Wednesday, June 14, 2006

Tidbits from "The Age of AIDS"

The PBS Frontline documentary, The Age of AIDS, can be viewed online in segments. A transcript is also available: Part One, Part Two.

Biggest surprise:

DONNA SHALALA: Forty percent of new AIDS infections came from IV drug use. I believed that we had an opportunity here for at least a narrow part of the campaign to eliminate new AIDS infections, to make a real contribution.

NARRATOR: But the Republicans who controlled Congress cast AIDS prevention in moral terms.

REP. DENNIS HASTERT (R), Illinois: If drugs are illegal in this country, and it's illegal to use cocaine or heroin or anything that's injectable, then you know, we shouldn't be handing out free utensils.

Pres. BILL CLINTON: The opposition to it was simply overwhelming.

Rep. MARK SOUDER (R), Indiana: -because you think the cause is right, to violate the law and enable people to violate the law-

Pres. BILL CLINTON: It was overwhelming in Congress and it was overwhelming within the drug control office of the administration, and it simply would have been reversed in the Congress if I'd done it. It just wasn't- politically, the country wasn't
ready for it.

DONNA SHALALA: I believe the president made the wrong decision. I said so at the time. No one tried to debate with me what the science said or what the right thing to do was, there was simply a straight political decision that was made.

I always thought that it was Shalala's hesitancy that blocked federal funding for needle exchange programs. It's interesting that she now lays it on Clinton, who lays it on Congress. The law at the time was that no funds could be spent unless the HHS Secretary (that would be Shalala) could certify that research showed that needle exchange programs did not contribute to increased drug use but did reduce HIV infections. She just never could be persuaded by the evidence. Of course Congress was the big stumbling block, but, if Shalala ever endorsed needle exchange as a means to reduce the spread of HIV, I don't recall that she ever did it where anyone could hear it.

Favorite line:
MECHAI VIRAVAIDYA: The religious institutions of this country have been extremely helpful. And luckily, we didn't have the church that kept on saying, "Don't use the condoms, don't use the condoms." That just shows you, with good leadership, real political commitment and financial commitment and great common sense, things can happen.

This is not an anti-church sentiment; Thailand is a Buddhist country, so the values of its people are different. Those values helped in the fight against HIV; Thailand's condom campaign reduced infections by 90 percent. The country is less tolerant of drug use. There has been no acceptance of needle exchange programs, so the epidemic continues to spread among drug users.

Made me angry:
Dr. MERVYN SILVERMAN: Due to Senator Jesse Helms, we could not fund anyone who would talk about homosexual sexual activities in their prevention activities. That's like saying we want to try and stop alcoholic-related deaths on the highway, but we can't talk about booze and we can't talk about cars. I mean, you can't do that. Without question, politics has been one of the driving forces in the spread of this disease.

Of course, we never learn, do we? For the time being, the restraints on PEPFAR have regarding "promoting prostitution" have been partially lifted, but there is every indication that new language in the Ryan White CARE Act will go further than Jesse Helms ever dreamed and ban any education that might "promote sex, whether heterosexual or homosexual."

Made me cry:
Dr. GLENDA GRAY: As HIV became more frequent and more commonplace in children, and as they needed more and more care, the ICUs in the country also made decisions not to admit children with HIV into their ICUs because it was terminal, and we needed to keep the beds open for children who had better prognosis. HIV became the new apartheid in South Africa. You know, we discriminated not on race anymore, but on HIV status.

The epidemic continues to be overwhelming in any number of ways, not the least of which is the continuing stigma of having HIV, the political nonsense that gets in the way of effective public health, and the perpetual frustration with lack of resources. At least we have hope.

If you missed "The Age of AIDS" when it was shown last week, make some time to watch it online or read the transcript.

1 comment:

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