FACTS againest MYTHS DECEMBER- JANUARY-2004
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- FACTS againest MYTHS DECEMBER- JANUARY-2004
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c o r/
G3W06
VIKAS ADHYAYAN KENDRA
December-January - Updated 2004
INFORMATION BULLETIN
Towards an AIDS Scam or AIDS Care?
Myths behind the AIDS “Epidemic”
COMMENT
he HIV-AIDS pandemic represents a major challenge for India today. Since the first AIDS case
in India was detected in 1986 HIV has been reported in all States and Union territories.Today,
however, its spread is no longer confined to the usual defined vulnerable groups but has spread
to other groups as well.
According to various reports Maharastara is one of the States with high HIV prevalence. It has
between 3.5 to 4 lakh HIV-infected people approx. 10 percent of India’s 3.5 to 4 m. cases.1 The
other States are Manipur, Nagaland, A.P., Tamil Nadu, and Karnataka. Gujarat and Goa comprise
the medium-prevalence States. UP, Bihar and Kerala rank among the low-prevalence State.
However, the low prevalence in these latter States is due to lack of proper classified data. The
actual extent and magnitude of HIV-AIDS at present is difficult to arrive at conclusively owing to
conflicting statistical information being reported by various interests groups.
According to the National Aids Control Organization (NACO), in charge of the monitoring and
control programs in India, a high-prevalence State is one where the percertange of pregnant
women, testing HIV positive at ante-natal clinics, has crossed 1 per cent and ii) where the
prevalence among high risk groups like sex workers has crossed 5 percent.1 These estimates
are based on annual surveys of only those who visited government-run clinics. In Maharastara
and Tamil Nadu, the infections are mostly due to heterosexual contact, while infections are
mainly found among injecting drug users and their sexual partners in Manipur in the North East.
WHO and UNAIDS reports that India’s national adult HIV prevalence rate of less than 1 % offers
little indication of the serious situation. A large number of people are affected in certain areas
leading to localised epidemics with an estimated 3.97 m people living with HIV at the end of
2001.
While normal heterosexual activity is the main route of transmission, certain areas have been
affected largely through other routes like the use of injectable drugs and unregulated blood
transfusion vis-a-vis blood donation. Mother to child transmission is also the single biggest
cause for concern and the major contributor in the massive rise of the ailment.
Q FACTS against MYTHS - December-January - Updated 2004
C FOR PRIVATE CIRCULATION, ONLY
Mother to Child Transmission2
>
New infection in children (0-14 years) - 0.8 m
>
HIV/deaths in children (0-14 years)
- 0.58
>
Children living with HIV/AIDS
-3m
>
HIV positive pregnant women
- 2.6 m
The estimates of the risk of vertical transmission are:
During pregnancy
-5-10%
During Labor & Delivery
-10-20%
During breast Feeding
- 5-20%
Pediatric AIDS another major public health problem.
Many children are born HIV-positive but test negative
months later. This is because the mother has passed
on the antibodies for the virus, not the virus itself, and
these antibodies disappear in 18 months3 Ironically,
however, children’s' homes all over the city of Mumbai
attest that even when children have become HIV
negative, these children experience discrimination
during adoption in that couples are unwilling to adopt
them out of sheer ignorance about HIV and unfounded
fears whether or not the child will be socially accepted.
However, ignorance of HIV can also be traced among
among urbane Indians. For instance two children in
Kerala living with HIV showed the extent of ignorance
even among India’s most literate state, Kerela. In a
Government High School in Kaithakuzhi Kollam district
the two children were the only ones in attendance. That
is because the parents of the other 119 pupils did not
send their children to school for fear they would be
infected by the two HIV children who had earlier been
turned away from four other schools. Moreover, the
guardians of these children had also to face threats at
home from local residents.
