Keeping AIDS under control

Thanks to our conscientious correspondent Greg from Sydney:

HIV 'supervirus' is a warning to all
February 17, 2005
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Australia must continue to shun a US-led holy war against AIDS, writes Bill Bowtell.


The detection in New York City of a new strain of HIV virus that is highly resistant to anti-retroviral drugs is deeply worrying. If the existence of an HIV supervirus is confirmed by tests now being performed by the HIV authority Dr David Ho and others, then there will be genuine grounds for concern about whether existing HIV containment strategies are working, or need to be radically overhauled to meet the potential threat of a new strain of the virus.

These questions are important and must be asked - and answered - if we are to continue to protect as many people as possible from infection and early death from HIV/AIDS.

In the initial case in New York, health officials said it was the first where a strain of HIV had been found that showed resistance to multiple classes of drugs and apparently led to a rapid progression from infection to AIDS.

But given the overwhelming and pervasive American influence in Australia's media and political affairs, how the American debate about the suspected supervirus develops will have a profound influence on our politicians and opinion formers. This may bring with it the risk that America's solutions to HIV/AIDS will become our solutions.

Before embracing whatever half-brained ideas about how to respond to this potential HIV problem emerge from America's political process, we must first separate opinion from fact.

Australia's record of great success in managing HIV/AIDS stands in contrast to America's catastrophic record of failure, venality and incompetence. After 25 years of combating the spread of HIV/AIDS, the US has an infection rate 10 times that of Australia's. In 2003 the rate of HIV prevalence in Australia was 69 per 100,000, compared with 600 per 100,000 in the US. The incidence of AIDS was 1.5 per 100,000 in Australia against 15 per 100,000 in the US.

An inevitable result of this large - and expanding - population of HIV/AIDS sufferers in the US is the inevitability of new strains of the virus emerging, such as the one now the subject of testing in New York. As well, there has been rising resistance of the HIV/AIDS virus in the US to treatment, as it continues to mutate.

The very large HIV/AIDS caseload in the US stems from the fact that its governments long ago succumbed to popular prejudice and fundamentalist religious pressure to combat the problem by adopting policies based on punishment, faith and emotion, not prevention, education and reason.

Honest sex education and condom use were dumped in favour of the promotion of abstinence from sex and monogamous marriage.
Nothing wrong in that noble ambition, but such foolish campaigns have done nothing to stop young Americans from conceiving, having babies or abortions at anywhere between four and seven times the rate of comparable countries, including Australia.

While America abandoned or greatly curtailed effective HIV/AIDS prevention programs, billions of dollars were funnelled into HIV vaccine research and provision of new drug treatments.

America chose to fund a permanent, fruitless quest for the Holy Grail of a HIV vaccine while shunning the common, convenient, cheap latex prophylactic that works like a charm to prevent HIV infection.
It was a great deal for drug companies and researchers but a lousy one for those Americans who pay for it with their taxes, health and lives.
While US governments waged a holy war against illicit drug trafficking and prostitution, drug use by Americans exploded, and pornography became a bigger revenue earner than Hollywood movies.

As the US criminalised and stigmatised HIV/AIDS in a manner unparalleled in any other country, its misguided policies ensured that many hundreds of thousands of Americans succumbed to avoidable HIV infection and death from AIDS.

In contrast, Australia's governments and its people understood that the fewer people infected with HIV in the first place, the less likely was it that the population at large would come in contact with the virus.

Unlike the US, Australia opted to control HIV through frank sex education, widespread distribution of syringes and provision of free, anonymous and therefore virtually universal HIV/AIDS testing.
The result? In 2005, many tens of thousands of young Australians are free of the scourge of HIV infection, our HIV and AIDS caseload is under control and managed well, and a relative abundance of resources is devoted to the treatment, support and care of our citizens living with HIV and AIDS. In short, a better deal for Australian families, and for Australian taxpayers.

The lesson is clear. If you want Australian HIV/AIDS caseloads to increase tenfold then follow America's example, and try to legislate and pray HIV/AIDS out of existence.

The looming moral panic about a HIV supervirus will be drummed up for US domestic political reasons by self-appointed experts whose motives are as dishonest as their record is atrocious.

Condoms, needle exchanges, honest sex education and Australian common sense will protect you and your loved ones from HIV/AIDS infection far better than laws based on fear, prejudice and ignorance of the evidence accumulated from 25 years of controlling HIV spread in Australia.

Bill Bowtell is a former senior adviser to the federal health minister (1984-87), former national president of the Australian Federation of AIDS Organisations and an architect of Australia's response to HIV/AIDS.