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AIDS at 25: Good-bye Toronto
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AIDS at 25: Good-bye Toronto
AIDS at 25: Good-bye Toronto
8-26-2006
The Toronto International AIDS Conference, which I've come to think of as an excercise in weird science, has been over for a bit, and here are some closing thoughts.
The first, via the NY Times, is from a doctor in NYC; she's very good at pointing out the enormous challenges awaiting anyone who contracts HIV, anywhere in the world, including America:
Fight Against AIDS: Small Triumphs, Sunny Optimism and Grim Reality
By ABIGAIL ZUGER, M.D.
Published: August 22, 2006
TORONTO, Aug. 15 -- Bill, Bill and Melinda dropped into our world for a few days here. It was an unsettling experience, much like coming home from work to find Mr. Gates regrouting your bathroom shower, Mr. Clinton fixing that broken window, and Mrs. Gates cheerily watering the plants.
Famous strangers were suddenly all over our turf, up on the podium at the International AIDS Conference talking with fluent enthusiasm about adherence and second-line drugs, microbicides and pre-exposure prophylaxis.
If they can make some order in our house, that’s fine. We can certainly use the help. But have they been warned that the foundation is irremediably cracked and leaking?
The old generation of AIDS celebrities now often skips this gigantic biennial event. (Robert Gallo, the co-discoverer of H.I.V., complained to a Toronto newspaper about the "circus" atmosphere and the lack of quality science.)
And so this year’s flashing cameras were aimed not at hostile activists and defensive researchers screaming at one another, but at Mr. Clinton and Mr. and Mrs. Gates.
What a pleasant change. This polished threesome may not grasp the more abstruse science of AIDS, but they seem reasonably familiar with the basics. And they are so optimistic as they describe the small triumphs that, thanks to the drugs their money is buying, are now studding the bleak landscape of AIDS in the developing world.
Mr. Gates even told us he sees a "happy ending" down the line.
It was nice to hear, but those of us who work in the developed world can tell him right now that his project, like the worst nightmare of a home renovation, will not have an end.
With our 10-year head start in disbursing AIDS drugs, we have learned many times over that the drugs are just the beginning. Once they are bought and dispensed, the work only gets harder. Side effects and failures are just part of it. Eventually, inevitably, you have to deal with that leaky foundation -- the health care system itself.
AIDS drugs demand an infrastructure. It has taken this country almost 20 years to cobble the first layer together: a network of people trained to administer drugs and watch for problems. At its best now, in states like New York, it functions like a smooth machine, delivering freely available medications, all the necessary tests and probably some of the best, most comprehensive AIDS care in the world.
Still, the beneficence stretches only so far.
And so when patients in our New York clinic need an appendectomy, a cardiac bypass, hernia surgery or a shattered ankle repaired, their wonderful state-sponsored AIDS-specific medical insurance will not pay.
For chemotherapy, a new hip, intensive physical therapy, a prolonged psychiatric hospitalization, cataract surgery, a hearing aid or the services of a good podiatrist, we simply have to cross our fingers and send them out into the fractured disaster that is the rest of our health care system and hope for the best.
Jackie found a breast lump a few years ago. By the time the mammogram had led to the biopsy and to the oncologist and the surgeon and the radiation and the chemotherapy, months had passed with that excruciating slowness familiar to those who know the scheduling habits of overcrowded Medicaid clinics. If the process had taken a few weeks instead of six months, would she have lived?
Bernard never even made it from the neurologist to the neurosurgeon before his brain tumor -- a huge one, but not malignant, as it turned out on autopsy -- put him into a terminal coma.
Charles, never much for medical care to begin with, gave up after a long afternoon’s wait in the cardiology clinic and just went home. A slightly more forgiving system may have saved his life.
Every one of them had AIDS which we had managed, with huge effort, to get under perfect control. The same goes for dozens of our other patients who have died from drug addiction or depression or even random urban violence.
What a waste, we say, every time.
Once you start taking care of people, there is no end. It takes a real health care system to treat even a single illness; AIDS drugs given without one are, in the end, just very expensive scaffolding.
All they do is let people live long enough to need everything else -- TB drugs and decongestants, insulin and hemorrhoid creams, cardiac catheterizations and hip replacements, mosquito netting, malaria pills and polio vaccines. Idealists would point out that food and water, housing, jobs, autonomy and civil rights should probably head that list.
Can Mr. Gates’s billions really begin to pay for a new world? That’s what it will take for his happy ending.
Abigail Zuger, who writes regularly for The Times, is a physician in Manhattan.
