The Public Health Sphere

The objection is raised: personally, i'd rather see effort and funding put into finding cures for diseases that aren't fully preventable, but that's just me

I'd like to put this issue in the context of a conversation I had today with a pragmatic environmentalist. He's not a global-warming zealot: he's as concerned, if not more, with toxin release, habitat destruction, water-table depletion, and a related set of other issues. Greenpeace flew fifty members to the Netherlands to push for progress on the latest round of Kyoto-accord talks: that's a lot of airfare, and he said he would have directed the money elsewhere.

Does he resent the emphasis? No. First off, the environmental movement magnifies concerns: it makes people willing to take small steps that have larger indirect benefits. Organically-raised food isn't all that much safer for the person who eats it, but it's far far better for the farm workers. Consumer consciousness about organic food is misplaced and slightly irrational, but the overall environmental impact of this consciouness is still highly positive. And secondly, one issue can be a wedge for other issues: a commitment to combatting global warming will have substantial contributions in fighting deforestation and reducing air pollution. Raised consciousness is raised consciousness: best not to look a Trojan Horse in the mouth.

So too, with AIDS. Should money be poured into AIDS research or basic public health measures? Put that way, public health, of course. But putting it that way is creating a false dichotomy. The preventability of AIDS is as much a matter of education as of "funding." Effort isn't a fixed pool that you can only draw so much out of: it's something you generate, something you renew, something you need to step back from and remind yourself of.

Silly, perhaps, to be spending huge sums on AIDS-drug cocktails when those sums could send decades worth of condoms into Central Africa. But this fact is silly in the same way that the whole industrialized First World is silly. Our entire planet is one large unresolved contradiction; the dichotomy between the North's and the South's experience of AIDS, I think, is little more egregious than most North/South dichotomies. And here at home, three quarters of a million reported cases of AIDS (and two fifths of that population still living with AIDS) is one of those numbers that does justify fairly serious investment. Investment in AIDS research has spillover benefits, has positive public health effects beyond its immediate results. AIDS research has proven one of the most politically palatable AIDS causes, one that really has helped forge a public consensus on the right responses to AIDS. Raised consciousness is raised consciousness . . .

That AIDS is "fully preventable" isn't a reason to avoid looking for cures. It's a reason to work like hell on prevention.

Yes, I did find this quote in an HTML comment. Not something I do here. No, I don't put the important stuff in comments . . . 1'12'00