August 29th, 2005

Why AIDS?

In the King of Swaziland/AIDS thread, commenter “anonymous” (another one? or the same? who knows?) writes (and, by the way, in case you’re interested, here’s the latest update on King Mswati of Swaziland’s newest shady antics):

I’ve always wondered why AIDS is such a “hip” and “cool” cause. Malaria kills 3 times as many and there are very effective ways to prevent and cure it. I hear nothing but crickets chirping when mentioned as number 4 on the list of “worlds deadliest killer”. So pardon my skepticism at the tears shed for AIDS victims. It has nothing to do with caring. I guess Bono or Elizabeth Taylor don’t have friends with malaria.
10,700,000 children died in the world last year and 57% were from causes incident to malaria. That’s just the children.

I haven’t checked on anonymous’s statistics, but it’s my impression that the general point he/she is making is correct: fighting the scourge of malaria is not particularly chic or popular in this country as compared to combatting AIDS. So, what goes on here?

I’ll take a stab at an answer. My take on it is that a new disease will always gets more attention than an old one because people are accustomed to the latter, and the new one grabs their interest at first merely because it is new. And I am in agreement that a disease that affects the US and western Europe instead of mainly Africa or other third-world countries (AIDS, as opposed to malaria) will definitely provoke more interest, because in the case of the former, “the bell tolls for thee.” It is just human nature to be more upset about something that can potentially affect you and your loved ones rather than strangers in a far-off place.

I think there’s something else going on as well. The idea of a disease spread by the type of sexual behavior that was championed during the sexual revolution of the 60s is particularly threatening to the generation that grew up during that time. There was supposed to be no downside to such liberation, and it’s a bitter and difficult pill to swallow when the dreams of the 60s die (sometimes it seems as though there are no dreams of the 60s that haven’t died). The fact that AIDS first appeared, at least in the western world, in the gay male population–which had so recently undergone its own liberation–was also highly ironic and difficult for those who had championed that cause. So it’s no surprise that the anti-AIDS campaign would be especially well-supported among people who believe in those other causes.

Furthermore, a disease such as AIDS would seem to have almost no natural limits (unlike malaria) in terms of how widespread it could become in an area such as Africa where it is spread primarily heterosexually, and where sexual practices favor it and don’t seem to be changing any time soon. Although in the West the transition to heterosexual spread has not kept pace with early predictions, that transition is still the unspoken (and sometimes spoken) fear of many who believe conquering that AIDS is of the utmost importance for us, too. One has only to look at Africa to see a demonstration of how bad things could get if this spread were to occur. Although sub-Saharan Africa has many special characteristics (read my previous post for a description) that make AIDS particularly likely to spiral out of control there, the great fear is that it could also happen here.

Another commenter, Huck (who, if I’m not mistaken, is an “anonymous” who came in from the cold), points out that public health authorities have not been allowed to use their resources fully to combat AIDS in this country because of concerns about invasion of privacy and the like. Coincidentally, back in the early 90s when I was in graduate school, I researched and wrote a paper on that very issue. I am old enough to remember the use of such tools as contact tracing against venereal diseases, and in the earlier days of the AIDS epidemic, when there were fewer victims, I was wondering why the public health system wasn’t employing the old tried and true weapons to combat the new threat before it increased exponentially. The answer boiled down pretty much to “politics,” although there were other and more practical reasons (or in some cases, excuses) given, too. Some day I might try to exhume that old paper of mine and summarize it here–my recollection is that it contained some interesting nuggets of information.

18 Responses to “Why AIDS?”

  1. earnest Says:

    Here’s a useful resources on breast cancer information worth a look: http://breast-cancer1.com/

  2. helpful Says:

    Here’s a useful resources on short-changed chemotherapy treatments worth a look: http://breast-cancer1.com/

  3. achamka Says:

    Here’s a useful resources on breast cancer worth a look: http://breast-cancer1.com/

  4. Anonymous Says:

    You may have thought you knew everything about First Aids; just confirm by reading the matter that is found in the following article.

