GAO says gw obstructs poor countries ability to treat AIDs

Discussion in 'Politics, Religion, Social Issues' started by Ugg, Jul 14, 2004.

  1. Ugg macrumors 68000

    Ugg

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    #1
    Link

    The GAO is generally a pretty impartial office so I tend to believe this without a doubt.

    Just another indication that gw's compassion is solely directed at the bottom lines of US business. His pledge of $15 billion is mostly hot air, as little has been delivered and then only by US business with the Christian Right's approval. It's so sad to see so many people dying because of a lack of true compassion and common sense and most of those deaths are due to the influence of the religious right, how do they live with themselves? Do they really think their god is going to overlook this?
     
  2. Backtothemac macrumors 601

    Backtothemac

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    #2
    Ok, I have lost two family members to AIDS, so I am speaking with knowledge of the disease, and how people die a miserable death.

    AIDS has a 100% mortality rate. Sure,, there are people living with AIDS, however there are not many, and those that go full blown, not just HIV, they don't last long. So, again, I will sound like an insensitive ass here, but why in the hell should we as the U.S. pay 15 billion to buy drugs that will not stop these people from dying, but only prolong their suffereing.

    Why not teach them not to have sex with virgins, because that doesn't stop the disease. Why should we pay for the irresponsible actions of individuals?

    I just don't understand the logic.
     
  3. skunk macrumors G4

    skunk

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    #3
    Agreed.

    This argument could be applied to all kinds of people with terminal illnesses. Suffering is a part of life, not something separate.

    And you were doing so well! Where does this "sex with virgins" thing come from, and what difference would it make to someone who already has AIDS?
     
  4. Sayhey macrumors 68000

    Sayhey

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    #4
    We should spend the money and do more for a whole host of reasons, B2TM. First, because it is the right thing to do to help our fellow human beings when they are confronted with this disease. If we try to ignore other people's suffering it changes our own character, it changes who we are. Second, the idea we can build a wall between ourselves and people who have AIDS is just false. The disease will spread with horrible consequences for the world if it isn't confronted by global cooperation. Last, this is not just a health care issue. This is a global economic and security issue. What do you think are the economic and political consequences to allow nations with rates of infection approaching 35 - 40% to fight this on their own. Do you want to destabilize entire regions of the world?

    This disease has to be combated with education and global financial resources if it is to be beaten. No country, least of all, our nation which has some of the most advanced experience and medical knowledge about AIDS can afford to sit this out.
     
  5. Backtothemac macrumors 601

    Backtothemac

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    #5
    One belief in some african countries is that you can cure yourself of the disease by having sex with Virgins.

    My point is not that I mind spending the money. It is not to spend it wastefully. Lets educate and prevent. And try to cure. Not wasting money on meds that may or may not help these people.
     
  6. blackfox macrumors 65816

    blackfox

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    #7
    BTTM,
    While I agree of course that education and prevention is the key to solving or at least mitigating the problem of AIDS transmission, in somewhere like Africa, it is a tall order. The cultural and educational differences are so vast, that one would need a lot of time to even make a dent. This precludes dealing with those who have already contracted the disease, unless they are given some sort of medical treatment to perhaps extend their lives. You could concentrate on the young and uninfected, but sexual relations often begin so young in some cultures, and children are often born w/ the disease.

    As far as the medicine is concerned, no it is not a cure, it is merely something to manage the disease. But taken in the scope of AIDS research and pharmaceutical development, we have come a long way in making the lives of HIV+ people longer and more livable, and with that, there is hope. Hope that some of these people may live long enough for a real cure to be developed. I do not find this to be a waste of money, and feel that hope should be given to all the people across the world who are unlucky enough to have contracted this disease.
     
  7. pseudobrit macrumors 68040

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    #8
    Let's not forget the horrible impact of the deaths on families: orphaned children, penniless widows.

    How many children are born every day in Africa whose parents will not live to see them grow even five years?

    Think how devastating it must be to families when 30% of the community -- fathers, mothers and children -- have HIV and will die in a few short years.

