Final Thoughts...

When thinking about HIV, I often think back to that timeless question. Which came first the chicken or the egg? In the case of HIV, the question becomes which came first HIV or poverty? It’s hard to argue against the fact that impoverished people are often the most at risk for contracting HIV. Lack of education, economic opportunity, and choice put the poor at a distinct disadvantage. Yet as D’Adesky talks about in the Carletonville chapter, HIV also can lead to poverty. Sickness leads to lack of productivity, while the price of treatment can leave families bankrupt. Thus HIV and poverty becomes one vicious circle.

The treatment model assumes that HIV came first (or at least that HIV should be the point of intervention). In doing so, they tend to address the cause and not the root of the problem. This is all too common nowadays. Whether it’s the influence of internet or improved technologies we tend to want the quick fix for things. Its easier to provide treatment than to alleviate poverty. I think this is also part of the reason HIV is spreading so quickly. People want instant gratification, be it sex or drug related, and don’t think of the consequences of their actions. In order to truly change behavior we need a MAJOR shift in our value system. The generations before us saw the benefits of sacrifice and thinking in the long-term, be it by rationing food and gasoline during World War II, or starting a Social Security program to pay now for future benefits. The treatment model applies the same old band-aid approach to HIV.

I really enjoyed reading Alex De Waal’s book AIDS and Power; mostly because he urges people to think outside the box. Clearly our current HIV policies are not working. The numbers of people with HIV keep increasing, yet we keep trying the same education and treatment campaigns.

D’Adesky and De Waal would agree that AIDS efforts are driven through institutional and political efforts, but D’Adesky focuses entirely on the micro issues of drug treatment and pricing where De Waal sees the bigger picture. I really liked De Waal’s idea about creating incentives for governments to act. Rather than rewarding government’s that have failed to take a leadership role in preventing HIV with large amounts of humanitarian aid and filling in where they failed to provide for their people, we should punish them for increased HIV rates. In the short term, the affects would be catastrophic and would lead to many unnecessary deaths, but for (gasp) LONG TERM thinking, this might be the best solution.

Also, I think there is real danger in treating HIV like a chronic disease. People let their guards down and make risky decisions. Stigma may be reduced, but what’s the use of decreased stigma when everyone’s walking around with HIV?

Finally, to answer one of my original goals of this blog about how I would start a book about HIV, I think I would start with a joke. Something that may be offensive, but is still a change from the status quo. Something positive. Something upbeat, and something that doesn’t involve boring figures…

So, I apologize for this one, it’s late….

Why did this book fail to give me insight?
Because it didn’t have enough visual AIDS.