  5. Anonymous Says:

    actually about 1-2 million children die from malaria each year. The reason there is no money for malaria research is because no one in the USA gets malaria anymore.

  6. OBloodyHell Says:

    > by the way, in case you’re interested, here’s the latest update on King Mswati of Swaziland’s newest shady antics):

    Note, mind you, that, according to the article, she “showed the bruises”. Anyone who knows what a real whipping is knows that it doesn’t leave bruises, it leaves scars.

    > Also, the sovereign treatment for malaria is DDT, which is worse than plutonium or something, according to the Silent Spring school of environmental wonderfulness.

    The laughable part is that Rachel Carson was demonstrated to have been full of it decades ago. No one in the media seems to have spotted this, however (likewise the fact that Nader’s Unsafe At Any Speed was wrong on almost every level on the day it was published).

    That said, one of the flaws of the arguments offered in these comments is that they note no human consequence with the DDT exposure.

    What gave you the idea that the Greens give a rat’s ass about the safety of humans? I’d think that the flaws in these arguments would be in glowing, flickering neon…

    Carson’s original book was about the destruction of animals/insects as a result of DDT use — Humans weren’t even remotely relevant.

    If you want more amusement, then you should note the number of out of control imported species which were brought in in order to manage some pest or another — and which inevitably continue to F up the environments they are in. If you find a chemical solution is causing a problem, you stop and it and its damage slowly goes away. This “preferred” “all natural” method, once a screwup is obvious, is forever… but the Greens know better than the rest of us. They must, because their hearts are in the right places!

    Unfortunately for all involved, their heads are consistently stuck in all the wrong places as well.

  7. Richard Aubrey Says:

    How? The WHO opened the definition of AIDS and, whoops, doubled the number of cases in Africa. Repetitive infections of STDs other than AIDS plus other factors such as starvation and so forth cause wasting death. Calling it AIDS instead of LWD (Local Wasting Death) helps in several ways.
    But the CDC guys were right, eventually, as was Fumento regarding Western society. Africa could be a matter of different reporting, different HIV, different practices which increase the likelihood of infection.

    Inadequate needle supply for medical facilities. You will recall several years ago when a US athlete visiting Russia suffered an accident and a Russian athlete offered for her use his stash of western-acquired medical sharps. It was thought to have been a grand gesture, as the Russian sharps production is a fraction of the need. The saftey factor went without saying.

    In addition, Uganda as a society seems to be doing well with the morals-based approach to preventing the spread. Of course, this absolutely fries some folks.

  8. Alex Says:

    Richard Aubrey,

    I didn’t claim that abstinence wouldn’t work for an individual. Surely it works for many individuals, as does the conscientious use of condoms for many others. My point, however, is simply that eradicating AIDS is going to be difficult for the very reason that its main mode of transmission is so intimately tied up with morals and desires. Even setting aside the fact that most everyone wants to have sex, in some societies we have morals and practices, like for instance the widow inheritance we just read about, that actually encourage infection. People will change their DDT-spraying habits far more easily than they will change their sex habits. Sex is influenced my culture, love, desire, and yes, fear of disease. But that’s just one part of the calculus, and for many it will not be the deciding factor.

    Also, I don’t know what those CDC folks falsified, but it seems abundantly clear that heterosexual contact is at least an effective means of transmission. Just look at Africa. How do you think all those women get infected?

  9. Richard Aubrey Says:

    Abstinence works for those who practice it, in conjunction with marital fidelity.
    It might be nice to figure out a way to live as we please with no consequences, but I’d like to eat like a horse and get back to my decathalon-capable 205, too.
    Whether a society can protect itself against AIDS by means of abstinence is one question. Whether individuals can is another.
    The answer to the second is, absolutely.

