Experts call for rethinking AIDS money

By MARIA CHENG, AP Medical Writer
Fri Jan 18, 12:38 PM ET

LONDON – In the two decades since AIDS began sweeping the globe, it has often been labeled as the biggest threat to international health.

But with revised numbers downsizing the pandemic — along with an admission that AIDS peaked in the late 1990s — some AIDS experts are now wondering if it might be wise to shift some of the billions of dollars of AIDS money to basic health problems like clean water, family planning or diarrhea.

“If we look at the data objectively, we are spending too much on AIDS,” said Dr. Malcolm Potts, an AIDS expert at the University of California, Berkeley, who once worked with prostitutes on the front lines of the epidemic in Ghana.

Problems like malnutrition, pneumonia and malaria kill more children in Africa than AIDS.

“We are programmed to react quickly to small children with AIDS in distress,” Potts said. “Unfortunately, we don’t have that same reaction when looking at statistics that tell us what we should be spending on.”

The world invests about $8 billion to $10 billion in AIDS every year, more than 100 times what it spends on water projects in developing countries. Yet more than 2 billion people do not have access to adequate sanitation, and about 1 billion lack clean water.

In a recent series in the journal Lancet, experts wrote that more than one-third of child deaths and 11 percent of the total disease burden worldwide are due to mothers and children not getting enough to eat — or not getting enough nutritional food.

“We have a system in public health where the loudest voice gets the most money,” said Dr. Richard Horton, editor of Lancet. “AIDS has grossly distorted our limited budget.”

But some AIDS experts argue that cutting back on fighting HIV would be dangerous.

“We cannot let the pendulum swing back to a time when we didn’t spend a lot on AIDS,” said Dr. Kevin De Cock, director of the AIDS department at the World Health Organization. “We now have millions of people on treatment and we can’t just stop that.”

Still, De Cock once worked on AIDS projects in Kenya, his office just above a large slum.

“It did feel a bit peculiar to be investing so much money into anti-retrovirals while the people there were dealing with huge problems like water and sanitation,” De Cock said.

Part of the issue is advocacy, from celebrity ambassadors to red ribbons.

“No one is beating the drum for basic health problems,” said Daniel Halperin, an AIDS expert at Harvard University’s School of Public Health.

Aside from southern Africa, most of the continent has relatively low rates of HIV, and much higher rates of easily treatable diseases like diarrhea and respiratory illnesses. Yet much of the money from the West, especially from the United States, goes into AIDS.

Halperin recently wrote a commentary in The New York Times on the imbalance and said he was astounded by the response. Most were positive, he said, with many AIDS experts agreeing it was time to re-examine spending.

Most AIDS officials say the solution is to boost the budget for all of public health.

“Why does the public health budget have to be so limited?” asked Tom Coates, a professor of global AIDS research at the University of California, Los Angeles. “Let’s not drag AIDS care and prevention down to the level of every other disease, but let’s bring everything else up to the level of AIDS.”

That may be wishful thinking.

“At the end of the day, there are limits to how big the public health pie can be,” Halperin said.

Since the discovery of anti-retrovirals to fight HIV in the 1990s, AIDS has virtually become a chronic, treatable disease in the West. But the disease has not been conquered so easily in Africa. Not only are the AIDS drugs too expensive for most patients, but major problems in the health system need to be fixed first.

“It’s hard to get Western donors to listen,” said Dr. Richard Wamai, a Kenyan doctor at Harvard’s School of Public Health.

Wamai said that some African health systems are so weak they cannot absorb the donations, and AIDS drugs are sometimes left in warehouses because governments cannot distribute them.

Still, “trying to redirect AIDS money will take a long time,” Wamai said. “It’s a bit like trying to stop an ocean liner.”

http://news.yahoo.com/s/ap/20080118/ap_on_he_me/rethinking_aids_1;_ylt=Amy35zzRg1CUtYEmPMlap3Va24cA

I am glad you think that the non HIV parts of the Specter essay make sense and that you think they can be turned to advantage by those who wish to replace the HIV=AIDS paradigm. Until you can express your perception as to how this is possible in words of two or even one syllable, however, I am afraid the ordinary gaping admirer of your brilliance such as your long suffering host is going to be left in the dark.

