Role of Science and Health Care in the AIDS Epidemic
. The increased funding for AIDS research, from federal and private foundation sources, eventually led to medical breakthroughs in understanding the biology of HIV, the epidemiology and pathology of the disease (see separate section
HIV biology and challenges in fighting the virus
). These discoveries led eventually to development of better and rapid HIV screening procedures, antiretroviral and combination drug therapies and improved health care modalities.
In retrospect, most of the basic science in HIV/AIDS research, in the United States and other Western countries, were largely funded by government research grants. Even AZT was developed mainly through federal grants, as a potential anticancer agent before the AIDS epidemic. Its initial development as a potential drug against HIV was also funded by federal grants. In fact, many of the current antiretroviral drugs came from prior anticancer research, also funded mostly by the federal government.
The AIDS epidemic has significantly altered the way government responds to health crisis. It galvanized researchers and medical research institutions and government to focus on the crisis.
It also necessitated the expedited review of new drugs and forced officials who make health policy to share power with patients and their advocates. Because of the urgency posed by the growing AIDS epidemic, Food and Drug Administration policies and practices were radically modified and streamlined to accelerate clinical testing and approval of promising drugs and therapies against HIV and AIDS. This development proved to be quite useful also to clinical testing and approval of drugs and therapies against other diseases. Moreover, discoveries about the basic biology of HIV proved useful in other areas of biomedical research and clinical therapy.
A large part of all the above changes begun with the insistence of the "gay community" -- through its grassroots campaign -- not to be ignored, victimized or made a scapegoat of the epidemic.
Limits of Science and Technology. In spite of all the progress made during the past twenty years, there is still no known cure against AIDS, or a vaccine against HIV infection. Partly, this is due to the remarkable ability of the HIV to evolve and mutate quite rapidly; thus resulting into a new population of a given viral strain that is resistant to the arsenals of antiretroviral drugs. In fact, there is even a great possibility that new viral strains will evolve, with multiple resistance to the arsenals of antiretroviral drugs. This reality is daunting and has dampened the euphoria once felt by the medical community, from the recent successes of combination drug therapies in managing AIDS related illnesses.
Of course, a man of science, well-versed in the principles of ecology, environmental equilibrium and evolution, would have had a rational skepticism from the beginning about the long term future of the antiretroviral therapies. This should have been evident from the inability of human technology to eradicate "pests", including insects, microbes, and other "unwanted" organisms with man-made pesticides, microbicides, etc.
In spite of man's attempts, it has not been able to keep up with the remarkable ability of "small" organisms to evolve. In fact, in most instances, because man does not have the ability to reproduce as quickly, human beings and other plants and animals were most affected, instead of the intended "pest" target.
The mere availability of drugs or technologies against HIV infection or the complications of AIDS do not guarantee conquest of the AIDS epidemic. For example, because of their high cost, the combination drug therapies that were so successful "in management of AIDS" in Western countries are essentially beyond the reach of most of those living with HIV/AIDS in less developed countries (LDCs). As argued in a separate section, there is not enough ">international fundcost of drugs and other necessities to combat AIDS in less developed countries (LDCs).
Prevention. The above realities argue that the ultimate weapon against AIDS is to avoid HIV infection. This would include understanding what drives people to conditions that contribute or lead to vulnerabilities to HIV infection. Some of these factors are too complicated to confront. For example, how should the international initiative against AIDS address the issue of poverty -- the major reason why people are driven to prostitution,
injection drug use (IDU)
, etc. that contribute to HIV infection vulnerabilities. Poverty is also the reason why those living with HIV/AIDS cannot afford the medical care to manage the disease.