TCS Daily


What Would Darwin Say About AIDS?

By James Pinkerton - December 1, 2004 12:00 AM

Today is World AIDS Day. So says the world AIDS establishment, which is dedicated to fighting AIDS -- or at least to talking a lot about fighting AIDS. Indeed, since three million people will die this year of the disease, perhaps a little more truth-in-labeling is called for. Perhaps today should be called instead World Darwin Day, because unless both science and society evolve, many millions more are going to die. Political piety is great for the chattering-class elite, but for those at real risk of AIDS, what's needed is a candid understanding of bio-social destiny.

Unfortunately, the World AIDS Day (WAD) folks see December 1 as a great occasion for consciousness-raising. Their goal is to create a "more AIDS Aware society in which everyone takes action." Such actions include "learning more about HIV, attending a World AIDS Day event or practicing safer sex." Surely everybody can perform one or more of those actions, and feel good for doing so. Because, as the AIDS-ocrats assure them, "no matter how small or large their contribution, they are all making a difference."

Needless to say, the media and cultural elites are doing their best to make WAD into a truly kumbaya occasion. On Monday, The Washington Post lionized ABC reporter Jim Wooten on the front page of its "Style" section; Wooten is the author of a new book about a young African AIDS victim, We Are All The Same: A Story of a Boy's Courage and a Mother's Love. And the critical encomia are piling up: The Chicago Tribune said of Wooten, "He has taken off the rubber gloves, torn away the plastic mask and touched the face of HIV/AIDS with compassion and humanity."

Meanwhile, over at The New York Times, the Grey Lady's AIDS offerings included a lionizing article about the efforts of Nadine Gordimer, South Africa's Nobel Prize-winning novelist, to round up good-thinking folks, each with his or her own bien pensée to contribute to an AIDS-awareness volume, Telling Tales. In the words of the book's publisher, Frances Coady, "Perhaps now more than ever we should appreciate the power of fiction, the will to fight injustice and suffering."

Much of the explanation of the failure to eradicate AIDS can be found in Coady's innocent-sounding statement. First and foremost, fighting AIDS isn't really a question of "will," it's a question of science. And as for "injustice," it's been the tangling of various agendas -- political and social as well as medical -- that has allowed AIDS to balloon since 1980. The reluctance to do anything to restrain sexual transmission of AIDS, both homosexual and heterosexual, was inspired by a fear of seeming repressive or intolerant. Nice sentiments, to be sure, but the natural world in which we must all exist is hideously incorrect, politically. Mother Nature, that bitch goddess, is now imposing what Darwin called "natural selection," in which the weaker and unluckier do not survive.

Such Darwinism is playing out in two ways, one medical and the other social. We can look at each in turn.

First, at various times, both the political left and the political right have had difficulty thinking clearly about AIDS as a scientific challenge. In his 1987 book And the Band Played On: Politics, People, and the AIDS Epidemic Randy Shilts detailed the lethally stubborn opposition of radical gay liberationists, who blocked public health officials from closing promiscuity-promoting bathhouses in urban centers in the 80s. The activists claimed it was "sexual fascism" at work. But that was "insanity," wrote Shilts, who himself would later die of the disease.

On a more basic level, many refused to concede that unlimited sex could be a killer. And so the AIDS fight was infused with a secular New Age faith, in which right thinking, plus maybe some herbs and vitamins, would provide sexual healing. It was an odd belief, akin to Lysenkoism, in which wishful thinking displaced bio-reality. Such positive-mental-attituding worked as well in the West in the 80s as it did in the Soviet Union in the 30s.

In such a hyper-politicized environment, of course, nothing as thorough as an HIV/AIDS quarantine was ever seriously considered. What did eventually emerge over time, at least in the developed countries, was a kind of voluntary self-quarantine; many at-risk individuals, especially those with good incomes and educations, stopped doing dangerous things. Others didn't stop "barebacking" like practices, and most of them probably aren't around anymore. Thus we see Darwinism at its most basic in a social context: the non-survival of the non-prudent, who thus become the non-fit.

But in terms of the virus, the coming of safe sex and the ending of unsafe sex came too late for many. The AIDS beast was loosed, free to ride, like one of the Four Horsemen, everywhere in the world. In the quarter-century since "Patient Zero", a Canadian flight attendant, was the first identified AIDS victim, the disease has been "liberated" to leap across oceans and continents, killing some 25 million. Today, 44 million are infected, and that number is rising by 15 percent a year.