    So yes, I say while medication may not save these people from death, it will prolong their lives and allow them to raise their children and provide for their families for as long as they can.
     
  8. Backtothemac macrumors 601

    Backtothemac

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    #9
    But would it be better for society to seperate them from society and let them die, thus ending the disease. None of the drugs will prevent the spreading of the disease.
     
  9. pseudobrit macrumors 68040

    pseudobrit

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    #10
    That strategy hasn't worked thus far, has it? The disease would never have progressed to its current state if letting it run its course was the cure.

    But they will improve the quality of life and stabilise the economies of the afflicted nations. The medication is less about stopping the disease and more about stopping the poverty and destroyed families.

    And a more comfortable (no one is dead, dying, hungry, sick or unable to work) people typically have the "luxury" of being more educated people, making the education and prevention prongs of the attack against AIDS all the more effective.
     
  10. skunk macrumors G4

    skunk

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    #11
    Not a very useful solution, really. They ARE society. Concentration camps? What happens to the children? Lock them up too? How many people will keep their condition secret under those circumstances?
     
  11. Neserk macrumors 6502a

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    #12
    Along those same lines... life is terminal. We are *all* going to die. Some sooner than others. Lets make sure the quality is there for those who are sick.

    Why is the United States responisble? Asking the wrong question! As human beings we are responsible for the care and well being of each other! We are citizens of a World. Countries and nations are temporary, human made, ideas. We are all in this together.

    I thought you said you were a social liberal? Doesn't sound like it to me.
     
  12. Ugg thread starter macrumors 68000

    Ugg

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    #13
    First of all, there is 3% of the population that is seemingly resistant to the virus even after repeated exposure. Our knowledge of this wouldn't have come about without research, research that involved prostitutes in Africa and in the West. Knowledge is power.

    Secondly, nobody knows how the newer drugs will impact lives, I've heard comparisons that HIV infection is where diabetes was in the 50s and 60s. Would you have denied diabetics the chance to live and the scientists the chance to study and learn about the disease simply because they were going to die horrible deaths? I think not. That is a quandary of medicine. Nobody knows when the next breakthrough is going to come and how it will impact the world. Also, many of the antiretrovirals discovered in the course of AIDS research were used to fight SARS, the epidemic could have been a lot worse had it not been for all the AIDS research that preceded it.

    One of the most difficult aspects of AIDS prevention and treatment in Africa is the subservient role of women in society. For many of them it's not a matter of choice. Education is the most important aspect of the fight. Should we be telling women who have no choice in the matter that abstinence is their only hope, or should we be supplying them with condoms and anit-bacterial gels and other things that would substantially REDUCE their risk of getting the disease when they aren't offered a choice in having sex.

    As far as the drugs are concerned. The gw & co. AIDS policy is geared solely to increase the profits of the drug companies. The third world and Clinton's foundation have progressed by leaps and bounds in producing drugs at lower costs and ensuring that people have access to them. If gw would only allow these other drugs to be purchased, and to use the existing health network even though some facilities may offer abortion services, the bill of $15 billion could easily be cut in half.

    You can't have it both ways BTTM. But in your eyes it seems that saving the world from a brutal dictator is more important than saving people from a disease that has killed more than all the brutal dictators in history.
     
  13. blackfox macrumors 65816

    blackfox

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    #14
    To change the nature of the debate back to the original post, which deals not with the wisdom of drug-treatment vs other options, but instead of whether the US's methodology in giving assistance to this problem is the most efficient and productive way to do so. Basically, whether possible political concerns are trumping health ones.

    The main issues are these:

    That the US chose to implement it's own independent AIDS program, apart from the Global Fund to fight AIDS, Tuberculosis and Malaria. The US initiative covers 15 countries, all but one in Africa (the exception being Vietnam, at Congressional insistence). The Global Fund covers 130, also covering Tuberculosis and malaria, major killers in those countries.

