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Gordon Nary

September 1997

Last month's terrorist bombing in West Jerusalem's busiest outdoor market killed 15 people and wounded more than 170. Israeli Prime Minister Benjamin Netanyahu laid the responsibility directly on Yassar Arafat, charging that the Palestinian leader had "not fought the terrorist infrastructure." The media labeled the massacre "a moral outrage."

The infrequency of acts of terrorism, rather than the carnage they create, captures the public attention. If there were hundreds of terrorist attacks daily, the public would soon accept such repetitive acts of terrorism as a daily part of life. While any act of terrorism is a moral outrage, one might argue that the greatest moral outrage is the lack of affect in our response to repetitive acts of terrorism.

Where is the moral outrage over AIDS terrorism? We lose 1000 children each day to the viral terrorism of HIV. Where are our leaders' commitments to fight the HIV terrorist infrastructure? Will the same political and religious leaders who claim to respect the sanctity of human life remain silent as the viral holocaust claims nearly 400,000 infant victims during the next 12 months? Will they continue to remain silent when most of these infants are denied access to the promising drugs and care available to some adults?

A few physicians with the leadership qualities and sense of urgency so absent in many of our political and religious leaders have accepted the challenge of responding to the unmet healthcare needs of these infant victims of HIV terrorism. Under the leadership of Mark Kline, MD, associate professor of medicine, Baylor College of Medicine, the Pediatric AIDS Committee of the International Association of Physicians in AIDS Care (IAPAC) has created an ambitious agenda, including the development of clinical guidelines for the management of pediatric HIV disease and a world congress on pediatric AIDS scheduled for fall of 1998.

Dr. Kline will present IAPAC's proposal to guarantee all US children with HIV/AIDS access to all necessary drugs, regardless of the financial status of their parents or guardians, at our Healthcare Resource Allocation Conference in Washington, DC, in November. Also on the program is a proposal to extend Dr. Kline's successful US-Romania Pediatric AIDS Medical Education Initiative to other Eastern European countries and to supplement this initiative with greater access to the global HIV/AIDS drug armamentarium for infected children.

IAPAC's Pediatric AIDS Committee has also been able to bring together representatives from the leading pharmaceutical manufacturers for the first time in the history of this epidemic to jointly address the challenges of restructuring and coordinating clinical trials to maximize treatment options for HIV-infected children. Other topics at the September 10 meeting in Chicago will include the challenges of getting children who are geographically separated from clinical trial sites into upcoming trials and the reestablishment of our moral obligation to make the needs of children an overriding priority. We hope that through this example of moral leadership by the medical community our political and religious leaders will join us in the fight against the "terrorist infrastructure" of the HIV pandemic. We need everyone's support for our association's proposal to reduce the rate of maternal-fetal transmission by 50 percent by the year 2000. A successful program could save the lives of more than 250,000 children each year. Isn't that worth at least the same effort that we invest in counterterrorism to prevent more bombing incidents?

©1997, Medical Publications Corporation

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