the world were able to get behind. The 3 x 5 Program. To treat 3 million Persons Living with HIV (PLHIV) by 2005. While it wasn't a vaccine, the world could now put money into a cause that had made the disease manageable in the developed world.

Yet beware. Is all this support truly genuine? President Bush surprised the world by pledging $15 billion to global AIDS efforts. However, it later became evident (according to the author, and I tend to agree) that the president's PEPFAR initiative was designed to a) sabotage the multilateral UN-back Global Fund. b) funnel more money into his core constituency of faith-based organizations that support abstinence only programs over the use of condoms. c) opens the market to big pharma to market their brand name drugs to the developing world.

AIDS is sexy at the moment, but as D'Adesky implies, it provides an altruistic cover for the developed world to quietly push their own agendas. While the current level of support and attention to AIDS is crucial to the developing world, who clearly doesn't have enough resources to provide services, both preventative and clinical, to address HIV on their own, efforts should be made to build the capacities of these governments so they don't become dependent on the western world for treatment.

So thats a rather pessimistic view of why AIDS is sexy at the moment. It is sexy because governments can hide their own personal agendas behind it? Well, maybe. But I think its a simpler matter, and it's the reason why I want to work in this field: we are all susceptible to it. Unlike Cancer where one may be genetically predisposed to get it, or malaria which is only concentrated in tropical climates, HIV is found everywhere. Not one country is not feeling the effects of this disease in one way or another. Yet, it is not a fair disease. In the developing world it is generally found in areas of extreme poverty, areas with low levels of education, areas with gender inequalities. These are issues that need to be addressed. Yes I want to work with HIV prevention programs, but I want to use HIV and the political and economic support it has gained in recent years to mask my own personal agenda of development.

We'll Start with a Foothill

Harsh. Plague. There is Hope. Darkness. Invisible. Silence. Black. Deadly. Deception. Combat. Mountains.

Hmm...Are these the thoughts going through my head while attempting to start up a new blog? Well, kind of. But they also represent a few key words in the titles of books depicting the harsh, deadly, dark, yet invisible mountain called HIV that we must combat or face certain annihilation of all mankind. I don't mean to be so over the top, but I had high hopes when I began the book "Moving Mountains: the Race to Treat Global AIDS" by Anne-Christine D'Adesky. Yet after reading the introduction I feel a little discouraged. It begins with a classic sob story:

Once upon a time in a desolate shantytown in Haiti, surrounded by abject poverty and a loving family, a man who was once a brilliant, brave AIDS activist stands vulnerable and delirious before us. And then he dies. It then goes on to talk about the 25 million people who have died of AIDS, and the 42 million affected with the virus, but make sure to note that 35 million of the 42 million are from less developed countries, and 28 million of the 35 million of those people live in sub-Saharan Africa which come to think of it, we learned in class that the 42 million was inaccurate and that it was closer to 40 million and of those 40 million only 26 million lived in sub-Saharan Africa. Clear everyone?

Next, as we slowly trudge up the first foothill, we learn of another woman who may die due to lack of ARVs and of the thousands that lack needed medications. We then learn about the costliness of ARV treatment, and the ugly profit motives of drug companies. Luckily we reach a plateau of hope with the influx of new Western humanitarian aid leveraged at AIDS groups but we start trekking again past the 6 million people in need of ARVs, toward the "doomsday" of dried up funds, weak infrastructures, stigma, and inequalities. Finally, as we approach the peak (of the introduction), we are urged not to jump yet, because interesting models from India, Cuba, South Africa and Russia that are right around the bend...

So I'm exaggerating a little. The introduction wasn't that bad, but I'm sick of every AIDS book, every AIDS article, and as Dr. Thurman mentioned in her lecture, every grant proposal using the same formula: A heart wrenching story, catastrophic numbers, followed by what we are doing wrong. I'm not sure I have the answer for how we should frame this epidemic, and hey, maybe that formula is working...AIDS is the trendy, fundable disease at the moment. It just seems like we have been following the same blueprint for years, with little success in actual decline in HIV infections. As we see from the recent UNAIDS statement: the"epidemic is outpacing the response."

Anyway, I chose this book because it contains country case studies from across the globe. While Africa is certainly the focus (rightly so) of much of the AIDS efforts, many other parts of the world are coping with this "deadly plague" as well. Also, the author chooses to focus on the treatment approach to reduce stigma and mitigate the effects of the disease. Coming from the world of a Peace Corps health volunteer who saw prevention as the golden ticket, panacea for all the worlds problems I am interested to hear more about what treatment has to offer.

So.....My Objectives for this blog:

1. Summarize and analyze the various country case studies presented in this book.
2. Treatment is ok....but is it sustainable? is it taking away funds from prevention?
3. Come up with a better way to start an AIDS book. (we'll see.....)
4. (Hopefully) link this book to several of the main themes touched on in class: "the West's" role in providing aid, individual vs. community rights, culturally appropriate messages, and the role of ARVs in this "fight"
5. Provide a mildly entertaining/interact format in which to address these issues.

I'll leave you with some tear jerking book cover images to keep you riveted and reaching for your pocketbook to donate to Save the Children until my next post....