    The Global Fund was created as an International Fund where countries and donors worked together in a way to maximize capacities and effectiveness. The Bush Administration itself was largely responsible for shaping the GF as an independent, multilateral, public and private partnership, as opposed to a WHO or UN program. The idea was to funnel aid from multiple countries to needed locales and let them run their own health programs, eliminating beaurocratic wastes in unnecessary duplicate support structures and burdensome demands on patients. Governments in need, had to develop competent plans which would then receive aid, which has taken a fair amount of time, with more time added from when that aid was actually put into the health care of those recipient countries.

    So Bush became impatient with this methodology, as well as concerned that other countries were not contributing their fair share, and so implemented his own independent initiative. Many find this an overly divisive plan of action, and in relation to the stated goal of curbing the AIDS epidemic, many complain that 15 countries is not enough, and that the Bush plan concentrates solely on AIDS, w/o regard to other dangerous diseases in the regions.

    As far as the Plan itself, it has been contentious for a number of reasons, these being:

    1. Generic vs. Brand-name drug treatments...

    The generic drugs are approved by the WHO and used by the GF worldwide. They are popular in many countries because the costs are roughly a-fifth of their name brand counterparts, but more importantly the generics have the ability to be combined into 2-in-1 and 3-in-1 pills (which is impossible for brand name drugs due to patent issues), which make the preparation of treatments easier and simpler for patients to follow effectively.

    The Bush Administration maintains that many of these generic drugs do not have FDA approval, making the US reluctant to believe in their safety or effectiveness. This view has been bolstered by the withdrawal of an Indian-made retroviral drug from the WHO list of approved treatments.

    Still, support for the use of generics has been so strong both in recipient countries and domestically, that the Bush Administration has opened up an expidited review of generic drugs, including the oft-used 3-in-1 pill. No foreign drug companies have submitted their products for review, as the US has yet to clarify it's approval process.

    2. Abstinence vs prevention.

    With the Bush paln relying heavily on drug-treatment to treat HIV+ people in various countries, the US policy has shifted away from a long-standing policy of prevention, to that of treatment. The insistence on abstinence education and resultant funding and networked cooperative programs through local churches and schools. Many complain that this is pandering to the Christian element in the US, and id undercutting responsible sex techniques, most notably condom usage. The US is against broad condom distribution as a primary preventative technique. Some local experts in Africa agree, noting the reluctance of men to use them. The Bush plan does advocate condom-usage for high risk groups, such as prostitutes, soldiers and drug-users. Many argue, that in many countries needing help, all people are high-risk, due to the high % of HIV+ in the populations. Many say the Bush plan ignores the basic realities that many young-people are sexually active and that marriage(another tenet of the Bush prevention plan) does not protect people from contracting the disease, or from coercion and sexual-violence which are common in some affected societies.

    3. Independence vs Integration.

    In going alone with an independent initiative, the US has largely eschewed the integration of AIDS prevention into the local health-care systms, instead providing help though the use of NGO's and foreign govermental aid and research agencies.

    Many have complained that this policy is often counterproductive to what the local govenment finds appropriate or productive policy in dealing with the problem. Many countries which need aid, but are used to the use of generic drugs and the use of existing health-care apparati, are now put in a position of having to accept costly name-brand alternatives, and a costly system of foreign consultants and NGO's. Often the presence of NGO's undercuts the efforts of the local Health-care system by drawing away resources and experienced personnel to higher-paying NGO positions. It also makes the policy more adaptive to foreign political maneuverings than the needs of the local government and population.

    Many have praised the Bush Plan, however, for the amount of money put forward, and the number of ill patients already on medication, drastically improving their lives, numbering in the tens of thousands. Money has also been put forth to help those displaced by losing family members to the Disease, including Orphan assistance.

    Still, many believe the initial success is somewhat illusory, as it has targeting many of the sickest (and easiest to identify), living mainly in the cities. After this, many say, the problem becomes a lot more complicated. Others also complain about the reliance on Numerical returns by the Bush Administration, which ignores the complexity of the disease and of the fight against it, concentrating only on the number of people on drug-therapy. Many believe their needs to be integration with the local Health-care structures of recipient countries for any credible long-term effort, as when the NGO's and personnel leave, what will remain? This approach is also so that a strengthened Health Care system will also be able to more effectively deal with other ailments, ranging from malaria and TB, to broken-bones and Pneumonia, as opposed to concentrating money only on AIDS drug therapy...


