Congratulations, Shodan, on being the only one clever enough to work out the secret code in my post where I blame Reagan for AIDS. All the other Dopers mistakenly thought I was responding to JThunder’s post right before mine where he claimed that AIDS was almost 100% preventable, but you saw through that sham instantly.
:rolleyes:
Of course it’s no reason not to work on a virus. I don’t see anyone saying that we should pull the plug on AIDS research, so I don’t know why you’re raising this point.
As for its level of funding, I think it’s preventability is a darned good reason to complain. The amount of medical research funding out there is limited. Why should we focus its use on diseases like AIDS, which are almost 100% preventable, at the expense of diseases which are far more difficult to control?
Once again, nobody here has advocated the removal of AIDS research funding, so I don’t think this objection is relevant.
JThunder and Magiver
I didn’t mean to imply that you wanted all funding halted to HIV. I think that those who question research into a disease because of its preventability IMHO don’t understand the scope of public health and epidemiology. I fail to see how my comparison to heart disease and lung cancer is inaccurate.
I agree, it is easy to prevent HIV infection. I agree, there has been a huge political push for education about this particular disease. But you have to understand that while “even Florida voters” can understand how to avoid HIV infection, this has not always been the case. Indeed, if you look at the situation nearly everywhere except for the USA, Europe, and Australia, HIV education is woefully low, and public education has proven extremely difficult. You ignore the process that got us to such a high education level in the USA. The public push you at least partially frown upon is what did it. It educated every American about HIV and how to prevent it. This was especially successful given the resistance to education some of the high risk groups like IV drug abusers and sex workers.
I would wager that a large majority of money poured into this disease went into the epidemiology and the public programs needed to get the word out on the streets. Things like safe sex education, community outreach, safe needle programs, and the like aren’t easy or cheap to set up, and I believe that HIV was the first time it was done on such a large scale in the US. So you are looking through an acquisition bias. Yes, its preventable. But the only reason people are acting to prevent it is because of the community programs. Those programs are due to the political push and subsequent increase in HIV funding. They have worked and are in all probability responsible for a continual reduction in HIV transmission throughout the late 1980s and 1990s.
Looking at the other major causes of death in the USA, we see the same kind of thing. The top 5 of the 6 top causes of death (heart disease, cancer, vascular disease, chronic lung disease, diabetes mellitus, excluding accidents at #5) can be mostly avoided. Obesity and smoking account for much of the risk. Simple things like regular breast and colon screening and wearing sunblock knock out another chunk. I bet a significant proportion of the NIH budget is spent trying to educate the public. One can look at the increased in spending on anti-smoking campaigns, many funded by NIH grants, and the reduction in smoking-related disease we are now beginning to see.
I don’t see much difference in terms of public health between the AIDS epidemic and smoking or obesity. Perhaps if you are not comfortable with the exact demographics or exact risk factors in HIV, you should come out and say so. That is a point on morality, not on public health. Becoming morbidly obese, chain smoking, and high risk sex are all unhealthy practices that cause disease. As a clinician and a researcher, I should educate my patients of this and I should treat the diseases. Morality doesn’t come into play. Public health does.
Also, just to be fair. There has never been a report of HIV being transmitted by mosquito, as implied by Squink. Transmission by stepping on something contaminated, to the best of my knowledge, has also never been reported. HIV is a very fragile virus which dies quickly in the environment. Once in the body, it does not establish an infection easily. We are lucky for this fact, which is something that was completely unclear from the early epidemiologic data. Part of the first public education campaigns were to dispel this kind of hysteria.
Funding for AIDS awareness is not the same as funding for AIDS reserach. They’re not even comparable.
Promote AIDS awareness? Sure. No problem.
Disproportionate funding for AIDS research, on the grounds that it’s the politically popular disease to fight? No way. That’s just pain irresponsible.
