Tuesday, January 03, 2006

Anniversaries

The U.S. Food and Drug Administration is celebrating its centennial anniversary this year. To mark this anniversary, the agency has launched a centennial web page that includes several items of interest for the trivia enthusiast. The FDA sponsors health fraud task forces in several states, including Texas; Texas AIDS Network participates in the Texas AIDS Health Fraud Information Network.

Another anniversary coming up this year is the 25th anniversary of (when we recognized) the AIDS epidemic. On June 5, 1981, the CDC published its first official report on the epidemic.

Both occasions matter to the AIDS community. The latter may seem an obvious matter of import, but it is more than a milestone. After 25 years, we've come a long way in our understanding of the disease, its causes, and how to prevent it. Regrettably, we still have neither vaccine nor cure. Worse, we seem to be locked in a time warp when it comes to preventing the further spread of the epidemic. This year would be a good year to knock down some of the barriers to stemming the epidemic. A couple of thoughts on that:

  • AIDS is not a gay disease, but the public still seems to think of HIV in those terms. This affects not only the willingness of individuals to think of themselves in terms of risk but also allows the not-always-hidden homophobia of policy makers to make AIDS funding a grudging priority and AIDS policy a tool for oppression. In 2006, we should address both parts of this mythology. We should reawaken the public to the risks of infection and the needs of those affected at the same time we need to be more open about the harsh impact that homophobia has had on our ability to fight the epidemic.
  • We don't have a cure, and yet the party goes on as if there were a cure. The complacency that has come with the availability of powerful new medications to treat HIV is entirely misplaced. Those medications, as wonderful as they are, are terribly expensive, have harsh side effects, and represent a lifelong commitment to an exacting regimen. We cannot afford to be complacent in either our commitment to preventing the transmission of HIV nor to dealing with the epidemic as it presents itself. That means, I would think, increased efforts to remind the public, especially young people, that prevention is ever so much better than hauling around a trash bag full of pills and listening for the little alarm that says it's time to take more. It would also mean addressing the complacency of donors and funders. Their job is not done as long as we have so many people without insurance, runaway medical costs, and a public safety net that has more holes than net.

No doubt there are more things that we should be talking about and working on for this anniversary "party," but this will surely keep me busy!

As for the FDA's centennial, I do urge you to check out that web site and tickle your trivia fancies. I would also point out that the FDA is an important part of our public safety net, which leads (surprise, surprise) to a couple of thoughts on that subject:

  • We don't have a commissioner. Again. Wouldn't it be nice to have a commissioner who has both the qualifications and the will to focus on the agency's mission?
  • The FDA is not a political plum. Without crossing the line into the politics of Washington, D.C., I think I can still say that we should so not be playing politics with this agency. This is an agency which, like so many other federal agencies, needs to be above the politics of whatever administration is in office and all over the science of the matters that they are dealing with.
  • The FDA is not a chamber of commerce. While I wouldn't think that their job is to get in the way of business, I also don't think that their job is to help business make a profit. The FDA should do its thing in a timely manner, but thoroughly, with public safety as its primary concern.

What we as citizens can do about these issues is far less than we might hope, but there is nonetheless work that can be done. Our congressional representatives need to know that the FDA needs stable leadership with solid professional qualifications and a commitment to mission (not politics). Our congressional representatives also need to know that political interference in the work of the agency is not acceptable. They need to know as well that the FDA can't do its job without adequate staff and funding. And we each should be participating, wherever possible, in the work of the FDA when it touches on HIV/AIDS. Commenting on the proposed rules for condom labels would be a good place to start.

A hundred years, twenty-five years. Time flies, does it not? Texas AIDS Network will celebrate its twentieth anniversary next year. Stay tuned.

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