The New Scientist Thinks We Can End AIDS in One Generation But I Don't
Published February 25, 2009 @ 09:44AM PT

(photo credit: Sully Pixel)
The New Scientist recently proposed a plan to end AIDS in the world. Basically, get everyone in the world to take ARVs, and push their viral load down to undetectable levels. Undetectable viral levels are not transmitted through sexual contact. No one new is therefore infected. Once the current generation of HIV-infected individuals reaches the end of their lives, your problem is over.
I realize that they meant this as a think piece, and the article and editorial are well worth reading. They’ve got some interesting information on treatment specifics with regard to CD4 levels, new hope for cures, and research on the sexual transmission of HIV.
But wow – way to oversimplify a complicated problem and propose an unbelievably bad solution. They allude to some of the huge problems with this plan in the article, “Persuading everyone with HIV to start therapy purely for public health reasons could be ethically dubious. To identify everyone who is HIV positive would require such widespread testing that some may feel it breached their civil liberties. Then there is the question of who would fund such a massive undertaking.” But that doesn’t even begin to touch the problems with this idea.
First of all, sexual transmission is not the only way a person can get HIV. In some parts of the world, like the former Soviet Union, HIV is transmitted primarily through sharing dirty needles. An undetectable viral load doesn’t eliminate that mode of transmission. We’ve seen HIV transmission in health care settings due to bad infection control, and outbreaks in China because of blood collection practices.
Not to mention that getting ARVs to everybody with AIDS runs much deeper than a funding problem. You need health care providers who can prescribe and manage treatment regimens, and a logistics system that will get the drugs to the places that need them. None of this could be solved overnight with a cash infusion. You need training, and that takes time. There’s no way around it.
I also take issue with the New Scientist article in general. It’s a little to prone to rely on hype and generalizations. I really don’t think that “in the west [HIV] is still seen as affecting mainly gay men, immigrants, prostitutes and drug addicts.” And I dislike the focus on “abroad” as a reservoir of HIV.
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Comments (16)
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Hey Alanna,
I have a bit of a dissenting opinion over at www.sghequity.org. I'd love to hear your thoughts as to why it is not a good idea to promote universal access to HIV meds.
Thanks,
Jon
Posted by Jon Shaffer on 02/25/2009 @ 01:37PM PT
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Jon, there's a difference between wanting everyone to have access to HIV meds and saying if everyone who's positive for HIV took meds that would solve the problem.
Posted by Cheryl Hopper on 03/01/2009 @ 08:21PM PT
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Cheryl - that was my point exactly! You said it better than I did.
Posted by Alanna Shaikh on 03/01/2009 @ 10:39PM PT
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HIV evolving warp speed around the globe ...
http://latimesblogs.latimes.com/booster_shots/2009/02/hiv-evolving-at.html
http://www.nature.com/nature/journal/vaop/ncurrent/abs/nature07746.html
Posted by Edward Snyder on 03/01/2009 @ 08:01AM PT
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There is a solution that is 100% effective in stopping all new cases of HIV and AIDS but it will never be suggested nor implemented because our sex crazed world would rather people sicken and die than exhibit some self control.
The solution is to end the practice of having sex with multiple partners, with people outside of the marriage bond, and all homosexual sex.
Posted by Elaine Biggerstaff on 03/01/2009 @ 08:31AM PT
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Why homosexual sex? Or are you one of those who still sees HIV "as affecting mainly gay men, immigrants, prostitutes and drug addicts"?
Posted by Alyssa Nguyen on 03/01/2009 @ 09:56AM PT
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If no one has sex with multiple partners, homosexual sex need not be prohibited. If you were arguing from logic instead of bias, you'd already have realized that.
Besides, this is a non-solution. Any "solution" to a problem that effectively boils down to "what if the problem magically didn't exist?" is a waste of time.
Furthermore, your phrase "our sex crazed world would rather people sicken and die than exhibit some self control" is rather insulting and a logical fallacy called false dilemma. It's possible for me to not want to force everyone to follow the same sexual practices, and still not want the HIV virus to spread.
Posted by Lo Carr on 03/04/2009 @ 04:32PM PT
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Correct me if I'm wrong, but I take great issue with "get everyone in the world to take ARVs."
No thanks. I'll put what i want in my body, and I don't trust Big Pharma and their pill pushing tendencies which have become commonplace in today's culture.
However, I would support making ARVs available to anyone who is HIV+ and wants treatment.
Posted by Meg Boudreau on 03/01/2009 @ 10:16AM PT
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Read the article. The plan is everyone in the world *with HIV* should take ARVs, not everyone regardless of whether or not they have HIV.
Her wording is a tiny bit misleading, but she goes on to talk about testing to identify all HIV patients, so clearly they don't mean the whole world. That would just be stupid and a waste of money.
Posted by Lo Carr on 03/04/2009 @ 04:35PM PT
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Elaine, I haven't seen such an ignorant statement in a very long time. You seem to believe that HIV is a "gay man's disease". And when it first hit the US, yes, it hit the gay community the hardest, but the fastest growing demographic (in the US) acquiring the disease is African-American women AND teenagers of ALL colors.
One of the big reasons that it hit the gay community the fastest and the hardest in the 80's is because our government, the government that I had no part in choosing (I was too young to vote), turned a blind eye to the fact that this disease was killing thousands of people annually. But because they were gay men, it was seen as okay because people like you believe that we are expendable.
