The 17th International AIDS Conference, taking place this year in Mexico City, kicked off on Sunday August 3, 2008 with the President of Mexico, Felipe Calderon Hinojosa, officially welcoming around 22,000 delegates from 175 countries to the gathering. While Mr. Hinojosa's appearance makes a change from 2006 when Canadian Prime Minister Steven Harper refused to attend the Conference taking place in his own country, it looks like nothing much else has changed from two years ago when it comes to actually dealing with the disease.
Of the 22,000 or so people who have shown up in Mexico City, one has to hope that they are all aware that HIV/AIDS can only be spread by an infected person sharing bodily fluids with an uninfected person. So in order to prevent the spread of the disease all you have to do is reduce the chances of that happening. Statistical evidence gathered over the past twenty years by organizations such as UNAIDS and the World Health Organization (WHO) shows that making condoms available for sexually active people and supplying clean needles to intravenous drug users are the two most effective ways of preventing the disease from spreading, as those are the two most common ways the disease is spread. (Please see Elizabeth Pisani's reference page at her Wisdom Of Whores Web site for support documentation and statistics)
However, judging by the way things are shaping up at the conference, people are either reluctant to talk about the issue of prevention directly or, even worse, oppose the means of ensuring delivery of preventative measures. For example, instead of talking about condoms and needles, the latest refrain is "prevention by treatment". While it is of course inexcusable that only four million out of the thirty-three million people worldwide currently estimated to be infected with the disease are receiving treatment, arguing that ensuring everybody infected is treated will prevent the disease from spreading is a fallacy.
Although it is true that once a person is on the anti-viral medication used to prolong an AIDS sufferer's life expectancy they are less infectious, they can still transmit the disease and need to take the same precautions that anyone else does. The problem is that statistics are showing that once people start taking the medication they believe they aren't a threat anymore and stop taking preventative measures.
Other problems with this approach is, what do you do about people who are infected but don't know it? If you don't know you're infected with the virus you're not liable to be taking the anti-viral cocktail of medications required to fight the HIV/AIDS virus, are you? Now consider that in light of recent statistics that show one in five of homosexual men in New York City who test positive for the virus already have full-blown AIDS. Considering how long it takes to develop full-blown AIDS after you have contracted the HIV virus — sometimes ten years — it means these men have been infectious for that length of time without knowing.
What makes that statistic truly alarming is that the gay community of New York City has been one of the most effective and organized in combating the disease and educating its membership about the dangers of unprotected sex and the importance of early testing. If those conditions exist among a community as aware and active as that, you have to wonder how many other people around the world are walking around undiagnosed. The normally reliable U.S. Centres For Disease Control and Prevention just announced that the figures they released detailing the number of new cases of HIV in the United States for 2006 was off by 16,300, as there were actually 56,300 not the 40,000 they had originally estimated.
What the hell's the good of using treatment as prevention if we don't even know how many people are even sick, or if they've been sick for any number of years before they even obtain treatment? Anyway, the whole idea smacks of closing the gate after the horse has escaped the barn. If you can prevent someone from getting the disease, they aren't even going to need treatment. It seems to me the folk recommending this new plan really need to remember the old adage of an ounce of prevention equalling a pound of cure. Especially since we don't even have a cure, only treatment that will prolong life, not save it.
Of course, the real problem isn't the people who are pushing this new strategy; the problem is the people caught doing the run-around. The biggest problem faced by people working in the HIV/AIDS field has been having to work around politicians and religious leaders who still live in caves and wont fund anything to do with needles, condoms, sex trade workers, or homosexuals. In order to secure funding, they have had to convince these folk that "innocents" (women, children, and straight men) are at risk and talk about everything but the people most at risk, and the ways that can best prevent the spread of the disease.
Just look at what happened yesterday, at what is supposedly a conference on how to fight HIV/AIDS. Canada's idiot Health Minister, Tony Clement, gave a press conference attacking Insite, the safe injection site for intravenous drug users in Vancouver British Columbia. He chose to do this in spite of the fact that it completely disregarded the information released by WHO spelling out how effective such sites are for harm reduction, specifically the spread of disease. His government's reason for not liking Insite or any other safe injection site? They can't arrest the people who use them.
Is it any wonder that the HIV/AIDS new infection rate still outstrips the number of people receiving treatment by a ratio of 5:2 when we're dealing with people with this type of attitude? According to the latest statistics from UNAIDS, for every two people receiving treatment there are five new cases of HIV/AIDS reported. For the longest time, people have even tried to avoid saying which groups are most at risk from the disease for fear of marginalizing them even more than they are already.
Thankfully people like Stephen Lewis, former UN special envoy to Africa for HIV/AIDS, and Joe Amon, health and human-rights director at Human Rights Watch, are at least demanding that the rights of those most at risk must be protected and steps taken to ensure their access to treatment. It's a small step, but at least it's a step in the right direction. Still, it's a sad state of affairs when, at a conference dealing with a disease for which there is no cure and no vaccine, they can't talk about the best ways of preventing its spread in the opening addresses.
I know it's early days yet and the 17th International AIDS Conference still has a way to go, but from the looks of things we're no closer to dealing with the reality of HIV/AIDS now than we were when the first conference was held. As long as we continue to allow a moral code based on bigotry and hatred to dictate health care, people will continue to die and the disease will continue to spread.