something of substance (p2)

I’m taking two subjects in epidemiology here. What is it? Good question, I googled it only after I enrolled. Basically, it’s global disease spread – sort of. It’s interesting for sure, and highly informative. We watched Contagion in class, not for its entertainment value but because of its realism, its plausibility – and its factual, scientific basis. What I got out of it? Well, I’m never touching my face, or absolutely anything, ever again. 

I’ve read more about virus’s, pathogens, bacteria, prions and mutations in the past week and a half then I have in my entire life. And the truth is kind of scary.

Did you know that one infected animal carcass can make its way into 8 tones of meat products? Yum. But irrelevant.

HIV is the case study for a lot of things. The need for a global response. The theory of zoonosis (humans getting disease from animals). An extended incubation period. The cause of immunodeficiency. The tenaciousness of virus survival. The ability to mutate, and replicate. The development of virus resistance etc, etc. Do I sound smart yet? I feel smart. Prepare for this to become a little academic. Watch this to kill some brain cells in the mean time:

I touched on this in my previous article but HIV isn’t really about HIV – in terms of the virus itself. HIV is instead about the environmental, social, political and global conditions which foster both its spread, and its survival.

 For example, lets talk South Africa. HIV spread so quickly within South Africa due to a prevalence of previous Sexually Transmitted Disease epidemics, migrating labour patterns, lingering apartheid values, increased mobility, cultural resistance to condom use, the low socioeconomic status of women, the promotion of promiscuity amongst men and cultural taboo’s around the conversation of sexual matters – amongst many others. And this is just one country, and in many others around the world a bunch of other things could be added to this list – at the forefront of which is simple lack of education, lack of health care, lack of global equality. HIV and AIDS is thus much more then a biological problem, it’s much more then a virus – it’s complicated.

I’ve said it before but I’ll say it again, HIV is a nasty one because it’s so, so unfair. Not only do conditions of poverty heighten the chance of HIV and AIDS infection, but they also then limit the access of individuals to antiretroviral (ARV) treatment as, still today, ARV access remains beyond the reach of most HIV and AIDS patients. An awful virus which destroys individuals, families, countries and economies, which is both preventable and treatable, and yet not everyone has access to that? Outrageous! It makes my heart hurt and I don’t know what to do about it.

the HIV virus. Not going to lie I just google imaged it.

 For example; in 2003, of the 6 million people in need of ARV’s, only 8% were receiving them. This treatment inequality is due to a number of interlacing factors. For one, health on a global scale has been largely transferred (through a series of policies and agreements) from being the responsibility of the state and the World Health Organization (WHO), to broader neoliberal global economic institutions, such as the World Bank (WB) and the International Monetary Fund (IMF) (or as I like to refer to them, Evil 1 and Evil 2). This global shift has created a priority switch, from public health equity to market efficiency. In turn, health problems – such as HIV and AIDS amongst many others – are perceived to be hindrances to economic development. This has resulted in worldwide cuts in public health budgets.

Therefore, under the World Trade Organisation’s (WTO) ‘Trade Related Intellectual Property Rights’ (TRIPS); developing governments are often inhibited from purchasing or producing ARV drugs at a price in which their people can afford. This was the case up until 1999, whereby ARV’s had to be purchased at market prices. This is blatant biocommodification in my opinion! Making people commodities, and putting dollar tags on health and life. People aren’t products!

But, here’s the question: do you put money into research, or into prevention, or into health care? Well, in 2001 (I understand that this now, was a really long time ago), 92% of the USA’s $14.2 billion spending on HIV and AIDS prevention went to developed nations. That’s right – developed. HIV is the most researched virus in history and yet, after more than 25 years of medical research it remains void of a biological cure. Depending on a number of factors, an HIV and AIDS infected individual may survive for a few years, or a few decades; but regardless and eventually HIV always wins, and the human immune system is destroyed. Thus, ARV treatment and medical research have not provided for the developing nations that need it most.  

An additional paradox caused by ARV’s is the fact that, due to increased spending on treatment; budgetary cuts have been made to other preventative methods of control, which – for the poorest of the poor – is often the only means that they have to information or assistance. Additionally, even if ARV’s are introduced into a developing nation, it is almost always only the local elite which are able to afford and have access to them; thus widening the gap of inequality within nations, as well as between nations. This then further cements the fact that HIV and AIDS is a social disease, which runs along class, caste, race and gender lines. Prevention must therefore address these inequalities. 

my "I'm really mad" face. Coupled with my morning hair face.

THIS MAKES ME MAD!!! Because the effective course of ARV treatment is sophisticated, and requires skilled medical professionals, facilities and regular testing; ‘Third World’ nations (I hate that term) have often been assumed to be just that, ‘Third World’; and thus beyond the technological and medicinal capacity to administer effective ARV treatment. Thus, being underdeveloped excludes you from the right to medication in this instance, development then leads to development, and underdevelopment leads to further underdevelopment. I guess it’s the whole, the rich get richer and the poor get poorer idea. The power of life and death is still in the hands of the colonizer. HIV and AIDS prevention is thus by its very nature embedded in the discourse of inequality. Okay, I’m getting passionate.

But do you see my point? It’s not about a virus, it’s about people. It’s about living in a fallen, hurting world. It’s about a need for HOPE! I’m still not sure where I fit into all of this, but with 9 weeks till Africa I’m getting pumped. It’s going to be a great contrast coming from the USA, the land of abundance, where I can’t finish a serving size, to Africa; with all its history and its beauty and its HIV.

I’m so ready to put faces, names and conversations to these ramblings, to be humbled and damn right proven wrong.