As it is now widely known the HIV infection is no longer
confined to just the so-called traditional vulnerable
groups. When it was first reported AIDS cases were
among gays but later observed among heterosexuals
and even among married couples. Today, the ailment
includes the youth and college students. According to
reports 50 per cent of new infections are to be found
among those below the 25 age-group. This is the new
The general causes for HIV
infection among children3
Up to one year old - parent-to-child
1 to 6 years - through parent or
thalassemia
6 to 12 years - substance abuse or
sexual abuse
12 to 18 years - substance abuse or
heterosexual exposure
vulnerable high risk group4. DATA by NACO indicate
that of 56,151 AIDS cases in the 0-29 age group in
India, 24,663 have been reported from Tamilnadu4.
For the period ending October 31,2003,2,126 children
below 14 have AIDS while 19,416 cases have been
reported in the age group of 15-29.
Apart from youth, the prevalence of HIV is also among
women attending ante-natal clinics among whom it was
higher than 1% in A.R, Karnataka, M.S., Manipur,
Nagaland and TN. It must be noted that women’s
vulnerability to the ailment are rooted in sexual, social
and economic inequality based on gender. This gender
bias is even further perpetuated by the
recommendation that had been made by the National
Commission for Women (Delhi) proposing a moralistic
amendment in the marriage laws making HIV/AIDS
as grounds for divorce. Gender inequality however is
also affected by a combination of factors such as class,
caste, sexual orientation, religion and culture.
The increasing levels of HIV-AIDS in women and the
consequent rise of pre-natal transmission highlight the
relevance of incorporating a strong gender perspectiv^^
into any strategy to address the ailment. Women’s
ability to negotiate their sexual relation is rooted in
their social and economic status. High dependence
on male partners and low education standards limits
women’s choices which often determine their sexual
relations even when faced with high risk and potentially
dangerous situation.
The intersection and overlap of different aspects of
gender inequality with HIV vulnerability further
substantiates the need for a more integrated and holistic
approach to HIV prevention and care that would focus
both on risk reduction and the removal of social,
cultural, economic and legal barriers to effective
prevention behavior. This also means addressing the
health, social and economic needs of those who are
already HIV positive or living with AIDS as well as
protecting families with HIV/AIDS from discrimination
and stigma. Easing the burden of care through a variety
of health, economic and social measures are also highl^^
critical.
Further, mind sets and belief systems also have an
influence on the capability of people to not only
comprehend the exact nature of the AIDS syndrome
but also the capability of people to live a healthy and
self-determined life. Another relevant observation is
that despite media campaign on safe sex practices a
large percentage (around 85 percent) of HIV infections
are due to unsafe sex. Many individuals continue to
also refuse to be tested for the virus. This, combined
with the disinclination to practice safe sex, makes
battling the spread of the disease almost impossible.
Denial, fear of embarrassment and shame, risk of
losing prestige and social status, job, housing are
factors to continuing rise of HIV infection. In this sense,
AIDS is not merely a public health concern and a
FACTS against MYTHS - December-January - Updated 2004
C
I
R
C
U
S5
A
PROJECTIONS: HIV infected people in India
i
CENTRAL INTELLIGENCE AGENCY (us): 5-8 million existing.
25 million by 2025.
q
WORLD BANK: 10.9 million by 2024
q
NACO: Existing, about 4 million and plateauing
challenge but a litmus test of tolerance and democratic
principles.
However, in this whole complex HIV-AIDS question,
the central issue in India and in the South is the
disturbing emergence of new information that
exacerbates our dilemma in effectively dealing with
the ailment. These are:
First, conflicting variations in not just the data on HIVAIDs affected people but on the various studies,
^approaches, the methodologies, etc, in addressing the
issue head on. For instance, Outlook magazine reports
of the peculiar prediction by the American CIA that
India alone would have 20-256 m. infections by 2010,
up from 4 m. today! The earlier issue of this publication
reports the following conflicting figures5.
