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Old 11-30-2008, 10:41 PM   #1
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Global AIDS crisis overblown?

Global AIDS crisis overblown? Some dare to say so - Yahoo! News

Global AIDS crisis overblown? Some dare to say so


By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer – Sun Nov 30, 11:58 am ET


LONDON – 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.

"AIDS is a terrible humanitarian tragedy, but it's just one of many terrible humanitarian tragedies," said Jeremy Shiffman, who studies health spending at Syracuse University.

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.

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."

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.

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.

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.

"There needs to be a rational system for how to apportion scarce funds," said Helen Epstein, an AIDS expert who has consulted for UNICEF, the World Bank, and others.

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.

"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.

These competing claims on public money are likely to grow louder as the world financial meltdown threatens to deplete health dollars.

"We cannot afford, in this time of crisis, to squander our investments," Dr. Margaret Chan, WHO's director-general, said in a recent statement.

Some experts ask whether it makes sense to have UNAIDS, WHO, UNICEF, the World Bank, the Global Fund plus countless other AIDS organizations, all serving the same cause.

"I do not want to see the cause of AIDS harmed," said Shiffman of Syracuse University. But "For AIDS to crowd out other issues is ethically unjust."

De Lay argues that the solution is not to reshuffle resources but to boost them.

"To take money away from AIDS and give it to diarrheal diseases or onchocerciasis (river blindness) or leishmaniasis (disfiguring parasites) doesn't make any sense," he said. "We'd just be doing a worse job in everything else."
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Old 11-30-2008, 10:44 PM   #2
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Special interest groups competing for resources? What a shock.
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Old 11-30-2008, 11:04 PM   #3
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You're right there is no crisis...
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Old 12-01-2008, 01:14 AM   #4
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Originally Posted by BonoVoxSupastar View Post
You're right there is no crisis...
That's a non-sequitur. Logically, from "crisis overblown" you cannot make the conclusion that the people in the article or AnnRKeyintheUSA are saying "there is no crisis". And the people in the article are clearly not saying that.

I think it really is a difficult issue. Currently writing a paper about malaria in Kenya, I found instantly that it is very difficult to find much information or statistics helpful to the topic of the paper about malaria, and same goes for other diseases, while you will have no problem getting plenty of information about HIV/AIDS. Sometimes you try searching for something on malaria and all you get is AIDS (sorry, the sentence might sound a bit weird).

Of course this isn't meant to denigrate the issue, and I don't personally think the crisis is overblown. But at the same time it is dangerous if you have one disease that gets almost all the coverage, while other diseases (almost) as harmful, widespread and dangerous hardly get recognized. That way, you are running the risk of developing a myopia which in the end won't solve the complex problem you are facing here: That African countries are struck by a multitude of severe diseases that all contribute to the poor situation they are in, and while you try to behead one part of the hydra the rest of it is alive and kicking.
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Old 12-01-2008, 07:36 AM   #5
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That's a non-sequitur. Logically, from "crisis overblown" you cannot make the conclusion that the people in the article or AnnRKeyintheUSA are saying "there is no crisis". And the people in the article are clearly not saying that.

I think it really is a difficult issue. Currently writing a paper about malaria in Kenya, I found instantly that it is very difficult to find much information or statistics helpful to the topic of the paper about malaria, and same goes for other diseases, while you will have no problem getting plenty of information about HIV/AIDS. Sometimes you try searching for something on malaria and all you get is AIDS (sorry, the sentence might sound a bit weird).

Of course this isn't meant to denigrate the issue, and I don't personally think the crisis is overblown. But at the same time it is dangerous if you have one disease that gets almost all the coverage, while other diseases (almost) as harmful, widespread and dangerous hardly get recognized. That way, you are running the risk of developing a myopia which in the end won't solve the complex problem you are facing here: That African countries are struck by a multitude of severe diseases that all contribute to the poor situation they are in, and while you try to behead one part of the hydra the rest of it is alive and kicking.
I agree completely, but my point is how can a true crisis really be "overblown"? It's a crisis or it isn't.

