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Frerichs, R.R. Theme for Fourth International Conference on AIDS in Asia

SEA-AIDS Network, March 31, 1996

Posted in response to:

SEA-AIDS, March 25, 1996

Could I perhaps put in my two cents on the theme proposed by Prof. Frerichs? Early detection connected with the newer treatments certainly gives hope for adding years to life. However as long as the treatments remain way beyond the pocket of the majority of those who will contract the disease in Asia, they remain a bitter joke... Following diagnosis, counseling will inevitably turn to treatment. We have ample experience of people who when told that treatments will cost $500 per month have disappeared, never to return to the doctor.

There sometimes seems to be a mental block among those who are better off that they cannot appreciate the condition of people who have $50 per month to cover all the living costs of themselves and their family.

I agree that we should not ignore the hope of reduced transmission which can result from earlier diagnosis, although I think this can be over stressed. But until there is hope that we can offer the means to maintain health at affordable cost (read dollars per year, not $000s per year), we should not raise hopes of adding years to the lives of those in Asia carrying the virus. If this concern can be addressed within the proposed theme, it would perhaps be easier to support.

Chris W. Green

Jakarta, Indonesia

R.R. Frerichs Posting

Mr. Green is correct to bring up cost, since money most be available if the newer drugs are to be used. We all recognize that the costs are high, but will they remain high? At what point is the cost too high? To me these are decisions that are better left to the marketplace. Individuals should be allowed to decide for themselves what they can and cannot afford.

Some might suggest that it is a cruel hoax to offer someone a test and then offer nothing more (except good advice) once the person finds they are HIV infected. Is it cruel to tell an infected husband so that he can use condoms or practice withdrawal to save his susceptible wife from becoming infected? Is unjust to tell an infected pregnant woman so that she can avoid breastfeeding or possibly even get zidovudine to save her newborn child? Is it wrong to tell those harboring the virus to avoid contact with tuberculosis patients or others harboring various microbes that might readily infect and end their lives? 

Perhaps, but I would not want to make that judgment. Instead I feel that everyone is better served by knowing that they are home to the virus, either for what they can do for themselves or what they can do for others. This is what self-help is all about. This is what early detection is all about.