Next up is another article from lifesitenews, which is a pro-life news source.
I'm a little chary of them, but the article is an interview with a Ugandan pastor named Martin Ssempa.
Lifesitenews claims that Martin was the "brains" behind ABC.
I don't know if that's true, but Martin, whom I'd met online via Dr. Edward C. Green, did write to me, asking if we could talk about how to stop HIV.
So I wrote back to him about the American MSM (men who have sex with men) HIV experience, explained to him about anal and Frot and masculinity and effeminacy and promiscuity and so forth.
He was very receptive to what I had to say -- which surprised me, because in theory he's "religious right" -- and there I go again, Bad Bill, talking to the religious right -- and usually those folks will not tolerate any discussion of same-sex desire, let alone practice.
My impression of Martin, however, is that unlike people in America, he can't afford to indulge in ideological games.
He lives in Africa -- he doesn't drop in on an expense account from time to time to deliver worthless advice.
And his concern is to save the lives of his fellow Africans and human beings.
So we were able to talk -- and I hope I'll talk with him again.
Here's the article, which by the way, misspells Pastor Ssempa's name throughout:
LifeSiteNews dot com
Wednesday August 16, 2006
International AIDS groups flooding Uganda with condoms and pornography causing increase in AIDS
By Hilary White
LAS VEGAS, August 16, 2006 (LifeSiteNews dot com) -- Hatred of motherhood and the family, a pathological fear of fidelity and sexual continence and loathing of traditional Christian values are the defining forces in the international fight against AIDS according to a long-time Ugandan AIDS activist.
Speaking to LifeSiteNews dot com from Las Vegas where he is giving talks, Martin Sempa, a Ugandan pastor and the "brains" behind the Ugandan effort against the spread of AIDS, says he avoided the Toronto AIDS conference because of the seething hostility to his message he was likely to find there. The only trouble is, he says, that the delegates in Toronto are missing the one thing that will save the lives of millions.
Throughout the 1980’s, the rate of HIV/AIDS climbed to a staggering 30% of the Ugandan population in line with most other countries of Africa. But since their establishment in 1987, the country’s home-grown programs of abstinence and marital fidelity brought the rate down as low as 6.2 per cent. The Christian churches, Catholic, Anglican and Evangelical, worked successfully with the government developing policies to promote marital fidelity and a "no grazing" message to "stay with your husband, stay with your wife."
But, says Sempa, "all hell broke loose" in 1994 when the news got out that a program based on sexual self-control, one rejecting the condom-plus-promiscuity approach of the international organizations, had succeeded so dramatically.
[That is essentially correct.]
AIDS groups began their own counter campaigns. The country is flooding with condoms and pornography and since 1994, the HIV/AIDS rate has begun to climb incrementally. In some areas HIV/AIDS is up to 6.7 per cent.
Sempa says that a dual "pathology" of hatred for abstinence and motherhood is driving the international AIDS campaign. What he calls "abstinophobia" -- fear of sexual abstinence and fidelity as a way of fighting HIV AIDS - and "matriphobia" -- "irrational paranoid fear of programs that promote marriage and motherhood" -- are "the last gasp of life for a sexual revolution that has gone stale in the west [and] is using the AIDS crisis as a means of keeping itself going."
"They’re afraid to mention it," Sempa told LifeSiteNews. "They are looking for any other way to combat the disease. The real problem is right in front of them, but they say, ‘Don’t tell me my promiscuity is wrong.’ "
The grassroots abstinence and fidelity programs, however, are deeply rooted in Uganda’s mainly Christian culture, he says. "People are very observant Christians in Uganda. There is 80 per cent adherence to Christianity in its various forms and our approach resonates with the culture, with public health and is economically viable."
Sempa says there is a gulf in the basic understanding of the nature of the problem. "Western experts, Bill Clinton, the UN, and the World Health Organization, look upon the AIDS problem as ‘not enough condoms.’ We on the ground, those who actually live in the country, see that the problem is too much promiscuity." This gulf sets home-based Ugandan AIDS activists against those attempting to impose a western-style culture of "free sex" with condoms at odds with traditional Ugandan culture.
The Ugandan success story is not over yet, however. While the AIDS rate has climbed, it is still among the lowest in Africa and the abstinence and fidelity program is being spread to other countries. Four other countries are importing the Ugandan program in the last year and are seeing some success already. HIV/AIDS rates are starting to fall in Kenya, Zimbabwe, Rwanda, Swaziland since the beginnings of implementation.
If Sempa had a message for Microsoft founder and philanthropist Bill Gates, who has used the Toronto International AIDS Conference to promote the condoms approach to combating the disease, he says it would be to point to his own long and happy marriage as an inspiration.