Second, the questionable nature of those active in
dealing with the AIDS syndrome especially the now
dubious role of the mega pharmaceutical drug industry
for whom AIDS presents a massive lucrative market
—products that range from condoms and HIV testing
kits to anti-AIDS drugs like ARVs, etc., and
microbicides protecting women to HIV Tests itself and
Medicare to HIV/AIDS treatment infrastructure. The
multi-trillion dollar global market for these products and
related facilities is heavily dependent on synthetic
drugs that allow an excessively high lucrative
investment based on the patentability of the drugs. A
large number of these pharmaceutical firms, to get
'access to this vast market, even exploit the fear and
vulnerability of HIV affected persons. Results of drug
trials for instance kept secret, released information on
it selectively, or even delayed trials in the single-minded
drive for maximum profits. Some have not bothered
with trials at all before peddling cure or palliatives of a
dubious nature. For instance, in the same magazine
(above) there is an overservation by the President of
the New York-based oraganisation, HEAL (Health
Education AIDS Liaison): “The big crime here is that
the pharma companies are passing off the HIV tests
and the anti-HIV 'treatments’ as accurate and effective
when both the tests and these anti-retroviral drugs which are extremely toxic - have already been
profoundly discredited in the US”.
Third, whether HIV-AIDS is really the #1 “killer disease"
both in India and in the South and therefore the country
faces an HIV-AIDS “epidemic” even making
India the so-called AIDS capital of the
World and according to the American CIA
that India along with China will see the
“next wave” of the global AIDS crisis. This
is in contrast to communicable diseases
e.g. TB, malaria, Hepatitis. B and even
asthma which according to reports
including the cited magazine (above) kill
more people than AIDS. See details on
pg.4.
Forth, is the hidden motive of the sudden
and incredible deluge of funds flooding into the country
for HIV prevention by global financial institutions,
private foundations like the Bill and Melinda Gates
Foundation, UN, among others.
In all this, however, the greatest consequence is on
the AIDS sufferers. Not only must they contend with
a ravaging ailment but also the stigmatized social
response that makes the coping with AIDS very difficult.
Effective public information campaigns need to de
stigmatise the ailment. Laws that protect the privacy
and dignity of HIV-positive people need to be
championed by public officials and NGOs. Above all,
prejudice and the social stigma around HIV-AIDS must
be tackled and banished. Zero tolerance is the need of
the hour—for those who for instance deny a child an
education, or refuse an expectant mother her right to
medical attention and treatment, or embarrass anyone
with AIDS into shunning such treatment.
Educational campaigns by Government and NGOs too
are limited by moral prejudice: they do not inform
correctly, and therefore, they do not prevent.
Consequently, they are largely useless. The
effectiveness of such campaigns depends upon the
challenge of an alternative to the existing
commercialized medical and health-care system. It is
not enough that education itself is the “key to effective
AIDS prevention” or that the “best friend is the condom”.
‘Safe Sex’ campaigns with posters, calendars,
booklets, videos including the so-called technological
THE AIDS LIE IN INDIA5
UNAIDS reported 3.10 lakh AIDS deaths in
India in 1999. NACO’s toll from 1987 to Dec.
2000 was a measly 1,759.
Figures reveal incidence of HIV in Manipur
fell from highest (18 per cent) to among the
lowest (0.4 per cent) in 1998.
NACO submits to Parliament in ’98 that there
are 81 lakh HIV/AIDS cases. Now scaled
down to 38 lakh cases.
NACO now describes UNAIDS figures as
guesswork. UNAIDS admits better
methodology is required.
FACTS against MYTHS — December-January - Updated 2004
3
approach of developing a vaccine are relevant but not
at all enough. The colossal expenditure on
sophisticated research and vaccine trials is also
inappropriate in especially societies like India. There
is always the risk of failure as for instance in Thailand
where such clinical trials have failed and that to after
millions of dollars being spent on such trials. Besides,
It is difficult to determine a vaccine’s effectiveness
without tests lasting several years.