The mosquito rumor persisted for years despite scientific evidence, research, to the contrary. It took a lot of public education to stamp out such irrational fears and get everyone up to speed on the real risk factors. Calling those factors simple, or obvious, today, does not do justice to the massive ignorance of the early 80’s. The internment camps never got built either. 
At least $80 billion dollars is supposed to have been spent on research on this disease since 1984, world wide (from the developed countries, at least).
The HIV “pandemic” was supposed to kill at least 25% of humanity, homo, hetero, bi, child, granny, whatever (the scare story of the late 1980’s).
On a positive note, I’m sure that the medical profession has managed to increase its knowledge about viruses in general, including the accused HIV retrovirus, which can’t actually be defeated by the “miracle” drugs that have been pushed on the public, such as AZT and the Protease Inhibitors, neither of which has ever been shown to have a positive benefit for anyone silly enough to take them.
The only effect of all this spending, as far as I can tell, has been an enormous enrichment of medical researchers at the expense of the taxpayers of various countries.
I have seen no evidence of any positive benefit as a result of all this spending, unless you count the low key reluctance of the Nobel Committee to award a prize for medicine either to Robert Gallo or Luc Montagnier (the “discovers” of HIV), or to both.
That isn’t any better.
How many people got AIDS from walking barefoot?
AIDS is almost 100% preventable. Use a condom, don’t use IV drugs. Throw in a disclaimer for hemophiliacs and children who catch it from their mothers, and you got it pretty well covered, at least in America. Duh.
Regards,
Shodan
:rolleyes:
:rolleyes:
maybe it would have, but without hindsight of how bad AIDS would eventually get who knew to try?
if putting a trillion dollars into it in 1980 would have solved it totally, who could justify spending that on a minor disease only a few people were getting. now we know it didn’t end up staying that way, but at first it really could have turned out to be a minor disease that was only surgeing temporarily and would soon die down never to be heard of again.
without future predicting powers its not possible to know which diseases will become problems and which will burn out and be foot notes in the back of medical books. we can’t spend a trillion dollars on ALL of them.
JThunder,
To my knowledge, there is no difference between AIDS awareness and AIDS research. The grants for the programs come from the same NIH institutes, even many of the grant structures are the same. All of the numbers I have seen for AIDS research I have always assumed have included AIDS awareness programs.
$80 billion worldwide (a figure I would like to see a cite for) over 20 years sure sounds like a lot. Not so much if you consider that the NIH alone, one of several granting institutions in the USA, awards around $14 billion in research grants every year. If I were to wager a guess, I would guess that AIDS research has never taken up more than 10% of NIH funding.
There are many reasons to work on AIDS besides the “sexy” ones. It is a new type of virus causing a large epidemic. The public health data is pretty good. It is really the first disease outbreak which we were able to research using a new set of computational and molecular methods developed during the 1980s. It is epidemiologically and molecularly interesting by itself.
And Alan Owes Bess, if you want to debate Protease Inhibitors and HAART, please start a new thread or resurrect the HIV denial GD thread of a few months ago. I’m pretty sure that the GD denizens dissected all the arguments against HAART in it. I’m also pretty sure that there are thousands of HIV positive individuals who would disagree with you about positive benefits of HAART. Those who got up out of their AIDS deathbeds, increased their CD4+ counts to normal levels, and reduced their viral loads to undetectable, would gladly describe to you positive benefits.
I would also like to meet some of these “enormously enriched” medical researchers who you believe have done something with this $80 billion. Most virologists, immunologists, and HIV specialists I meet are comfortable on their basic science or internal medicine salary.
The reason that Gallo and/or Montagnier haven’t won a Nobel is because there was nothing particularly groundbreaking about the isolation of HIV. Retroviruses had been isolated before. Just because it was a big deal in public health doesn’t make it more novel.
Again, you’re missing the obvious.
Let’s suppose that AIDS awareness funding and AIDS research funding do indeed come from exactly the same sources. (This is probably an oversimplification, IMO, but let’s grant the premise for now.) This does not mean that AIDS awareness is the same as AIDS research.
