interesting article

Global AIDS crisis overblown? Some dare to say so

By MARIA CHENG

AP Medical Writer

As World AIDS Day is marked on Monday, some experts are growing more outspoken in complaining that AIDS is eating up funding at the expense of more pressing health needs.

They argue that the world has entered a post-AIDS era in which the disease's spread has largely been curbed in much of the world, Africa excepted.

"AIDS is a terrible humanitarian tragedy, but it's just one of many terrible humanitarian tragedies," said Jeremy Shiffman, who studies health spending at Syracuse University.

Roger England of Health Systems Workshop, a think tank based in the Caribbean island of Grenada, goes further. He argues that UNAIDS, the U.N. agency leading the fight against the disease, has outlived its purpose and should be disbanded.

"The global HIV industry is too big and out of control. We have created a monster with too many vested interests and reputations at stake, ... too many relatively well paid HIV staff in affected countries, and too many rock stars with AIDS support as a fashion accessory," he wrote in the British Medical Journal in May.

Paul de Lay, a director at UNAIDS, disagrees. It's valid to question AIDS' place in the world's priorities, he says, but insists the turnaround is very recent and it would be wrong to think the epidemic is under control.

"We have an epidemic that has caused between 55 million and 60 million infections," de Lay said. "To suddenly pull the rug out from underneath that would be disastrous."

U.N. officials roughly estimate that about 33 million people worldwide have HIV, the virus that causes AIDS. Scientists say infections peaked in the late 1990s and are unlikely to spark big epidemics beyond Africa.

In developed countries, AIDS drugs have turned the once-fatal disease into a manageable illness.

England argues that closing UNAIDS would free up its $200 million annual budget for other health problems such as pneumonia, which kills more children every year than AIDS, malaria and measles combined.

"By putting more money into AIDS, we are implicitly saying it's OK for more kids to die of pneumonia," England said.

His comments touch on the bigger complaint: that AIDS hogs money and may damage other health programs.

By 2006, AIDS funding accounted for 80 percent of all American aid for health and population issues, according to the Global Health Council.

In Ethiopia, Rwanda, Uganda and elsewhere, donations for HIV projects routinely outstrip the entire national health budgets.

In a 2006 report, Rwandan officials noted a "gross misallocation of resources" in health: $47 million went to HIV, $18 million went to malaria, the country's biggest killer, and $1 million went to childhood illnesses.

"There needs to be a rational system for how to apportion scarce funds," said Helen Epstein, an AIDS expert who has consulted for UNICEF, the World Bank, and others.

AIDS advocates say their projects do more than curb the virus; their efforts strengthen other health programs by providing basic health services.

But across Africa, about 1.5 million doctors and nurses are still needed, and hospitals regularly run out of basic medicines.

Experts working on other health problems struggle to attract money and attention when competing with AIDS.

"Diarrhea kills five times as many kids as AIDS," said John Oldfield, executive vice president of Water Advocates, a Washington, D.C.-based organization that promotes clean water and sanitation.

"Everybody talks about AIDS at cocktail parties," Oldfield said. "But nobody wants to hear about diarrhea," he said.

These competing claims on public money are likely to grow louder as the world financial meltdown threatens to deplete health dollars.

"We cannot afford, in this time of crisis, to squander our investments," Dr. Margaret Chan, WHO's director-general, said in a recent statement.

Some experts ask whether it makes sense to have UNAIDS, WHO, UNICEF, the World Bank, the Global Fund plus countless other AIDS organizations, all serving the same cause.

"I do not want to see the cause of AIDS harmed," said Shiffman of Syracuse University. But "For AIDS to crowd out other issues is ethically unjust."

De Lay argues that the solution is not to reshuffle resources but to boost them.

"To take money away from AIDS and give it to diarrheal diseases or onchocerciasis (river blindness) or leishmaniasis (disfiguring parasites) doesn't make any sense," he said. "We'd just be doing a worse job in everything else."

Copyright © 2008 The Seattle Times Company

gift time

It's the time of year where one must start thinking about what gifts to give loved ones. I must admit I haven't even started shopping yet, but I do have some ideas. I think this year I'll be doing most of my shopping online so that I can have my purchases shipped directly to them. With the new job, I might not be making it home for Christmas. One website I've been looking at has motorcycle parts and accessories. There are accessories for most manufacturers, including Harley, Honda, and kuryakyn. Most everything was on sale, so there are definitely some good deals to be had this Christmas.

a cat and a fireplace

The apartment that I'm soon moving out of has a fireplace. Guess who discovered this fireplace? That would be my cat, my white cat. She's not really white anymore. Though thankfully I caught her before she got too disgusting. There are quite a few black sooty spots though and I'm not sure if she's going to let me give her a bath. She likes the water alright, but she's never been fully submerged. Maybe I'll try a wash cloth first.

the trauma of moving

I think Jewels is going to be upset when I make her move again. She is really loving the sliding glass door we have in this apartment. We didn't have one in the last apartment nor will we have one in the new one. So I'm taking away the only thing she seems to like about our new home. Hopefully she'll find something else to love. And hopefully we won't move again for a long time so she'll be able to adjust and understand that we really do live there. It's probably hard right now since I left most everything in boxes--including her toys. I just didn't see a reason to unpack it all when it just has to be packed and moved again soon.

staying safe

You know, it’s interesting to see what sort of advances we’ve made in protective gear for those who risk their lives to protect us on a daily basis. Can you imagine being a police officer back in the 50s? Granted the sophistication of the criminals they were fighting wasn’t as great either; it’s a never-ending cycle of advancing protective gear and the weapons that are used against it. Still it’s nice to know that our officers have what they need—at least in the cities that have the budgets! There’s all sorts of stuff out there, like 5.11 Tactical Knives. And it’s not just officers who can buy these things, the general public can to so that you can stay safe while walking down the street late at night. Right now there’s even some promotions going on if you follow the link I’ve provided; you can get a really great deal this way.

a happy cat

Well I found PetCo. So Jewels once again has a fountain to drink her water from. The last one stopped working and I didn't feel like replacing it before the move. But the poor thing is so spoiled that she didn't want to drink standing water out of a regular bowl. It's probably not the best idea to give into her, but I suppose I've traumatized her enough with the move.

wondering...

Would it be completely ridiculous to go back to school again? I know I only just graduated, but there are so many more subjects I'm interested in. Or I could take a writing workshop at UW and maybe actually get somewhere with that novel I'm supposedly writing.

moved in

Well, Jewels and I are in the new place...but we're moving again! I just don't like this place well enough to stay when I can spend a few more bucks to get a better place. Good thing I moved to a place that's owned by a large company that has lots of other complexes around here that I can transfer to. So that's what I'm going to do. It's unfortunate that I'll spend almost a month with my things still in boxes, but soon it'll be over and I'll have a really great new place. It'll be a better commute too, so it's good all around.

I hate moving

I wish getting a new job and moving to a far better city didn't mean having to pack everything up and move it. There's far too much work to do in very little time. I would really appreciate it if employers stopped with this whole two weeks notice business and started allowing something more like two months to move.