    OK, after writing all that, I don't want to write my opinion, I will leave this as a conversation piece to other posters. Quickly, however, my eggs are in the Integration basket...FWIW
     
  14. Ugg thread starter macrumors 68000

    Ugg

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    #15
    Where do you find the time! Great post as usual it presents both sides of the story, thanks.

    One of the biggest problems with NGOs and direct foreign aid is that it does tend to destroy local systems as well as create a dependency that is rarely maintainable over the long haul. The next prez may well decide to support the GF and then the entire process will begin again, wasting billions of dollars and destroying local health care systems.

    There is no easy answer but the costs would be much lower if generics were allowed by the US and if prevention systems that WORK were given priority over religious/political dogma.

    I agree that integration and the resultant building up of local health systems is the best long-term solution.
     
  15. blackfox macrumors 65816

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    #16
    haha...I have a lot of free time on my hands this summer as I am primarily a Grad Student, but took the summer off. Other than that, I have a part-time job, plus some freelance design and editing work which keeps me at home in front of the computer anyway...also, as to the info, I read a lot, and am blessed with a photographic memory (although some *ahem* lifestyle choices chip away at that a bit).

    As far as the substance of your post, I agree w/ the possible exception of the costs of switching/integrating to GF, as the US has not yet spent the bulk of it's money, as it is designed to be dispersed over several years (5-10 I think), and local health services would only improve under this integration, although there would be some change-over problems. As some countries, like Mozambique have proved, if the local government is strong enough, it can force the US to implement at least partial integration strategies. This is in contrast to Nations like Zambia, whose governments are essentially out of the loop, or S. Africa, which insists on it's own (and controversial) plan of engagement of the problem, creating integration problems from the opposite side.
     
  16. Backtothemac macrumors 601

    Backtothemac

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    #17
    Ok, let me clarify, because I don't think I have been clear. AIDS, nor HIV are airborne viruses, thank God. So, if someone get the disease, the majority of transfers of it occur because of lack of education, or someone that just doesn't care (IE, someone that wants to contract it, or spread it). So, take that 15 billion (after we actually give it to be used) and put it into research to develop a cure, and into education that would prevent the spread of the disease. Those that have HIV, get them medication that can slow the arrival of AIDS, and those that have AIDS, well, there isn't much that can be done. So, do the humane thing and let them live the remaining time in as little pain as possible.

    However, let me be clear. There should be a cut point. There should be a point that you say, damn, we can't help everyone, because some people don't want to be helped, i.e. the virgin cure idea. They are spreading the truth, and the people still do it because of it being an old belief. Man, Kevin Smith was right. It is better to have ideas, than beliefs.
     
  17. Ugg thread starter macrumors 68000

    Ugg

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    #18
    Neither is diabetes or lung cancer. Both occur mostly because of bad choices although heredity does have some influence. Are these people to be left to die because the refuse to exercise and eat properly and quit smoking? AIDS doesn't exist in a vacuum nor should it be singled out due to its being transmitted sexually. If you're going to apply this to AIDS then you need to apply it across the board. What's more important though is getting people like Ashcroft the hell out of people's lives and allowing them to decide when to die.

    Here is a link to an article about how Botswana's use of antiretrovirals in the past two years has literally transformed the country's attitude to the disease. With the second highest rate of HIV infection in the World, it is stunning that such a small country has been able to achieve so much in such little time and with so few resources. To cut people off from hope and medicine because some witch doctor is proclaiming that only abstinence or sex with a virgin is the only way to prevent the disease is BS! Once again, money should follow the successes like Botswana and Thailand and not be thrown into expensive US drugs and failed abstinence only programs where no assistance is given to any organization that provides abortions. What do Abortions and AIDS have in common by the way?

    I agree that throwing money at a problem isn't going to cure it but money needs to be available where it will do the most good and forcing poor countries to buy American made drugs is not a wise use of that money. gw flunks the compassion test once again.
     