Nobody in this thread has complained about promoting AIDS awareness. I think we all agree that this is a laudable task which deserves continued funding. In contrast, AIDS research garners a disproportionate amount of attention, with little hope for a cure. Pouring additional money into AIDS research is pretty much flushing one’s dollars down the drain.
Promoting AIDS awareness is a strategically sound goal. Aggressive funding of AIDS research is not. That doesn’t mean that we should pull the plug on AIDS research; however, it does mean that we should recognize that it shouldn’t be a priority.
The implication has always been that President Reagan did not want to reallocate or increase taxes for Gays because it was a reward for bad behavior (they brought it on themselves).
So how do you determine the ROI on either research or preventive outreach? Do you take the premise that an emerging crisis requires a reallocation of medical funds or overall increase in taxation?
One thing that struck me in the 80’s (and it’s not a Gay thing), is the stupidity of people in the face of the obvious. I remember programs that interviewed people who admitted they knew the danger and that they ignored it. All those ads pointed out the realities of the disease but it still didn’t sink in. The one thing nobody speculated on was the fact that the REALLY stupid people simply died off. Not everyone on the planet indulged in bathhouse sex. The majority of people act in a similar social manner. The increased reduction in the rate of AIDS may have been a simple bell curve phenomenon of human behavior.
Eh, a vital part of medicine and science is dealing with the obvious loathing of change by a large segment of the population. My grandfather had a triple bypass two years ago. He has exertional angina again, perhaps because of a stenosis of his right coronary artery or his bypass graft. Yet every week, we take him out, and all he wants is fried chicken and french fries. Don’t think we don’t try and get him to change. I feel about the same as lung cancer patients sitting outside of the hospital chain smoking as people still engaging in high risk sex or sharing dirty needles. Change in the public behavior comes slowly. Teaching prevention alone won’t help people who have already contracted the disease nor the large chunk of people who are not getting the message. In order for you to be logically consistent, you should also be arguing that we should not research adenocarcinoma of the lung because 99% of cases are totally preventable by not smoking. The only difference I can see is with the palatability of the risk factors and the population groups affected.
About this awareness issue. Let me again state that the funding sources are the same. The dollar values become confounded. It becomes difficult to say what is spent on awareness and what on research. I would seriously doubt that anywhere close to 5% of total NIH research grants are spent on HIV primary research, a number which IMHO can be easily justified by the anatomy, mechanics, and epidemiology of the HIV retrovirus.
Lastly, the vast majority of research dollars has nothing to do with a “cure.” This demonstrates IMHO a misunderstanding of how research works:
Research has to start somewhere, and we have no idea how to get to a cure. We are not just blindly shooting in the dark. HIV research has directly led to improved vaccine technology (applicable to many viruses), better antiviral medications (applicable to many viruses), better public outreach and education (applicable to all outbreaks). It has directly led to reversing and halting the course of a lethal disease. We are not giving this money away to people who think of some crackpot HIV cure and want a billion bucks to test it out. Most of this stuff is peer reviewed and very scientifically sound.
There is IMHO enough room under the $14 billion NIH umbrella to accomodate small new outbreaks like West Nile and SARS. If there is a serious new outbreak, you bet I believe in increasing NIH and other sources of funding. You bet I believe in moving focus towards the epidemic. Part of this happens naturally – scientists are drawn to the more pressing health issues, change the focus of their labs, submit new grants on the outbreak. Part of it may have to be hastened, by increasing scrutiny given to those renewing grants.
Ya know, I am unfamiliar with Reagan’s exact position on HIV, homosexuality, and what else. I don’t wish to imply anything about his morality of policy decisions. I haven’t mentioned Reagan yet in this thread. I am simply stating that money towards HIV research has been relatively well spent, and has been the major reason why HIV seroconversion has become far less common and is no longer a death sentence. I have argued that increasing this level of funding probably wouldn’t have hastened therapy, but it probably would have sped up the time to a good diagnostic and screening test. This alone would have saved hundreds of lives.