AIDS: Overblown Global Crisis?

Cross posted from Monkey in the Middle

Today is World AIDS Day. The day the whole world is suppose to remember that there is an pandemic happening through out the world. Right now, about 40 million people in the world are living with HIV infection or AIDS. This estimate includes 37 million adults and 2.5 million children. In the United States alone, more than 1 million people are living with HIV. A large number, but there are other diseases that infect more people and take more lives each year.

As World AIDS Day is marked on Monday, some experts are growing more outspoken in complaining that AIDS is eating up funding at the expense of more pressing health needs.

They argue that the world has entered a post-AIDS era in which the disease's spread has largely been curbed in much of the world, Africa excepted.

In Africa some nations are almost 100% infected. Uganda is one of these. And those infected are not able to receive the necessary medical treatment needed for long term survival. Drugs that can slow the infection rate down, or prevent secondary infections from occurring are not being given to those most needy. Some of this is due to the cost of the drugs, other is the bureaucracy in many of the developing world.

Roger England of Health Systems Workshop, a think tank based in the Caribbean island of Grenada, goes further. He argues that UNAIDS, the U.N. agency leading the fight against the disease, has outlived its purpose and should be disbanded.

"The global HIV industry is too big and out of control. We have created a monster with too many vested interests and reputations at stake, ... too many relatively well paid HIV staff in affected countries, and too many rock stars with AIDS support as a fashion accessory," he wrote in the British Medical Journal in May.

Just like every other UN Agency it seems. This is nothing new. Just another bit of wasteful money mostly donated by American Taxpayers.

Paul de Lay, a director at UNAIDS, disagrees. It's valid to question AIDS' place in the world's priorities, he says, but insists the turnaround is very recent and it would be wrong to think the epidemic is under control.

"We have an epidemic that has caused between 55 million and 60 million infections," de Lay said. "To suddenly pull the rug out from underneath that would be disastrous."

The estimate of 55 to 60 million people is a bit high. It is more like 35 to 40 million people, many of which would not have been infected if the men of their nations would wear a condom. But that would mean that they aren't masculine enough. It would demean their manhood to wear one. So they don't, they visit prostitutes who are infected, they become infected and then infect their wives. Nice gift honey but I wanted a new washing machine!

U.N. officials roughly estimate that about 33 million people worldwide have HIV, the virus that causes AIDS. Scientists say infections peaked in the late 1990s and are unlikely to spark big epidemics beyond Africa.

In developed countries, AIDS drugs have turned the once-fatal disease into a manageable illness.

And the rate of infection is also down. The highest risk groups today are drug users and teenagers. I guess teens don't believe in safe sex either.

England argues that closing UNAIDS would free up its $200 million annual budget for other health problems such as pneumonia, which kills more children every year than AIDS, malaria and measles combined.

"By putting more money into AIDS, we are implicitly saying it's OK for more kids to die of pneumonia," England said.

Measles can be prevented by inoculations. They are low cost and do work. Pneumonia kills millions each year, but we keep hearing there isn't any money to help these people.

His comments touch on the bigger complaint: that AIDS hogs money and may damage other health programs.

By 2006, AIDS funding accounted for 80 percent of all American aid for health and population issues, according to the Global Health Council.

In Ethiopia, Rwanda, Uganda and elsewhere, donations for HIV projects routinely outstrip the entire national health budgets.

In a 2006 report, Rwandan officials noted a "gross misallocation of resources" in health: $47 million went to HIV, $18 million went to malaria, the country's biggest killer, and $1 million went to childhood illnesses.

It is time that these nations get to use the donated funds where they need it the most. If malaria is killing more people each year, then they should use the funds there. It is the logical approach to a health crisis that these nations are facing.

AIDS advocates say their projects do more than curb the virus; their efforts strengthen other health programs by providing basic health services.

But across Africa, about 1.5 million doctors and nurses are still needed, and hospitals regularly run out of basic medicines.

Experts working on other health problems struggle to attract money and attention when competing with AIDS.

What good is basic medical services when there are no medicines to treat the basics? In Africa there is a shortage of doctors, nurses, medical technicians, and medicines. There is no shortage of suffering though.

"Diarrhea kills five times as many kids as AIDS," said John Oldfield, executive vice president of Water Advocates, a Washington, D.C.-based organization that promotes clean water and sanitation.

"Everybody talks about AIDS at cocktail parties," Oldfield said. "But nobody wants to hear about diarrhea," he said.

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I'm sorry Mr. Oldfield, but there is no way you are going to ever get anyone to talk about diarrhea at a cocktail party. At a frat house party, maybe. But the average person doesn't even like to think about diarrhea.

AIDS is a glamor disease. Scores of the A-List celebrities just have to come out and say something about AIDS every year. If you don't, then your career is ruined. But Roger England is correct. The world is spending too many resources on one illness and neglecting other serious problems. It is time that the individual nations involved in this have a bigger say on where donated monies should be spent. Yes AIDS patients should receive the medicines that will help them survive many years, but money should be spent to prevent treatable illnesses like measles, to help patients with malaria, and even start providing the basic health care that would prevent all these illnesses.

And on this World AIDS Day, I think that my tax money would be spent in a better way.

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