  18. Taft macrumors 65816

    Taft

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    #19
    OK, we are in agreement that education is essential to stopping the spread of AIDS. However, I find your previous comments, like, "Why should we pay for the irresponsible actions of individuals?" not only callous, but unrealistic.

    Go look at some of the statistics on this page about AIDS in Africa: http://www.churchworldservice.org/FactsHaveFaces/aidsfactsheet.htm

    11 million orphaned kids fending for themselves (literally, I might add, as ophanages are far more rare there). Giving parents medicine so that they can live and care for their family seems a pretty noble cause to me. Or should we say "screw them," too. Who needs orphans, right?

    Then take a look at research like this: http://www.smh.com.au/articles/2004/07/10/1089000399600.html?oneclick=true

    4 out of 5 cases of a mother with AIDS giving birth while on nevirapine resulted in an uninfected child. So, even though it was the PARENT who was irresponsible, we are going to sentence their children to death, as well?

    Education IS necessary. But medicine is necessary as well, if you have a want to reduce the collateral damage this disease causes. And if you don't...well, I guess you just don't care. I'm not sure there is an excuse for that kind of apathy.

    Taft
     
  19. Backtothemac macrumors 601

    Backtothemac

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    #20
    Taft, first let me say that you are right. Nevirapine can make a huge difference, and that is the kind of drug that I would support. However, have you ever seen someone die from AIDS? There isn't a medication that will let someone with full blown AIDS be healthy enough to care for their children. Education is the only way to stop this disease. That, or seperation of those infected from those that are not.

    Manditory AIDS testing thoughout society, followed by seperation of those infected. That or education. So, when I make a comment about helping those that are irresponsiblie. Look at my like. Things like the "virgin cure". That stuff drives me wild. I am not heartless. I just don't like everyone looking to the US for help when they need us, and damning us when we do what is in our best interest. Yes, we as people have an obligation to help other people, but does our government? That is my question.

    Also, where is the help from Europe? Other countries. That is also my point. Yes, I will gladly donate 15 billion a year as President of this country if Europe, Asia, the middle east, Canada, Australia, etc all match our donation.
     
  20. Taft macrumors 65816

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    #21
    That is a good point. There is a double standard in that, when the European countries are stingey, they get a free ride, but when we are, we are attacked. I guess it comes from being the most powerful and rich country in the world. We do, after all, have the disposable income. :p

    Taft
     
  21. Backtothemac macrumors 601

    Backtothemac

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    #22
    And with that, que the music. Ba ba ba......


    Great post man. That is the point that I was trying to make. But when you look at Europe as a whole. They are really almost as rich as the US. When you look at the middle east as a whole. Well, we all know the answer to that.

    It is the double standard that I have a problem with and thank you for posting it better than I could myself!
     
  22. pseudobrit macrumors 68040

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    #23
    Time to bust out the stats.

    • Economic Aid: Donors (select nations giving over $1 billion a year)

      Japan: $7 billion
      ----
      United States: $6.9B
      ----
      UK: $4.5B
      France: $5.4B
      Germany: $5.6B
      Netherlands: $3.3B
      Sweden: $1.7B
      Denmark: $1.6B
      Norway: $1.4B
      Spain: $1.3B
      Switzerland: $1.1B
      Belgium: $1B
      Italy: $1B

      All of Europe combined: $29.63 Billion

      Source: CIA World Factbook
     
  23. pseudobrit macrumors 68040

    pseudobrit

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    #24
    It's not like things such as the "virgin cure" or the spread of HIV are a result of personal irresponsibility. It's simply their way of life and culture. We shouldn't condemn them because they're ignorant. These are people who cannot read or write and often have no safe water supply. Your frustration is misguided; we need to invest more in these cultures before we can condemn them for being irresponsible. The average US high schooler has more spending power than these people.

    We as people, eh?

    "this nation, under God, shall have a new birth of freedom -- and that government of the people, by the people, for the people, shall not perish from the earth."

    Mr. Lincoln says people are the government and the government is the people.
     
  24. Backtothemac macrumors 601

    Backtothemac

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    #25

    I agree with you on your first point, but that quote is way out of context, and you know it ;)
     

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