I am not in any way hostile to the science of endogenous retroviruses and for all I know of the matter maybe most of our junk DNA is made up of such elements, and they may be of great importance in the scheme of things in ways we have yet to discover, and possibly the number of retroviruses which are exogenous may be minimal by comparison, or whatever, that is not the point here.

For we are not reading Specter’s piece with any great faith in it as a guide to science we can count on while he is in the hands of people who accept the long exploded premise that HIV causes AIDS, and neither he nor they are people we can count on for guidance until this misunderstanding is banished from the assumptions they are working on, whether it is directly involved or not.

That is the problem with the whole field, and one which we are trying to solve in our modest way by insisting on the correction. If you can produce anyone involved who is willing to repudiate HIV=AIDS publicly we would be glad to trust their other perceptions about the reality of the world of retroviruses, but not otherwise. We certainly don’t trust anything that Specter writes on the topic. It is rather like expecting Samantha Powers to give us the correct analysis of what is really going on in the Sudan. None of these people has any credit in our book, as long as they are taken in by this prima facie absurd claim.

That is why it is incumbent on you to make perfectly clear what it is you are trying to say, so that even I can understand it, and know what it is in Specter’s account that you agree with and support and confirm. Please feel free to be long winded if that is necessary to do the job.

His comments on what is also called “horizontal gene transfer” in evolution are spot on.

His predictions for Africa are the worst kind of unvalidated scare-mongering but after all, he produced an excellent sound-byte.

But let me submit that you’ve misread the Specter piece, not considering that it is a mixture of good science journalism and nonsense. In other words taking the sharp red pencil to the nonsensical HIV parts leaves us with an excellent overview of the state of research into endogenous retroviruses.

“To change the belief you have to change the framework.”

Exactly. And this is precisely how we can use the correct parts of the Specter peace.

MacDonald says, “The predictable answer from HIV enthusiasts will of course be that attacking this key control mechanism is just one, therefore not necessarily sine qua non, among the endless number of ways the endlessly resourceful, endlessly multi-tasking, endlessly mysterious tiny piece of unremarkable RNA accomplishes its deadly purpose. The HIV-AIDS hypothesis is, in other words, endlessly unfalsifiable.”

That’s it. This is precisely how they keep the paradigm going and why WE should move beyond the catch-phrase “harmless passenger virus”.

Also (MacDonald), “Martin Kessler and the rest, Dr. Maniotis has solved the linguistic problem for us. What is called HIV in orthodox-speak is now called a ‘molecular signature’ in rethinker-speak. We acknowledge that a molecular signature is registered, but we suspend judgement as to what signed, where it came from and what it means.”

I’m still amazed that our A-team dissident scientists can’t come together on this.

And TS, you then respond, “In other words, MacD, if you would, hew to the grand tradition of NAR and spell everything out so even the likes of the humble host can follow it, otherwise there is no hope of getting the message across to the HIV faithful if they come here to learn from their betters.”

Aaarrgggh … do you have to play THIS CARD at this CRITICAL MOMENT? Don’t you see from recent news that the HIV establishment FULLY COMPREHEND, one could even say they’ve co-opted the MacDonald/Naylor critique.

You then add insult to injury with (to MacDonald), “The dear host does not know what the heck you are talking about. Is there some law on the planet you speak from which forbids saying straightforwardly, like a real man, what your point is, that the paper proves to your satisfaction, which Rezaf agrees with”

You write this long-winded essay on the Specter piece and then once again go mickey mouse with the feigned incomprehension bit – you’re all purpose defense against the valid science of endogenous retroviruses? And you make a crack about being a “real man”??!! What the F*** is this supposed to add to the discussion?

Robert Houston has constructively redirected this thread to a critical analysis of certain parts of the Specter piece. So let’s move forward on that basis, TS. You can help by not insisting on this ridiculous admonition that everything needs to be reduced to “sound-bytes”. The HIV sound-bytes are precisely what destroy the credibility of Specter’s otherwise good science journalism.