Efforts so far to deal with the issue of HIV and AIDS
have thus not only been ineffective but also
questionable.The fear of AIDS - rather than AIDS itself
- is part of the panic that is widespread and very often
artificially generated. AIDS has been responsible for
much hysterical discrimination with even instances of
human rights violation.This has led to assaults on the
rights and dignity of HIV infected persons in areas of
work, education, housing and travel.There have been
reports of some groups like sex workers and truckers
who have often been subjected to compulsory HIV
testing without pre-test and post-text counseling.
Hospital patients who have been tested without their
consent have sometimes committed suicide when
confronted with the results of the test. Women in labour
have been refused entry into maternity homes and have
been forced to deliver their babies on the roadside.
Thus, AIDS is not only a very serious problem but
first and foremost a social and psychological problem
with not only serious consequences at the level of
individual suffering but also at the wider societal level
of human rights, equality and the power equations
between the sexes which women in particular find it
almost impossible to negotiate ‘safe sex’ with men or
their clients. However, with the exception of rape, men
and women are equally responsible for their safe sex
practices.
Still further, the task is to struggle against the iniquitous
social structures that lie at the base of the AIDS crisis
- that uproot and make the impoverished migrate to
urban centres to eke out a living, and in the process
separating husbands and wives. In the long run,
measures like the cancellation of foreign debt,
increased production of nutritious food for local
consumption rather than for export, and fairer wages
would be comparatively more effective in checking the
spread of AIDS. In short, there is the need to also
carefully study the best ways to reach communities
whose basic ways of seeing things are not written in
any textbook. Indeed there is the need to intervene
into the control of the infection by other means. For
instance, the more holistic health-care systems
indigenous to societies of the South which emphasizes
that it is the basic balance and health of the body
which determines whether a person succumbs to a
disease.Traditional health-care systems need also to
be dispassionately taken into consideration along with
other mainstream and alternate therapies as they hold
great promise in the prevention of AIDS. Most disease
can be treated by holistic healing modalities. The
principles of healing are rather simple; a) the body heals
itself b) there is an inner environment and not just the
outer environment c) treatment should not be worse
than the disease6.
Strategywise, priority in the control of AIDS must be
on prevention. Effective and creative educational
programmes, easy availability of cheap and high
quality condoms, additional investment in clinical
sterilization techniques, women-controlled
contraceptive choices, universal blood screening,
clinics and health awareness have benefits that will
increase the general welfare of the people. Condoms
mean lower STD (Sexually Transmitted Diseases) rates
in general; improved clinical procedures reduce a
variety of iatrogenic illnesses that health-related
programmes can build on. Today, however, the
immediate need is for strategies like harm reduction
(rather than focusing on “war on drugs”) on the one
hand and on the other to prevent the trafficking of sex
workers from the South.
To conclude, it is necessary to also dispel the various
myths generated by vested interests like a section of
the health care sector, the drug companies and others,
both government agencies and NGOS, hand-in-glove
with these vested interests.
MYTH: AIDS is a highly contagious disease.
FACT: AIDS is not a single disease but a ‘syndrome’
or group of specific infections, cancers and other
conditions which occur because the body’s immune
system has been compromised. Examples of possible
specific diseases include ‘pneumocystis carini
pneumonia’and ‘cytomegal virus’. Because AIDS is a
syndrome it is a diagnosis, not a disease7. AIDS
cannot, therefore, be ‘caught’, although people with
HIV can transmit the virus to others. That is, the
infection does not spread through air or water or simple
social contact. It is not contagious in the same sense
as measles, chicken pox, influenza, common colds,
TB, typhoid, cholera even plague and small pox. On<
the other hand transmission of HIV require a heavy
KILLER DISEASES IN INDIA
CAUSE OF DEATH
NUMBERS
Cardiovascular Diseases
Respiratory Infections
Diarrhoeal Diseases
Cancer
Perinatal Conditions
Tuberculosis
Maternal Conditions
Diabetes Mellitus
Astma
Malaria
AIDS (from 1986 till 2001)
28,20,000
9,87,000
7,11,000
6,53,000
6,12,000
4,21,000
1,25,000
1,02,000
21,000
20,000
(NACO) 2,524
Source: Outlook, December 2, 2002
Q FACTS against MYTHS - December-January - Updated 2004
exchange of body fluids from an infected person, which
in everyday contact situation does not reach the critical
stage.
