This issue of the Journal was completed the day before I left for the XI International Conference on AIDS. I've attended these conferences for more than ten years, and have always been optimistic--even when the pessimism over Concorde was as thick as espresso.
But as I am packing my bags for an eight-day stay in Vancouver, I have lost my optimism. While there is little doubt that this will be the first of these international gatherings that will be marked with hope and promise that we now have many of the tools we need to manage this disease effectively, I have finally come to realize that these conferences have not seriously addressed AIDS as a disease of societal inequity. Its symptoms are the devaluation of the lives of those affected through the withholding of drugs necessary for survival.
I am pessimistic about the failure of governments to understand that the right to life is synonymous with the right to a healthy life. We can continue to debate whether healthcare is a social right or a social need. The ultimate reality, however, is that the failure to provide appropriate medical care to those who would die or suffer without it is a human rights violation, a violation of our right to life.
Unnecessary pain is unnecessary pain whether it is inflicted by torture authorized by a totalitarian government or whether it is the result of being deprived of appropriate medical care by an insensitive and uncompassionate government. Unnecessary pain and unnecessary death are human rights violations and must be dealt with as such.
I am pessimistic about those political opportunists whose platforms ostensibly are based on a right to life, but who fail to address the 7.6 million infant deaths that occur annually worldwide. I am pessimistic that the call for mandatory HIV testing of pregnant women in the US may actually add to rather than reduce this statistic. I am pessimistic over the growing support for the denial of healthcare to illegal immigrants.
I am pessimistic over the growth of economic discrimination which devalues the lives of the poor, the ill, the newborn, the elderly, and all of the "nonproductive" members of our society. I am pessimistic over the failure of the media to check out Richard Lamm, a third-party presidential candidate, who promoted the concept that "the elderly have an economic duty to die." I'm pessimistic over the fact that this concept of an economic duty to die underlies much of our current global healthcare policy and has become the economists' version of ethnic cleansing.
Amid this sometimes debilitating pessimism, at least one organization, the Global Network of People Living with HIV/AIDS, will be hosting a satellite symposium in Vancouver that will try to address some of the obstacles to providing medications to those who will die without them. This may be the most important session of the conference--at least for the 95 to 96 percent of the global population with HIV who, without some imaginative programs, will not have access to the drugs discussed at this conference.
This article was provided by International Association of Physicians in AIDS Care. It is a part of the publication Journal of the International Association of Physicians in AIDS Care.