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The HIV/AIDS pandemic: failures and questions

Posted by plosmedicine on 31 Mar 2009 at 00:17 GMT

Author: Yann Meunier
Position: Lecturer
Institution: Stanford Prevention Research Center
Submitted Date: December 10, 2007
Published Date: December 10, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

With the HIV/AIDS pandemic still progressing everywhere, I have identified deficiencies at 3 levels in 18 areas with the following questions:

(a) Individually
- The limited and selective capacity for empathy. Since these issues are often intertwined at the personal level, how many programs target HIV/AIDS, stigma and discrimination together?
- The compartmentalization of the mind. What will it take to tackle linked challenges (AIDS, TB, nutrition, poverty, etc) in a vast and integrated manner?
- The false sense of normalcy. Will the new generation of doctors and scientists who will have lived all their life with the HIV on the planet refuse the status quo?

(b) Nationally
- The initial skepticism of the medical community. Why are the proponents of AIDS denialism allowed to proselytize their criminal views?
- The slowness of the political response. How many hundreds of thousands have died of AIDS or contracted the HIV because a specific therapy was not available for political reasons? (See Thabo M’Beki’s example).
- The very powerful influence of the entertainment star system. Why can’t we see that the laudable anti-AIDS efforts made by entertainment stars also reveal the inability of national and international structures to provide adequate funds and the fragility of these sources of income stemming from the aura of a few individuals?
- Exaggerated perceptions. Have we learned the lesson given to us by the excessive expectations from the anti-protease breakthrough followed by loosening in preventive measures?
- AIDS fatigue: When will we start publicizing positive results more than good intentions?

(c) Internationally
- The restricted ability to coalesce and face a common and invisible enemy. After the grotesque dispute between professors Gallo and Montagnier that deprived us from a serological test for too many months, why wasn’t a flexible international entity created to prevent this kind of deleterious feud?
-The failure of existing structures such as W.H.O.
- The lack of proper financial means. What is being done to close the widening gap of US$8.1 billion between funding and resources needs in 2007?
- The digital divide.
- The incapacity to implement lasting widespread behavioral change. Have we really learned from the formerly touted models of successful prevention campaigns like Thailand’s?
- The weak responses to social stigma. Since: (1) The main obstacle to the control of the HIV/AIDS pandemic is the known reservoir of million of unidentified healthy carriers and (2) Education campaigns either failed or are too slow, what is the strategy to bring these people out of the shadow?
- The inability to tackle the ultimate basic catalyst to the HIV progression: poverty.
- The strong resistance of multinational corporations. Have we learned from the AZT patent protection by GSK and what are we doing to promote more progressive policies such as Gilead’s with its Truvada sold at US$24.51 per daily dose in the U.S. and 87 cents ppd in Africa? (Gilead also offers its drug recipe to generic makers).
- The religious obstacle. Since abstinence only does not work, how many millions will have died and suffered in vain before this religion-based strategy is abandoned? Moreover, if you don’t play the game, how can you set the rules?
- The boundless propensity to wasting. In 24 years how many HIV/AIDS and related topics congresses and alike have been held? What have the millions of travel, accommodation and meal expenses yielded? In the information age, what are the real benefits of these countless pagan Masses?

No competing interests declared.