There are those that have posted articles similar to this in the past with their own agendas in mind trying to prove that there is no crisis, it's made up by the liberal media, etc...
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Old 12-01-2008, 08:13 AM   #6
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Originally Posted by Vincent Vega View Post

Of course this isn't meant to denigrate the issue, and I don't personally think the crisis is overblown. But at the same time it is dangerous if you have one disease that gets almost all the coverage, while other diseases (almost) as harmful, widespread and dangerous hardly get recognized. That way, you are running the risk of developing a myopia which in the end won't solve the complex problem you are facing here: That African countries are struck by a multitude of severe diseases that all contribute to the poor situation they are in, and while you try to behead one part of the hydra the rest of it is alive and kicking.
I agree with you here. People don't die of HIV/AIDS they die of secondary infections or other things like malaria, tuberculosis, yellow fever, etc. Like you I'm not saying to ignore HIV and focus elsewhere but it seems more and more like HIV/AIDS awareness is the "hip" thing to do. In the USA if you have money you can get HIV and maybe never even get AIDS. If you can address and treat the secondary infections and other problems that are the real killers you might live into old age.

When I was in Africa honestly I was more disturbed by the number of people that either don't have access to a mosquito net or simply won't use one. No one has a cure for HIV but geez, nets are relatively cheap and simply to use. A little education and support on that front goes a long way as far as preventing the spread of malaria.

But, I do think all the attention given to the HIV/AIDS pandemic is important in order to fight the stigma of the disease. Maybe it's more about us in the west changing our attitudes that people deserve what they get...
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Old 12-01-2008, 10:19 AM   #7
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I thought malaria was going to be solved by 2015 according to Bono.
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Old 12-01-2008, 10:41 AM   #8
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I thought malaria was going to be solved by 2015 according to Bono.

What year is it now?
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Old 12-01-2008, 11:30 AM   #9
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What year is it now?
Progress? If what Liesje says is correct.
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Old 12-01-2008, 11:39 AM   #10
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I wasn't sure what you were getting at with the way you phrased it...
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Old 12-01-2008, 12:52 PM   #11
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I thought malaria was going to be solved by 2015 according to Bono.
Can it be solved? I don't know much about it, but I know someone that had it (someone from my school, not an African). Or is the 2015 date meaning everyone should have a net by then? When I was there we used nets and were on antibiotics to "prevent" it but even then there's no guarantee (as evidenced by someone getting it). I was sick with fever when I got back and had to be checked twice, could not give blood for years even though I used the nets and took the pills.
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Old 12-01-2008, 01:28 PM   #12
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If I didn't know any better I'd think BVS and purpleoscar were married lol

Perhaps there is a disproportionate level of resources allocated to AIDS in developing countries. Although, if the developed world is in a post-AIDS era, then there is an underlying injustice/imbalance that persists that the AIDS crisis highlights more so than say, malaria.

It's more of a political issue than a health issue which I can understand would frustrate health professionals who are trying to address a broad spectrum of mortality risks across broader populations.
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Old 12-01-2008, 02:25 PM   #13
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one of the simplest steps that we could take to nearly eradicate AIDS, that's almost akin to simply buying people mosquito nets, would be to make an HIV test a routine part of a yearly physical. if everyone knew their HIV status, it's unlikely they'd pass it along to others since condoms do work, and those who are positive might choose other positive sex partners.

in the Western world, the best thing you can do to fight HIV is to get yourself, and five friends, tested. and get them to get five friends tested, etc. though it does seem that the people who most need to know their status are the least likely to get tested.

but that's the best way to start.
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Old 12-01-2008, 03:22 PM   #14
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Making the test routine would take the stigma away and sadly I think there are too many people who'd rather see the stigma of risky behaviour stick.
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Old 12-01-2008, 03:33 PM   #15
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A large problem is that we are throwing too much money into the development of a vaccine that may be a fool's dream.

We may instead have to accept that HIV is going to be in the population much like many other viruses that were never eradicated, and that if we can learn how to control the spread and how to develop better and cheaper treatment, then that is the better way to proceed at this point.
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