HIV infection like hepatitis B or syphilis spreads through
blood-to-blood contact or through a sexual route.
Therefore, it cannot be contacted through the sharing
of cutlery, shaking hands, swimming pools, or toilets;
or through coughing, sneezing or spiting; sharing of
public places or using amenities like transport; or by
attending the same school or workplace, etc. Even if
people live and work in the same household or worksite
with an infected individual, the HIV virus cannot be
transmitted. Nor is it spread by social lip-to-lip kissing.
This is because when the virus is present in saliva
(and that is unusual) it is only in very small amounts,
insufficient to infect anyone. Moreover, according to
the US National Institute of Dental Research this is
also because a protein in saliva protects the white
blood cell from infection.
As such a person with HIV does not need to be isolated
or quarantined. Even in situations where one is in
Btuations where one is in direct contact with blood
from someone infected with HIV e.g. giving first aid at
a road accident, that blood would have to enter the
bloodstream to be infected. If an infected person is
injured and spills some blood this can be cleared up
perfectly safely by using diluted household
disinfectants like Dettol or bleach which will kill any
virus present; even by hot water and washing-up liquid.
MYTH: AIDS today is the single most hazardous
disease, killing more people than any other known
diseases.
FACT: Over-exposure and minute media coverage is
responsible for the mass hysteria and paranoia over
AIDS. For instance, the hype on the visit of high profile
dignitaries from the world of business and
entertainment some of whom like Richard Gere,
billionaire Bill Gates of Microsoft have visited India
taking up the issue of HIV-AIDS adds to this over
exposure.
However, in terms of human-to-human transmission,
HIV is the least dangerous, when compared to other
viral diseases like TB, jaundice, small pox which are
fast-acting and highly fatal. True, AIDS may be the
most serious threat to have confronted the medical
community in recent history, but it certainly dwarfs in
the presence of an insidious viral diseases that attracts
little attention despite claiming, according to WHO, upto
2 million lives every year. Comparatively, Hepatitis B is clearly a vicious diseases for which, of course,
there is a vaccine unlike AIDS. Yet, Hepatitis - B
remains one of the most unconquered disease
worldwide. It is 10 times more infectious then HIV and
accounts for more deaths in a day than AIDS causes
in a year.
The battle against
these infectious
diseases, however,
does not preclude
the fight against HIVAIDS
MYTH: One of most
effective means in
checking
the
spread of AIDS is
through mandatory
testing of HIVeffected people and
placing them under
quarantine.
AIDS Cases1
Tamil Nadu
Maharashtra
Andhra Pradesh
Gujarat
Mumbai
Karnataka
Manipur
Madhya Pradesh
West Bengal
Delhi
Nagaland
Others
44.7%
16.7%
7.9%
6.5%
4.7%
3.2%
2.2%
1.9%
1.7%
1.5%
0.6%
8.4%
FACT: Further to the point made above, mandatory
testing is also unethical! Under Article 21 of the Indian
Constitution, it is also unconstitutional.
When read with Article 14 (equality and non
arbitrariness), this has been held to mean that firstly
there has to be a law, i.e., a statutory enactment,
providing for deprivation of liberty: and that law must
be fair, just and reasonable, both substantively and
procedurally. For instance, taking recourse to the Public
Health Amendment Act, the State of Goa had enacted
a law providing for mandatory testing and isolation of
HIV positive persons.
