Map of life expectancy at birth from Global Education Project.

Tuesday, December 21, 2010

A miracle

A conversation I had today got me thinking about the times I've lived through. I worked my way through graduate school doing consulting work for community based organizations. My friend Wayne Wright, who died of AIDS in 1995, was Executive Director of the Multicultural AIDS coalition, and he connected me with many community based AIDS service organizations, for which I did program planning, proposal writing, strategic planning and other work.

Wayne had really bad luck. Effective treatment for HIV became available just after he died, with the approval of indinavir in 1996. Up until then all we seemed to do was death watches and memorial services. If you weren't in a big city and didn't have any relationship with heavily affected communities it was just something happening to other people, and specifically other people who you probably didn't like very much. (That's "you" in the generic sense, not referring to my own readers.) I'm not gay but there I was in the middle of it, one friend or respected colleague after another, young men mostly, energetic and passionate and committed to good works dying horrifically. It wasn't just the individual losses that kept piling up, it was the devastated communities, whole swaths of life smashed and the pieces scattered to the winds.

This must be what it is like to be in the midst of war. I'm sure great disasters like Hurricane Katrina or the southeast Asian Tsunami felt similar. But for most of us, such plagues belong to history. They're just stories in books we haven't read.

And then the miracle happened. One of the most important AIDS-related institutions in Boston was the Hospice at Mission Hill, where the lucky went to die. In 1996, they started rising from their death beds, emaciated bodies filling out with muscle and fat, people who had figured out how to die suddenly having to figure out once again how to live. The latter problem was sometimes harder. Nowadays the biggest challenges people with HIV usually have are the challenges of growing older, living with a burden to be sure but not necessarily a very large one. It was astonishing. I do not have words for this event.

And so there must be special circle deep in hell reserved for the lunatics who continue to deny that HIV causes AIDS and that antiretroviral drugs keep people with HIV healthy. Some of them, such as Mathias Rath, are psychopaths whose evident motive is greed. Others, such as Peter Duesberg, are evidently afflicted with profound psychological problems. You can read about a whole bunch of them here. Sadly, they still manage to convince people not to take the pills, and the result is that those horrible deaths still happen when they really don't have to.

Now, people in Africa still can't get access to treatment, and we're falling farther and farther behind. More people are infected each year than are enrolled in treatment programs. And that's even starting to happen in the U.S., where the states are broke and are putting people on waiting lists for antiretrovirals -- including right here in Rhode Island, which isn't exactly Mississippi. In the richest country in history, we're telling people to go drop dead. Hey, at least the rich people don't have to pay two percent more in taxes on the portion of their income they can't shelter completely.

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