AIDS
Acquired Immune Deficiency Syndrome
BACKGROUND
Since the first AIDS cases were reported in 1981, through mid-1994 more than 402,000 AIDS
cases and more than 241,000 deaths have been reported in the United States alone. This is
only the tip of the iceberg of HIV infection, however. It is estimated that nearly 1
million Americans had been infected with the virus through the mid-1990s but had not yet
developed clinical symptoms. In addition, although the vast majority of documented cases
have occurred in the United States, AIDS cases have also been reported in almost every
country in the world. Sub-Saharan Africa in particular appears to suffer a heavy burden
of this illness.
No cure or vaccine now exists for AIDS. Many of those infected with HIV may not even be
aware that they carry and can spread the virus. Combating it is a major challenge to
biomedical scientists and health-care providers. HIV infection and AIDS represent among
the most pressing public-policy and public-health problems worldwide.
COSTS
I think that the AIDS epidemic is having a profound impact on many aspects of medicine
and health care. The U.S. Public Health Service estimates that in 1993, the lifetime cost
of treating a person with AIDS from infection to death is approximately $119,000.
Outpatient care, including medication, visits to doctors, home health aids, and long-term
care, accounted for approximately 32 percent of the total cost. Persons exposed to HIV
may have difficulty in obtaining adequate health-insurance coverage. Yearly AZT expenses
can average approximately $6,000, although in 1989 the drug's maker did offer to
distribute AZT freely to HIV-infected children. The yearly expense for DDI is somewhat
less at $2,000. Therefore, if the AIDS epidemic is not controlled, its cost to American
taxpayers will become overwhelming.
I feel that the effects of the epidemic on society at large are increasingly evident.
AIDS tests are now required in the military services. Various proposals have been made
for mandatory screening of other groups such as health-care workers. A number of nations,
including the United States, have instituted stringent rules for testing long-term
foreign visitors or potential immigrants for AIDS, as well as testing returning foreign
nationals. In the United States one frequent phenomenon is the effort to keep school-age
children with AIDS isolated from their classmates, if not out of school altogether.
Governmental and civil rights organizations have countered restrictive moves with a great
deal of success.
There is little doubt in my mind that the ultimate physical toll of the AIDS epidemic
will be high, as will be its economic costs, however the social issues are resolved.
Concerted efforts are under way to address the problem at many levels, and they offer
hope for successful strategies to combat HIV-induced disease.
Politics and AIDS
In the United States, I feel that AIDS provoked a grass-roots political response, as well
as government action. First evident in urban gay men, AIDS moved an already politically
organized gay community to create service, information, and political organizations, such
as Gay Men's Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP). Those
groups have lobbied the federal government for funding and favorable policies. ACT UP was
formed in 1987 to urge speed in drug approval and to protest high prices for AIDS drugs.
By successfully promoting reforms, ACT UP and other advocates have provided a model for
other disease groups, particularly breast cancer advocates. During the 1980s, AIDS groups
accused the government of neglecting its duty in responding to AIDS. Critics cite
government reluctance to promote condom use as a prevention method, and the fact that
President Ronald Reagan did not mention AIDS publicly until April 1987, six years after
the epidemic began.
The epidemic's spread to people of color, often drug users and their intimates,
introduced race into the politics of AIDS. Competition for funding and influence arose
between gay and minority groups. Disagreements emerged about prevention methods, in
particular needle exchange programs. Many African Americans and Hispanics viewed needle
exchange as promoting drug use in their communities, while others cited its role in
curbing HIV transmission.
The AIDS activists have helped increase federal funding for AIDS from an initial $5.6
million in 1982, to over $2 billion in 1992. The 1990 Americans with Disabilities Act
included protection from discrimination for people with HIV; the Ryan White Comprehensive
AIDS Resources Emergency Act was passed to provide funds to cities hard hit by AIDS.
CONCLUSION
As you can see, AIDS does not discriminate by color nor socio-economic status as was
once believed. It has become an epidemic for the entire nation and will need the
cooperation of everyone to control. Already, many private and government organizations
have been created to help deal with the problem. And millions of dollars are being spent
in research and treatment, as well as in helping people cope with the problem. The
social impact of AIDS is substantial and it can no longer be ignored.
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