    Several years ago, two docs from the CDC admitted they’d lied about the threat to the straight community from AIDS. The reason was to spread panic far and wide or there might not have been the political pressure to address the issue. Might be true, as far as motivation goes, but there are some in the field who, this confession notwithstanding, and Michael Fumento’s book notwithstanding, either haven’t gotten the message and still believe in the threat, or hope others are gullible, for the same reasons the two CDC guys did.

    To claim abstinence (including fidelity) won’t work for an entire society is one thing. To imply it won’t work for individuals is quite another, and false.

  10. Alex Says:

    neuroconservative & shrinkwrapped:

    I think those numbers may give the wrong impression. Let’s take the example of AIDS v. heart disease. First, I would want to compare the total amount spent on heart disease over the years with the total amount spent on AIDS. AIDS is still a relatively new disease, and scientists are still figuring out what can and can’t be done. Heart disease has been around forever, has been researched forever, and so it would be unsurprising if the amount of new work to be done in a given year were much smaller.

    Second, because AIDS, unlike heart disease, is communicable it has the potential, as we have seen in Africa, to reach society-threatening epidemic levels. Because of commuicability the risk presented by AIDS is greater than the risk presented by heart disease, even if that isn’t represented in current death rates.

    And last, there is a large difference in life-years lost between AIDS and heart disease. I don’t have the numbers, but I’m sure that the average age at death from heart disease is a lot older than from AIDS. Furthermore, advances in heart medicine might increase that age by mere months, whereas advances in AIDS treatment (particularly a vaccine or cure) would easily increase the number by decades. People with heart disease can have their lives extended, but will probably die of heart disease sooner or later. People with AIDS, if it could be treated, might live another 50 healthy and productive years. Given these three factors, I don’t think such spending priorities are completely out of order.

    There is of course the question of how AIDS reasearch money should be spent. Personally, I’m a big fan of Michael Kremer’s research on creating vaccine markets that will spur productive research. He also writes on malaria, tuberculosis, and a number of other important but neglected diseases. I highly recommend reading his stuff.

    Richard Aubrey & AVI:

    As for malaria, I’ve been interested in DDT for a while, ever since reading this article. It really seems to be the best solution. And I really do think that if more people knew the costs and benefits they would agree. Only a fringe of the hardest-core environmentalists would still oppose it. But most people don’t know.

    Anonymous 6:21:

    Leaving aside your nonsense about AIDS furthering the leftist agenda and leftists wanting certain regions of the world to be unlivable, which quite frankly makes no sense, there is the issue of your policy recommendation: abstenance. That’s funny, because this whole thread was inspired by a similar suggestion by King Mswati of Swaziland. Sex is basic to human nature and society, and I think only someone fairly naive about human nature would ever characterize an abstenance solution as “simple.”

    This, in my analysis, is the thing that makes AIDS a trickier case than malaria, albeit currently less of a killer. Contracting and preventing malaria can be done without much reference to the societies involved. In contrast, AIDS is transmitted through an act that is at once emotionally-charged, potentially shameful, and basic to most societies and to human propagation generally. Likewise, preventing AIDS usually involves explosive emotions, overcoming shame, and in many cases the reformation of social mores and reorganization of long-standing cultural norms. It is unsurprising that it has been so stubbornly difficult to control, and has wrecked such havoc on the societies it affects.

  11. Richard Aubrey Says:

    AVI. I did some studies on the subject of subSaharan Africa about forty years ago. For reasons I cannot now recall, I did a paper on the prospects for malaria eradication in East Africa. It was well received, as were several of my blind shots over my academic career.
    One of the ways to DDT various places was for guys to take a pump/backpack and walk around buildings and homes and barns and puddles and whatever, spraying DDT powder in all directions. This was their job; they did everything but bathe in the stuff. I found no reports of ill health among the guys who walked in a cloud of DDT their entire working day.
    I’ve always wondered.

  12. Anonymous Says:

    AIDs is a lifestyle desease and furthers the leftist agenda. DDT ‘cures’ malaria but also allows regions to be livable that the lefties want to preserve for whatever. So AIDs good DDT bad, people die.