This was challenged on the grounds of violation of
Article 14 and 21 of the Constitution. The Goa bench
of the Bombay High Court rejected the challenge
except on the limited ground of allowing the persons
affected an opportunity to rebut the findings of the
HIV test. An AIDS Prevention Bill was introduced in
the Rajya Sabha on August 18,1989 on similar lines
but had to be withdrawn after protests by human rights
groups as it had focused on sex-workers, gays and
drug users as “high-risk” groups.
Apart from this aspect of human rights violations,
testing of (say) prisoners for HIV infection will however
not arrest the spread of the infection. It could well be
counter-productive. If the test is mandatory as opposed
to voluntary, the spread of AIDS might actually get
aggravated;
In 1992 at a Meeting convened by WHO on the issue,
the conclusion was that there was sufficient evidence
that such testing was not in the interest of public health
in any way that voluntary testing cannot. HIV testing it
says can be Classified as being done with or without
informed consent. “Mandatory testing and other testing
without informed consent has no place in an AIDS
prevention and control programme”.The modes of HIV
transmission are limited and known and specific action
can be taken for checking its spread. Instead, such
patients should be integrated within the community
and helped to take up responsibilities in not infecting
others. Isolating them would jeopardize the educational
(/FACTS against MYTHS — December-January - Updated 2004
5
and other efforts to prevent the spread of HIV, causing
extra burden and unnecessary human suffering. The
Committee of Ministers of Europe also similarly
recommended that “there should be no compulsory
screening (for HIV infection) of the general population,
nor of particular population groups".
There is however no disagreement on testing for HIV
for which clear indications exist. However, it appears
counter-productive and, at times, disastrous to test
each and every person seeking help of counseling
agencies, etc., for HIV. An otherwise healthy and
carefree person will be reduced to a cowering mass of
despair on being told that s/he suffers from an incurable
disease. Worse, society at large and even those
considered near and dear will be treated with the same
revulsion that was once the fate of the leper.
If the logic of testing each and every patient for HIV
was to prevail when checking those most likely to
convey AIDS to others, the whole medical fraternity
must also be tested. Similarly, the staff and all patients
should be tested for all STDs, infective hepatitis and
a number of other contagious diseases. In short, mass
screening - even screening of particular groups - is
not an effective strategy at all. Moreover, such testing
diverts scarce resources from effective AIDS control
programs. In a large country like India it is thus
economically infeasible. It would only end up testing
the so-called ‘high-risk’ group i.e. sex-workers,
intravenous drug users and gays. Apart from the fact
that this would be irrational (as HIV infection is not
related to sexuality but to unsafe sexual practices)
and reinforce prejudices against HIV carriers, thereby
provoking discrimination, it will defeat the very aim of
the programme in as much as it will drive persons of
the ‘high-risk’ groups under-ground. Such as isolationist
approach is thus bound to boomerang.
MYTH: Prostitutes are high-risk group in the spread
of AIDS.
FACT: Historically, prostitutes have always been
accused (and later victimized) for directly being
responsible in the spread of STDs and, today, AIDS.
It is a long-standing stereotype.The chances of a HIVinfected man transmitting the infection to a woman
are higher than a HIV-infected woman doing so to a
man. Besides, about three-quarters of the AIDS cases
in the country due to HIV infection are through
unprotected multi-partner heterosexual relationships
with more men than women indulging in multi-partner
sexual relationships. If female-to-male transmission
of infection is lower than that of male-to-female
transmission (as studies show) the prostitutes are at
a lower risks of getting infected by them. They enter
the trade, disease-free. Only in the course of prostitution
that women and increasingly children get afflicted with
STDs and HIV from male clients. More than being a
“high-risk” group, a prostitute is thus more of a group
at risk. When they do receive and transmit HIV and
AIDS, it is totally involuntary. Unlike their clients women 1
lack the right to use condoms or the power to negotiate |
safe-sex.The existing unequal power-equation among I
the sexes in society is the obstacle.
