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Opinion Column
For the week of July 26 through August 1, 2000

Significant moral questions sparked by the World AIDS Forum

Commentary by ADAM TANOUS
Express Staff Writer


Given the current infection rates and also given that 19 million people have already died since the beginning of the epidemic, it seems likely that AIDS will be even deadlier than the Black Death of the 14th century when 40 million Europeans were killed by bubonic plague.


If there is one bright spot to the history of the AIDS epidemic it is the speed and conviction with which the gay community first responded to the threat. It was vigilant in educating people, galvanizing action, and demanding political response—such as getting government money flowing into the research world.

They faced enormous barriers of bias that came about when the Christian right linked AIDS with deviance. Much of the bias was built upon scientific ignorance as exemplified by Rev. Jerry Falwell when, in 1983, he proclaimed on television, "AIDS is God’s punishment…We do reap it in our flesh when we violate the laws of God."

Granted, the scientific findings at the time were limited. Nonetheless, it never occurred to this conservative faction that a virus could be responsible for the disease in the first place; and that it is possible a virus might not consider a host’s sexuality when determining its path of infection.

The result of that resolve by the gay community was that the infection rate decreased significantly. But then, as the disease spread among the heterosexual population and the I-V drug population, it became clear that the problem was a very complex one. Still, scientists responded admirably.

A tremendous amount of work was done trying to understand the disease. Specifically, great strides were made in understanding modes of transmission and ways of detecting the virus. These advances paved the way for massive education and prevention programs.

Concurrently, scientists studied new drugs and their effects on the virus. After several permutations of clinical drug tests, it now appears, almost 20 years after the first appearance of the disease, that people infected with the virus can live for many healthy years without developing AIDS.

Of course, I am talking about America. There is a much more depressing scenario playing out in the rest of the world, specifically in Africa.

At the recent World AIDS Forum held in South Africa, it became apparent that the somewhat positive course of events in the United States is not at all representative of Africa. The data that came out of the conference indicated that the epidemic is raging out of control, killing millions of people.

To fill out the factual picture a bit, here are a few samples of the horrendous figures coming out: The AIDS infection rate in the U.S. is 0.61 percent. In Botswana the rate is 35.8 percent; in South Africa, 19.9 percent; in Zimbabwe, 25.1 percent.

Worldwide, 34.3 million people are living with HIV or AIDS. More than 24 million of those people live in sub-Saharan Africa (71 percent). Because of AIDS, the projected life expectancy in 2010 in Malawi is 35 years. Without AIDS it would have been 58 years. Namibia’s life expectancy has fallen from 70 to 38 years. Life span’s have been cut nearly in half.

Given the current infection rates and also given that 19 million people have already died since the beginning of the epidemic, it seems likely that AIDS will be even deadlier than the Black Death of the 14th century when 40 million Europeans were killed by bubonic plague.

What also became apparent during the conference was that there is a widening gap between the majority of victims today—generally from poor and undeveloped countries—in terms of access to resources that can be applied to control the problem.

It is a disparity that poses significant moral questions.

The sophistication of medical care and its inherent high cost are increasing much faster than the economic means of third world nations. The question arises: If we have the medical capability to solve or diminish a health care crisis outside of our borders, are we obligated to implement it and pay for it? It is a scenario that, I think, wealthy nations will increasingly be confronted with.

It is one way this plague differs from that of the 14th century. This time around we actually know how to control the disease. The people of the 14th century had no moral qualms, because they didn’t have any solutions. We have the drugs and the educational programs at our fingertips. The money is the rub.

Dr. Peter Piot, head of the United Nations organization monitoring the spread of AIDS, has said that it would take a minimum of $3 billion per year to deal with the AIDS problem in Africa.

Certainly it is easy to say we don’t have the money. But when we constantly hear about massive budget surpluses (in the trillions) and things like the military’s recent spending of $100 million for a one-shot test of an anti-missile system (one that failed as it turns out), it seems a less defensible position. Furthermore, if Africa collapses socially and economically—and it likely will if nothing is done—the cost to the U.S. will be far greater than $3 billion per year.

It may be, too, that it is not a purely economic decision.

We might also look at such a calamitous situation from a broad perspective—that is, in evolutionary terms. From a purely physiological point of view, HIV presents a significant challenge to our livelihood. And it appears that with our fine scientific minds, financial commitment and political resolve we have found a way out of the noose, in the U.S. at least. But perhaps there is more at stake.

What makes humans unique in the animal kingdom is our compassion and sense of ethics. It would seem that those qualities have to play into our survival as a species. It is hard to believe that our sense of morality is like the appendix in our guts—a quirk or oversight of evolution with no apparent function. Surely, we possess compassion and morality so that it may be expressed.

Trying to rationally extrapolate where the paying of large sums of money to prevent suffering and death will lead us is a futile exercise. We rarely do the right thing because we can foresee the result. We do not have that kind of vision. Usually, we do it because we can.

 

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