    It’s agenda driven, pure and simple.

    Oh, there is a simple cure for AIDs, a wonder NIH hasn’t found it yet, it’s free, just don’t do it.

    Confusing isn’t it.

  13. Rick Ballard Says:

    Apropos of the point AVI is making, Uganda simply doesn’t hold the ‘approved’ view.

    Nothing kills like liberals.

  14. Assistant Village Idiot Says:

    Richard Aubrey steals my first thunder. Malarial mosquitoes are killed by a 1% concentration of the amount of DDT used in the 60′s, which is in turn a 1% concentration of the DDT they used to spray directly all over people — the soldiers at Normandy and kids in NYC for example — before that. None of those humans showed any reported negative effects. As the anti-DDT crowd overlaps significantly with the we-have-too-many-people-on-the-planet crowd, the irony is ugly.

    As to AIDS treatment, we were originally not allowed to make reference to the gay-male connection when it first appeared at my hospital in 1984, because gay rights advocates were telling providers that it was insulting to bring it up. A year later the political correctness reversed, and the complaint was that the disease was being ignored because it was seen as a “gay disease.” (We are hard to please sometimes.)

    It helped to start this socialist bleeding heart on the long road to (an eccentric) conservatism.

  15. Dad Says:

    Wouldn’t it be interesting if DDT cured or prevented AIDS?

  16. Richard Aubrey Says:

    Also, the sovereign treatment for malaria is DDT, which is worse than plutonium or something, according to the Silent Spring school of environmental wonderfulness.
    Talking about malaria and the zillions of death since Rachel Carson wrote her book would point a finger at those who are, although impossible to embarrass, interested in avoiding blame.

  17. ShrinkWrapped Says:

    Neo,
    I think you missed some crucial compnents that make AIDS a “chic” disease rather than Malaria. You are correct that AIDS is an issue for America and Europe and Malaria affects people who are effectively invisible to our media, but there is more to it. When I was a Resident in Psychiatry at Bellevue, I saw first hand some of the earliest cases of GRIDS (Gay Related Immuno-Deficiency), which was what it was being called before the HIV virus was isolated and described. It was thought to be an illness that affected Gays by virute of something in their lifestyle. When it was discovered to have a viral cause, the Gay community drove the bus, the media and Hollywood jumped aboard, and they all pushed for funding to fight AIDS with a vigor rarely displayed for other diseases. The fact is that the Gay community in the media centers of NY & LA has always been wealthy, influential in the arts and letters, and motivated. There was tremendous pressure to force the view that AIDS is an equal risk to men and women, homosexual and heterosexual, despite the fact that the evidence is to the contrary in the West. The greatest risk factor for hetersexually transmitted AIDS is poverty. The main risk factors over all are homosexual (M/M) sex and IV drug use. It is a myth, pushed by Hollywood, the liberal press, and the AIDS establishment, that all of us are equally at risk. In Africa, heterosexual transmission is the norm, via various social and cultural factors, (how much homosexual activity exists in Africa is impossible to gauge) and it took a Republican President to expand funding for AIDS treatment and prevention in Africa.
    AIDS is a Politically Correct disease with a powerful, moneyed constituency, and that is why it gains a disproportioinate amount of money and press.

  18. neuroconservative Says:

    This is a very important issue that has received scant attention. I wonder how many people are aware that more than 10% of the annual budget of the National Institutes of Health is spent on AIDS research (nearly $3 billion out of a total budget of $28.8 bil).

    This chart demonstrates that 10x as much money is spent (per US death) on AIDS than breast cancer, and 70x as much as heart disease. Perhaps the disproportionate AIDS funding is justified, based on the global scale of the problem. However, I don’t think that this decision has ever been openly placed before the general public (as opposed to interest groups that have a strong agenda). Would these priorities survive an open debate?

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Previously a lifelong Democrat, born in New York and living in New England, surrounded by liberals on all sides, I've found myself slowly but surely leaving the fold and becoming that dread thing: a neocon.
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