Sexual transmission being one of the main modes of
HIV transmission it was erroneously believed that it i
was multiple sex partners that led to HIV. Recent 1
studies, however, indicate that general sexual activity
and unprotected sex leads to the infection. Thus,
prostitutes are not the source of AIDS or so-called I
high risk group.
Trying to track the spread of HIV from prostitutes flies
|
in the face of both epidemiology and genitourinary data.
“Even with the hypothesized greater transmission from
women to men if men have genital ulcers, the
probability of transmission cannot, and in the
epidemiology does not, become equal". If prostitution
is one the main explanation for the spread of AIDS,
even if each “prostitute” “infected” several men, each
one of those men could in turn be expected in infect
several other women (his wife, other prostitutes, and
others) since the odds of male-to-female (or male-tc^) 4
male - it is the receptive partner who is at the in
creased risk) infection are still greater. Combined with
the increased infection of women due to blood, there
should be more women than men, not the same
number.8
MYTH: Vaccine trials on AIDS are essential in
especially the South. Apart from the direct benefits
of a successful AIDS vaccine, these trials will
confer substantial and lasting benefits to these
countries.
FACT: AIDS vaccine trials in the South are highly dicey
proposition! Cindy Patton, in “Inventing Aids” shows
how Phases One and Two of these trials are focused
on low-risk Western subjects but Phase Three is aimed
at determining whether the vaccine actually works on
‘high-risk’ persons in the South, as a deterrent to HIV
infection. In other words, the trials will determine
whether the vaccine is harmful to bodies of Westerdft
subjects. On the other hand, citizens from the South
in the Phase Three trials will discover whether they
have received enough vaccine to stay uninfected. The
logic of the Phase Three trials is that these are urgent
as the people in the South face a great danger of
exposure to the HIV virus. And anyway, the proponents
maintain, the vaccine’s effectiveness cannot be tested
until and unless people are subsequently exposed to
the agent! What is, however, cleverly masked is the
high risk that these Phase Three trials involve which
do not effect western subjects! Further, as Patton
observes, there are a number of crucial questions apart
from the ethnocentrism linking these trials. First,
existing epidemiological data certainly does not
suggest that HIV is more rampant (for instance) in
any locale in the South than in (say) New York, Paris
or Amsterdam. Second, if people are dying of AIDS in
(2 FACTS against MYTHS — December-January - Updated 2004
huge numbers, as western news reports are wont to
exaggerate, who then is left to serve as trial subjects?
Third, if preventive steps are certainly possible (and
here, ethicists must explain where and why prevention
works - if it works in the Sodom of New York, why not
the Eden of Zimbabwe), then who benefits from the
risks of the vaccine trials? Fourth, if some important
number of the HIV cases in the South are attributable
to poor blood screening resulting from the low efficiency
and high cost of the Western developed tests, are
vaccine trials being funded instead of improved
screening methods? Is the moderately high (an
unavoidable) risk of receiving an HIV-infected blood
transfusion to be another route of exposure for potential
vaccine trial subjects? Finally, what provisions ensure
that citizens in the South and their societies as a whole,
will actually be first to receive the vaccine, once
developed? Here, the precise arguments about the
problems in rural clinical practice — “They cannot
properly diagnose AIDS” — come into play as alibis
for not distributing the vaccine. Obviously, the AIDS
vaccine trials focuses disproportionately on
strengthening the scientific and medical infrastructures
of the South in preparation for such trials — in these
societies. Finally, if every one participating in the trial
is successfully educated towards protection and
correct condom use, etc., how will scientists be able
to tell if a vaccine protests against HIV infection.
The contradictory nature some of these racist
perceptions lining these vaccine trials renders them
all the more insidious.
MYTH: The Anti-Retroviral (ARV) therapy is also an
effective treatment to guard against HIV and AIDS.
