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Fighting AIDS in the 21st Century

By Akbar Ali

It may seem hard to believe, but AIDS has only been a major human disease since it was first identified in 1981. After the initial scare of an impending epidemic and a series of international programs designed to educate populations to combat the spread of the debilitating disease, many nations settled into a period of complacency about AIDS despite the fact that it has claimed as many as 25 million lives over the last 27 years. With all the media attention on the threats of terrorism and climate change, awareness about AIDS and its continuing destruction of specific populations has all but vanished off the radar of the international agenda.

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The World Health Organization currently estimates the global population of those living with HIV and AIDS at nearly 35 million, making it the deadliest pandemic in recent human history.
Which is why a recent comment by Sam Rodriguez, president of the National Hispanic Christian Leadership Conference, is particularly striking in terms of both content and timing. Rodriguez, in a discussion with journalist Bill Moyers about the growing role of Latino voters in American politics, framed the debate about justice and righteousness in contemporary America by asking the following question: "Is America committed to eradicating terror and eradicating Al-Qaeda? I would say 'yes,' only if we are as equally committed to eradicating AIDS."

Which of course raises the question "Are we?" The short answer is "no," not because of an unwillingness from political leaders but because of a collective malaise about the entire epidemic, symptomatic of the pervasive attitude that AIDS is 'their' disease and needn't be dealt with directly as the full-blown epidemic it has become.

The World Health Organization currently estimates the global population of those living with HIV and AIDS at nearly 35 million, making it the deadliest pandemic in recent human history. So why is there so much apathy and disinterest expressed towards AIDS, not only on the part of global, civic, and community leaders but from the healthcare industry itself?

AIDS still carries a very strong stigma of incurable disease, sexual impropriety, and yes, death. But the collective silent echo from many quarters has made the epidemic that much more difficult to manage. Additionally, AIDS is viewed primarily as a disease affecting those who "deserve" it (drug addicts and prostitutes) and those living in environments where populations are viewed as expendable (India, China, and Sub-Saharan Africa). Economic and racial prejudice play important roles in how AIDS is perceived across the world, and unfortunately, these perceptions will need to be challenged before any effective and organized effort against AIDS can materialize.

The good news is that there is at least a general consensus among major political leaders and healthcare professionals that the first step to eradicating HIV and AIDS is education. Awareness about how the disease is spread, its primary symptoms, and what can be done to contain it once it has been contracted is the primary aim of HIV and AIDS prevention.

It is equally important for local officials to integrate programs which combat false assumptions about HIV and AIDS. Different cultures have varying perspectives on sex, sexuality, and treating medical ailments which can lead to the dissemination of beliefs that are not only false but harmful. For example, a sizeable portion of the South African population believes that sexual intercourse with a virgin will cure an individual afflicted with AIDS. Needless to say, this is nothing more than a patently false superstition which has led to further spreading of the disease, oftentimes through rape of young children and even infants.

Currently, the U.S. government advocates what is known as the "ABC approach" to AIDS education:
  • Abstinence or delay of sexual activity, especially for youth
  • Being faithful, especially for those in committed relationships
  • Condom use, for those who engage in risky behavior
Though this seems very elementary, it has proven effective, especially in Uganda where HIV rates have dropped precipitously from 15% to 5% of the total population. Other regions of the world will no doubt require more complex strategies.

Another major hurdle to be addressed is the supply of medication. Non-industrialized nations often have limited resources to access drugs which have been proven effective in the treatment of HIV. A combination of drugs known as highly active anti-retroviral therapy (HAART) has been especially effective in allowing HIV patients to live relatively healthy and normal lives after contraction of the virus occurs. But the lack of access to those who need it most has led to the demise of millions. In 2005 an estimated 2.5 to 3.5 million lives were lost to AIDS, of which 570,000 were children.

For those living with AIDS in the United States, there exist a number of healthcare resources which can be utilized for treatment. The no-profit, Los Angeles-based AIDS Healthcare Foundation is the world's largest provider of HIV medication and treatment which proclaims its mission as to "provide cutting-edge medicine and advocacy, regardless of ability to pay." Currently it serves over 27,000 AIDS and HIV patients in the United States, Africa, Central America, and Asia, offering everything from testing and medication to insurance plans and emotional support.

The United States is unique in that it is the only nation in the world where HIV and AIDS occur at higher rates among homosexual men than in the mainstream population. Because of this, organizations such as the Manhattan-based Gay Men's Health Crisis (GMHC) have implemented the AIDS Health Insurance Program (AHIP) which provides coverage for those living with AIDS or HIV-related diseases who are unable to qualify for Medicaid but unable to pay for their own insurance. Many prominent public figures, including New York City Mayor Michael Bloomberg, Bill Cosby, Barbara Walters, Celine Dion, and Rosie O'Donnell have become actively involved in AIDS advocacy through working with GMHC, the nation's oldest not-for-profit AIDS service organization.

For many, the battle against AIDS and HIV will be a classic case of "too little, too late." Undoubtedly, the plethora of distractions and misplaced priorities will prove to be as formidable a challenge as finding a breakthrough cure for HIV and AIDS has been. Clearly, this needn't be the case, but only time and a collective willingness to change can offer real hope to the millions across the world running out of both hope and time.

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