Part of the problem is lack of sex education that teaches kids to protect themselves when having sex. Your abstinence-only education programs have been proven time and time again that they DON'T work.
Perhaps you should do a little research. This disease dates back to the 1950's, and crossed the primate/human species barrier through hunting. Perhaps we should make hunting illegal instead of sex.
You also seem to fail to realize that there are other forms of transmission beyond sex. In some regions of the world (and now very few here in the US) it is still transmitted through blood transfussions. It is also spread through IV drug users who share needles. There are even some accidental transmissions such as nurses who obtain it through a needle stick (again this is rare in the US, but still happens occasionally.)
I do not have HIV/AIDS, but I'm sick of people like you getting on your self-righteous high-horse telling other people how to live their lives. You mind your own business and others will do the same.
Posted by Dave Hershey on 03/01/2009 @ 12:21PM PT
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Total agreement that abstinence only programs aren't as effective as programs that actually inform teens about methods of birth control, which I suspect has everything to do with the fact that abstinence-only programs decimate the number of teens having sex only in a 50s sitcom world where no one has a sex drive. If they want to make an impact, bring in teens who are HIV positive and have suffered various STDs and girls who have gotten pregnant and have them tell their peers why you need to be careful (ditto for teaching kids to stay away from drugs). We need programs designed for the real world.
I'd heard somewhere that men who engage in homosexual sex are many times more likely to be HIV+ than hetero men, and that's why gay men aren't allowed to donate in the US. There were sources listed to back up what was being said that seemed to be legit but where I heard this from wasn't the most unbiased of sources, so I'll ask you.
Posted by Cheryl Hopper on 03/01/2009 @ 08:42PM PT
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Unprotected homosexual sex has a slightly higher risk of blood-to-blood contact, thus a greater risk for HIV.
The ban on blood donations, however, is leftover from the early days of the epidemic and is, in my opinion, discriminatory and bad for public health. We test all blood for HIV. Ruling out blood donations from people because they may or may not engage in a moderately more risky practice limits our blood supply needlessly.
Posted by Alanna Shaikh on 03/01/2009 @ 11:03PM PT
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New Scientist did not propose a plan, Alanna. They reported discussions among scientists and health officials which may eventually lead to a plan. Their role in this matter is journalistic.
You've raised some valid concerns. But given the medical technology available now and for the foreseeable future, the idea of expanded testing and expanded use of ARV drugs to reduce the infection rate seems to be the only avenue of attack available to us. And even if you reasonably postulate continued infections from blood transfusions and shared needles, having a broad program of detection and virus interruption should get case trends going in the right direction.
Posted by Terence McCain on 03/02/2009 @ 02:02PM PT
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Dear Alanna Shaikh,
My belief is any "action" to solve a problem, if even for temporarily, until a legitiment solution is implimented, "no action" is worse.
I'm sure many people have ideas to solve the HIV/AIDS epidemic, and/or STD's in general, yet face implications of bringing that idea to the forefront due to lack of resources, belief, assistance, etc. and too much external doubt. Anything and everything is possible, with with an open mind, and faith.
I am one of those individuals that proposed a 21st Century HIV/AIDS Intervention Cure (already in affect) for the 2009 Inauguration. I didn't win but I wouldn't mind opinions or feedback.
Just click on the hyper link, as my name below, to view yet another proposed solution.
Thanks in advance, and may God continue to bless us all. :0,
Posted by Kurt Reid on 03/03/2009 @ 09:22AM PT
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Please don't flame me for this, but I'm just curious... why is it unethical to make people with HIV take drugs that makes them not contagious? If I had HIV, I wouldn't want to risk giving the disease to other people. Is there something I don't know about the drugs that's really unpleasant, that makes this wrong? Because if there isn't, I think a person would have to be pretty selfish to NOT be willing to take the drugs for the sake of public health.
Posted by Lianne Lavoie on 03/17/2009 @ 11:21AM PT
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This discussion is getting to be like that story of an elephant and several blind persons...Each one describes what he touches and feels as the best description of the elephant!
Modern medicine like agriculture has no doubt made great strides. Hence taking drugs per se is not unethical. I take Nebistar SA and 50mg of asprin every day for my so called "essential" hypertension.
But a fundamental flaw is there in most developments of science and technology emanating from the west. They think that they know everything and don't like dissenters.
Indian Ayurveda has prescribed many medicines from the time of B.C.which are being followed by today's allopathic medicines which use chemically pure extracts of phytochemicals.
We have several cures for conditions of hepatitis, HIV Aids and cancer in many different systems of Indian Ayurveda, Islamic-Unani, Siddha -developed by Sadhu saints mostly from medicinal plants and extracts of ashes and metallic residues which are all Eastern systems of medicines.
The system of Pranayama is even more advanced than Ayurveda.
There are even today many psychic healers in ndia and in the East. One of them personally cures patients by touch and blows with his hands and feet. He works at the astral body level. It is not Pranic or Reiki healing. It is heavy and laborious work but he says that he has treated 30-40,000 patients in the last twelve or more years. He is not interested in publicity. He has tried training others but this works only through him! The West has of course a technical classification index. They would call it "faith healing". This concept is of course borne out of Christian religious faith. There is no religion involved in this as practiced by this person nor in Pranayama, which can be followed by one and all.
To conclude, I quote a Tamil (ancient of cource!) proverb: "What we have learnt is worth a fistful of soil. What we dont know is the size of this Earth!
Posted by Santhanam Ramasubrama... on 03/17/2009 @ 10:48PM PT
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