AIDS: I care..., do you?<\/p>\n
Chris W. Green, AIDS activist, Jakarta<\/p>\n
That is the slogan accompanying this year's World AIDS Day,
\nwhich again falls on Dec. 1. Yes, I know it sounds a bit arrogant
\n-- but forgetting that, what does it really mean?<\/p>\n
Interesting word, \"care\". Look it up in the dictionary and you
\nwill find it has many different meanings. I guess those who
\nthought up the slogan intended it to mean \"I feel concerned about
\nAIDS\", or perhaps \"I worry about AIDS\". I like to think they also
\nhoped we would read it to mean that we were willing to care about
\nand care for people with Acquired Immune Deficiency Syndrome
\n(AIDS).<\/p>\n
With 37 million people living with Human Immunodeficiency
\nVirus (HIV) and AIDS around the world, we can no longer just
\nmouth platitudes like \"prevention is better than cure\" --
\nparticularly when there is no cure. Yes, prevention continues to
\nbe very important, but many believe that it can only be effective
\nif it is integrated into care and support for those infected.<\/p>\n
Given that HIV, the virus that causes AIDS, can only be spread
\nby those who are already infected, it seems obvious that those
\nwho are infected should play a crucial role in the prevention
\nresponse. But this can only occur if they are aware that they are
\ninfected. And because of the stigma and discrimination that a
\npositive diagnosis of HIV infection can bring, few of those who
\nfeel they might be infected see any benefit in being tested. They
\n\"know\" that there is no cure for AIDS, and expect that they will
\nbe left to die if it becomes known that they have the disease.
\nWho will care for them?<\/p>\n
Until recently, many felt that there was little that could be
\ndone for people with AIDS in the developing world. The new
\ntreatments that started to become available in America and Europe
\nin the mid 1990s were far too expensive for all but a very small
\nhandful of people with AIDS in the developing world. Who could
\npossibly raise the US$15,000 that was needed for one year's
\nsupply of drugs -- and do that for life?<\/p>\n
But over the last year, a breakthrough has occurred. With
\ncompetitive pressure from manufacturers of generic drugs in India
\nand Brazil, and strong advocacy from activists around the world,
\nthese prices have dropped dramatically. Now, people with AIDS in
\nIndonesia can access this therapy for Rp 120,000 (US$11.5) per
\nmonth -- and there are hopes that even this cost can be reduced.
\nAlready many are starting to take advantage of these low prices
\n-- and more are asking to be tested as a result.<\/p>\n
But although HIV can infect both rich and poor, it tends to
\naffect disproportionately those in the bottom layers of society,
\nfor whom even such relatively low costs are still out of the
\nquestion.<\/p>\n
For example, we are seeing an explosion of HIV infection among
\nprisoners, primarily as a result of infecting drug use -- a
\nrecent survey in a Jakarta prison showed that 17.5 percent were
\nHIV-positive. The prison authorities admit that their budget for
\nhealthcare is Rp 700 per prisoner per year, enough only to buy a
\nfew aspirin. How could they possibly offer effective treatment to
\nthese people? Who cares?<\/p>\n
But within one or two years, these prisoners will be released
\nand returned to the community. Will they care about infecting
\nothers? Do they even know they are infected, or understand what
\nthat means?<\/p>\n
Evidence is accumulating that use of the new potent drugs can
\ndepress the level of HIV in the body to a level that greatly
\nreduces the likelihood of transmission to others. Given that
\npersuading people to change their risky behavior, while not
\nimpossible, is very difficult, offering this therapy can have a
\nsignificant effect on prevention.<\/p>\n
Yesterday I received a call from Joyce Djaelani at the Yayasan
\nKita drug recovery center in Bogor. They have been asked to take
\nin a young drug user who is showing symptoms of AIDS. The parents
\nhave given up and just want him out of the house. Who cares?<\/p>\n
Another junkie bites the dust... But, before he dies, the
\nchances are that he'll continue to share needles with others who
\nmay not be infected. Caring for him could break that cycle of
\ninfection. But where is the hospital willing to accept a current
\ndrug user with AIDS?<\/p>\n
Few enough are willing to accept people with AIDS, let alone
\nactive drug users. I know, there are no easy solutions to this --
\nanywhere in the world. But who cares?<\/p>\n
AIDS and drug use stretch our feelings of humanity to the
\nlimit. Many of us find it difficult to empathize with drug users
\nor others whose behavior puts them at risk of HIV infection. But
\nis it not our society that has allowed the conditions to exist in
\nwhich such behavior occurs -- or even actively promoted them?<\/p>\n
If we are to make any impact on the spread of this epidemic,
\nwe must care about AIDS -- and care for those infected.<\/p>",
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"sponsor": "Okusi Associates",
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