He said, "The best thing Bill Gates can do for Africa is to speak about how his own marriage to one wife has helped him be successful in life."
"Bill Gates’ best story is not his money, but his marriage to Melinda. He has had the experience of being faithful to one wife. He needs to bring that story to all those who have come from divorce and broken homes. We don’t need more condoms from Bill and Melinda, but more hope -- and fidelity in marriage is a message of hope."
[emphasis mine]
When the article says "The country is flooding with condoms and pornography" what does that mean?
I'm not sure what's going on right now.
But when Western "AIDS prevention experts" first descended on Africa, they used material which had been developed to deal with the American / European MSM epidemic.
Material like brochures and comic books geared to gay men.
These materials of course are sexually explicit and refer to all sorts of arcane acts which are not known and / or certainly not common to a place like Uganda.
I'm talking about things like felching.
Is that pornography?
Not in the sense of commercial porn, but, again, it is sexually explicit.
Look for example at the comics distributed by Healthy Gay Scotland -- another Orwellian-named ASO.
And it was dropped into a culture which speaks very delicately about sex, and with a great deal of circumlocution.
"Western experts, Bill Clinton, the UN, and the World Health Organization, look upon the AIDS problem as ‘not enough condoms.’ We on the ground, those who actually live in the country, see that the problem is too much promiscuity."
Pastor Ssempa is correct.
The same is true of those of us attempting to impact the American MSM epidemic.
The "experts" keep insisting that the MSM problem is "not enough condoms."
It's not.
The gay community is drowning in condoms.
The problem is the risk behavior.
And that risk behavior is anal penetration.
That's the problem.
Which no one wants to acknowledge.
Instead they push condoms.
And many of the people pushing those condoms are really -- insane.
Here are some pix from Toronto of dresses made of condoms.
I'm not making this up.
The first is being viewed by an Indian transvestite -- probably a prostitute.
And the second is being viewed by -- a child.
Talk about cults.
Making dresses out of condoms, and then showing them to kids, is truly cultish behavior.
So: what we're left with, after the science of treatment, is an unwillingness to actually deal with the behaviors that are spreading the disease.
And a debate that's incredibly polarized.
That interview with Pastor Ssempa appeared on a pro-life website.
Why isn't it in the NY Times?
Because the Times is pro-choice, the Times is pro-condom.
Do you think "lifesitenews" would do an interview with Bill Weintraub?
No.
Because I'm "a homosexual."
So how serious is lifesitenews about ending the epidemic?
And how serious is the NY Times?
This is from a precis of an editorial in the Boston Globe, another "liberal" paper, on 8-22-06 as reported by Medical News Today.
"Drugs alone will never keep up with HIV/AIDS if there continue to be four million new infections every year worldwide," a Boston Globe editorial says, adding, "While researchers hope someday to develop a vaccine and a microbicide that women can use to protect themselves, those breakthroughs are several years off at the least. So for now, health agencies will have to rely on other tools to slow transmission of the disease." According to the Globe, the ABC prevention method -- which stands for abstinence, be faithful and use condoms -- is a "sound, low-cost approach to prevention, but it has not proven equal to the challenge."
What a bizarre statement.
ABC has worked in every country which has given it a try.
It's more than equal to the challenge.
HIV prevalence in Uganda is at about 6% -- the lowest in sub-Saharan Africa.
In Swaziland, where the social marketing of condoms has been intense, HIV prevalence at one point was at 38%.
Guys, one of the last speakers in Toronto thunderously denounced ABC and the Bush admin's PEPFAR as "colonialism."
But, as Martin Ssempa just described, and as is well-known, ABC is an INDIGENOUS program.
It's AFRICAN -- not American.
Condom campaigns are colonialist; ABC is not.
Then Bill Clinton endorsed male circumcision (MC) for Africans.
Well, MC may prove to be effective in Africa.
But why is it okay to suggest that African men have their foreskins lopped off -- but not okay to suggest that Abstinence and Fidelity, which is an African program, work too?
That makes no sense.
Unless you understand that removing the foreskin, in theory at least, permits the men to go on being promiscuous; while abstain / be faithful tells them to stop.
As Jim Chin said, AIDS has been "the collision of political correctness with epidemiology."
A collision in which millions of human beings have lost their lives.
And we really have to be clear about that.
The epidemic in the US was brought on by political correctness;
and has been sustained by political correctness for 25 years.
Bill Weintraub
© All material Copyright 2006 by Bill Weintraub. All rights reserved.
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