If you listen to some activists, the answer to the world’s AIDS crisis is simple. Just break international patent laws, rip off the drug companies, shower the Third World with protease inhibitors and all will be well. I wish it were that simple. The decision by major drug companies to sell their drugs to developing countries for no profit seems to me to be a sensible compromise between addressing a world health crisis and not killing off the financial incentives to find AIDS treatments in the first place. As long as the cheaper drugs cannot be reimported, Merck’s proposal sounds promising. If we want to make the drugs even cheaper, then there’s nothing stopping governments from subsidizing them. But then we have the real problem: how do you ensure effective administration of the meds? As anyone close to this epidemic knows, taking your HIV meds half-heartedly is arguably worse than taking nothing at all. HIV mutates swiftly around weak medicines and becomes resistant to them. Currently, the regimen is grueling. I take well over 30 pills a day, for example, and if I miss one dose by more than a couple of hours, I risk becoming immune. I’m not alone in feeling sick and tired after I take my pills – an inbuilt incentive to avoid taking them. My time spent volunteering in the local AIDS clinic here was enough for me to worry about how effective such treatments were for poor, underclass women, who had to juggle extraordinary pressures as well as a complex, nauseating drug routine. Now multiply that a dozen times for impoverished Botswanan farm-workers and you see the extent of the problem. That’s why today’s Washington Post op-ed by Barry Bloom is important. Better to save fewer people in monitored, TB-style enclosures and prevent resurgent, resistant HIV, than to try to help too many too indiscriminately and make the situation all the worse. There are some platitudes in the piece, but the analysis is sound.
PASTEL POLITICS: Check out this electoral map. It’s a variation on the famous red-and-blue map, but adjusted so that each state is colored a different blue-red purple hue depending on the actual share of the vote each candidate received. It makes the point in color that I tried to make a while back in the New York Times. We’re not quite as divided as we think. And we’re all a fabulous shade of lavender!
The Dish 