Safe Observer

THE AIDS ALTERNATIVE

Changing direction in the fight against AIDS

The ‘safe sex’ campaign based on the simplistic allegation that sex is the ultimate cause of the AIDS pandemic has totally failed. Its only result has been to encourage international racism!

The explanation in terms of sexual behavior puts the blame on individuals, race, 'contaminated' countries. The underlying concept is that the individual has a free choice on the market for sex and condoms: infection is proof of having made the ‘wrong choice’. The strategy is a family planning strategy, not one to fight AIDS.

The campaign strategy is designed to avoid looking at the real causes of the AIDS pandemic.

A young adult in North America or Europe has an estimated risk of 1/10000 of contracting HIV through a heterosexual contact with an HIV carrier.

But the risk is hundred times higher or more for a person who lives in a poor country with endemic bacterial or parasitic infections.

We need to address the natural and man-made environment in which the HIV virus has been able to proliferate and continues to proliferate.

Four related reasons why HIV spreads fast among poor populations:

1 - Parasitic and bacterial diseases, by stimulating the immune system, create the conditions for the HIV virus to multiply. High viremia = fast transmission, very efficient in the individual and in the population.

Tuberculosis disease, for example, increases virus production in the HIV-infected person. The co-infected TB-HIV⁺ patient is contagious, produces high quantities of HIV and bacilli and progresses faster to immunodeficiency.

Transmission through sex, blood, or from mother to child is largely dependant on HIV viremia.

The TB patient who is not yet HIV infected, appears to be more vulnerable to infection in case of contact with HIV, because the immune changes induced by the bacilli are very propitious to HIV uptake and development.

Malaria also, which is flaring up - even among normally more resistant young adults - because of HIV, enhances viremia and transmission of HIV.

It is also true of other diseases that are common in developing countries. It is particularly true of Hepatitis where co-infection can lead to fulminant hepatitis and AIDS diseases.

Intestinal and urinary tract parasites and worms, bilharzias and others, common among people living in poverty without access to clean water or proper sanitation, are also stimulants for the multiplication of both TB bacilli and HIV virus, increasing transmission and vulnerability.

When HIV arrives in a community with a high load of tuberculosis it spreads like wildfire! This is what motivated Anthony Fauci, director of the NIAID, to say in 1996, that the fight against HIV in Africa required a renewed effort against endemic diseases.

Provision of condoms is like offering umbrellas under tropical rain, no protection: abandoning poor populations in disease, misery and death.

2 - Widespread use of sharp instruments and needles without sterilization. When HIV enters communities via the drug trade with injecting drug users, there is explosive HIV spread. This non-sexual mode of transmission was the key to hepatitis spread in poor communities; when HIV arrived, it traveled the same route and still does.

HIV is easily transmitted by needle stick sharing and injury, by piercing, by street dental care, by tattooing, and by any and all procedures that involve contact with blood when sharps are not properly sterilized, and the higher the viremia, the greater the risk. Lack of equipment and training means that this mode of transmission, very small in well to do countries, is extremely common in poor countries.

Unsafe blood transfusion alone is reported to account for over one tenth of all cases in poor countries; it played an enormous role in getting the epidemic started in the early years. Total safety is an impossible goal when the rate of new infections is so high and the resources so few. Furthermore, the increase in malaria cases means that more transfusions are required.

3 - HIV has more ‘portals of entry’: skin lesions, untreated small wounds, gum bleeding. Ordinary sexually transmitted diseases create lesions of the skin mucosa that make it easier for HIV to penetrate.

Poor communities have untreated skin problems and injuries to a very large extent, and incomparably more than well to do communities.

Home care for AIDS patients puts more and more women at risks: recommendations on universal precautions are quite strict on measures to take to avoid accidental transmission from casual contact, with soiled linen, razor blades, etc. This is because care givers, whether in health facilities or at home, run the risk of getting infected if the scientifically established universal precautions are not respected.

As the number of full-blown AIDS cases increases, the likelihood of all these forms of contamination increases accordingly.

4 - Sex trafficking, due to increase in poverty, conditions of migrant labor, investment in ‘sex’ tourism and flourishing organized crime. Traffic in poor children and women used as sex slaves is an important factor in HIV propagation.

International investment in sex tourism – representing 14% of Asian GDP today… is fast expanding and has benefited from large World Bank investments in Thailand. Drug traffic is intertwined with sex traffic. the great expansion of both in recent years has spurred HIV epidemics. AIDS campaigns had the dubious merit of baptizing poor women obliged to sell themselves as “sex workers”!

Forced migration of labor, inherited from the Apartheid economic system, contributed to the wild spread of HIV in all of Southern Africa. Today, the displacement of single laborers in “Free enterprise zones” with sub-minimal labor laws, and the practice of shrinking State responsibilities will spark new ‘opportunities’ for HIV

The economic impact of AIDS has only begun to be felt. In destroying the labor force, AIDS is bringing about a dramatic fall in national production, and especially agricultural production, in the entire developing sector. Time to act is short.

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The neo-liberal marketing approach to AIDS is in fashion; it is extended to other diseases in replacement for public health.

We must urgently return to a medical, epidemiological and socio-economic approach.

Potemkin villages notwithstanding, HIV is spreading uncontrollably and fuels every other condition and disease.

We are facing the collapse of the human species' specific environment.

To change direction:

Strengthening and equipment of public health structures.

Massive employment of human resources for health care, with decent pay.

Development of regional capacities for the manufacture of generics and pharmaceutical products.

Public programs for water management, access to clean water and sanitation.

Scientific research on interactions of diseases.

All out research on preventive and therapeutic vaccines.

…/…

To change direction:

Training and material: needles, sterilization and waste disposal.

Creation of hygienic centers for dental care.

Emergency measures to decrease blood transfusion and make it safer.

Vast screening and treatment programs for all common STDs.

Creation of light and mobile health structures to assist women in home care.

Basic nutritional support for all patients in all health structures, including outpatients.

Creation of municipal services for assistance to orphans and families.

Global measures to curb drug, child and women trafficking and money laundering at the top. Action against large-scale profiteers, not the victims.

A clamp down on sex tourism.

Respect for adequate norms in working conditions.

Canceling the debt of developing countries would suffice to free needed resources.

INTERNATIONAL COALITION TO FORMULATE

AN ALTERNATIVE PUBLIC HEALTH APPROACH TO AIDS

Join the coalition:

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