FACT: The advocacy of such an unwarranted HIV
treatment without proper counseling or informing HIV
patients about the drawbacks of such a therapy is
dangerous. According to knowledgeable health and
medical specialists there is strong case for ARV to
taken by HIV patients provided that i) HIV patients
-xieed to undergo such a treatment ii) their CD4 count
(a laboratory test which measures their immune status)
falls below 225 iii) patients are informed of the high
costs (including hidden costs of regular laboratory
tests) iv) the risk of side effects in many people v)
irregular treatment could be dangerous and vi)
treatment is no guarantee for a cure and needs to be
taken life long with a very high level of adherence.
This requires excellent rapport with the patient and
ensuring that the patient has understood the financial
and various other implications and vii) the quality of
the drug
of cholesterol and other lipids in the blood, raising
concern that HIV positive persons might face the threat
of another epidemic of heart disease. It could also
lead to lipodystrophy, narcotic overdose, insomnia, and
high blood pressure. Further, indiscriminate use of
ARVs to pregnant mothers is fraught with danger. If a
cigarette chain smoking mother can deliver a ‘blue
baby’; if an alcoholic mother can deliver a ‘drunk child’,
if thalidomide can produce ‘monster babies’ one is
unwittingly playing with the future generation, by
demanding that the HIV positive mother be given ARVs
compulsorily.
On the last point, in India with poor quality control
mechanism there is also the situation where the
approval process for drugs like ARVS are not strictly
adhered to. This was the case for instance of a patient
who had complained to a local clinic of passing AntiRetroviral drugs intact in the stool.
Reference:
1.
Sekhar, V.C. “There’s Positive & Negative News
for HIV in State", Times of India, December
15,.2003.
2
World Health Day: Parent to Child Transmission,
Free Press Journal, April 7, 2003.
3.
Kamdar, S. HIV Positive Children Have Few
Takers, Times of India, December 1, 2003.
4.
Sujatha, R. Lessons About AIDS, The HINDU,
November 24, 2003.
5.
Kumar, D. “Back from the Dead”, Outlook,
February 25, 2002.
6.
Rebello, Dr. L. “AIDS No Morel”, University Today,
July 15,2002, Delhi.
7.
The AIDS Syndrome, Third World Guide, 89/90,
Montivideo,1988.
8.
Patton, C. Inventing
London, 1990
9.
Patent Rights Over Pharmaceutical Profits, South
Link, #1, New Delhi, 2002.
10.
Tharoor, S. “A Positive Strategy: India Can Win
the Battle Against AIDS”, Times of India,
December 1,2003.
11.
Werner,Dr.D.”What Causes AIDS?”, Third World
Resurgence, August, Malaysia, 1994.
12.
D’Cunha, Ms.J.”AIDS & Prostitution”, FRCH
Newsletter, #1, 1993
13.
AIDS, Seminar, #396, New Delhi, 1992.
14.
Pandya, S.K. The Patient with AIDS, Medical
Ethics, February, Mumbai, Bombay.
15.
Smith, J.W. AIDS, Philosphy and Beyond, Gower
Publishing Co., Ltd., England,! 991.
It must be noted that the US federal health authorities
today realise that ARVs are hoax and that the effects
of ARVs are toxic — that is, they include nerve
damage, weakened bones, unusual accumulation of
fat in the neck and abdomen and drug-induced diabetes.
Many people have developed dangerously high levels
Q FACTS against MYTHS — December-January - Updated 2004
AIDS,
Routledge,
HIV is not spread by
Shaking hands
Caring for someone with AIDS
Sharing belongings
Touching and Kissing
Insects
GMO
GMO
GMO
Please feel free to reproduce material from this publication but with due credit.
— — —————— —— T
Facts Against Myths is a bi-monthly bulletin offactual
information on a number ofdevelopment myths and
fallacies, etc, including information against alien
development models, paradigms andfalse concepts
on caste, creed and gender.
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