Yet shockingly, a century-and-a-half after The Origin of the Species,* many Americans reject Darwin. These folks are thus ill-equipped for the various medical and social competitions they will confront in their lives, AIDS aside. According to Gallup, only a third of Americans, in 2004, accept Darwinian evolution; a full 45 percent agree with the statement that "God created human beings pretty much in their present form at one time within the last 10,000 years or so."

In view of the high stakes, the Darwin-deprived might take a look at the cover story of November's National Geographic, which asks, "Was Darwin Wrong?" The magazine's answer is "no." And indeed, a full understanding of Darwinian selection is the key to a full response to AIDS, and to a fully responsive public-health system.

Writing about disease as a phenomenon, author David Quammen observes that "the dynamics" of microbes within human populations, "can only be understood in terms of evolution." Quammen continues, "The capacity for quick change among disease-causing microbes is what makes them so dangerous to large numbers of people and so difficult and expensive to treat." That is, "By natural selection they acquire resistance to drugs that should kill them. They evolve. There's no better or immediate evidence supporting the Darwinian theory than this process." And so penicillin, for example, became available in 1943 to fight staphylococcus aureus infections, and yet resistant strains of staph were observed as early as 1947.

The same Darwinian evolution occurs in viruses: "Some viruses evolve quickly, some slowly. Among the fastest is HIV, because its method of replicating itself involves a high rate of mutation, and those mutations allow the virus to assume new forms." That is, like penicillin before it, all the AIDS medications, now and in the future, are subject to being OBE -- Overtaken By Epidemic.

If people don't understand this evolutionary reality, they will make the mistake of thinking that AIDS can be "cured." The plain fact is that many illnesses mankind once thought it was rid of, such as malaria and tuberculosis, have made big comebacks, even in prosperous societies. True eradication comes when the virus is extirpated from the natural environment, as has been the case with smallpox, where only a few samples exist, locked away frozen in vaults.

In the meantime, efforts to medicate AIDS on the cheap have boomeranged, contributing to accelerated evolution of the viral enemy. The use of substandard generic drugs around the world has strengthened the AIDS strain, in ways that Darwin anticipated, by weeding out the weaker pathogens, giving more room to the stronger. Here at TechCentralStation, Dr. Terrence Blaschke, of the Stanford Medical School, has warned about "the risk of suboptimal therapy, which can accelerate the emergence of drug-resistant HIV." But just how substandard those drugs were did not become clear until recently, when the World Health Organization was forced to withdraw approval for many of the drugs used in Africa.

In other words, the worldwide battle against AIDS could still be lost, because the virus, like everything else in the natural world, is constantly on the evolutionary move. And that spells more trouble for political -isms. As we have seen, the Religious Right will have to get next to the idea that Darwin was right about biology. Meanwhile, the Secular Left will have to deal with the even blunter fact that if nature is in endless competition, human nature, being nothing more than a subset of the whole, is similarly in endless competition. The message can be put simply: Learn or Die.

This message most needs to be heard in the Third World. Interestingly, for all the touchy-feely treacle about Jim Wooten and African AIDS in that Washington Post article, the piece contained a few significant bits of political incorrectness -- or as some what call it, reality-based reporting. Specifically, Post scribe Linton Weeks did not use the word "racism" once; moreover, he placed much of the responsibility for the African annihilation on "cultural" issues, discussions of which were once off-limits to Western chroniclers:

"Part of the AIDS in Africa problem is knowing how to even get at the problem. There are cultural barriers, Wooten explains. Many African men refuse to believe that AIDS is a sexually transmitted disease. They eschew condoms. And they adhere to certain popular folkways that can be fatal. For instance, some men believe they can be cured of AIDS by drinking a certain medicinal tea or, even more insidious, by having sex with a virgin.

"In the upper echelons of power, there are other battles. Many national leaders refuse to admit that the AIDS crisis is spinning out of control. Wooten points out that South Africa's President Thabo Mbeki has said publicly that there is no HIV virus, and even if there were, it wouldn't cause AIDS. Foreign assistance in combating AIDS is an insult to Mbeki's masculinity, Wooten says."

Profoundly destructive behavior is Darwinianly self-liquidating, of course. And that's true everywhere; hence the jokey-creepy "Darwin Awards". But in the case of an infectious disease such as AIDS, the innocent are taken, as well as the dumb.

The Third World, especially sub-Saharan Africa, finds itself in a paradox of progress. Poor places have advanced enough to have transportation and urbanization, both of which facilitate AIDS spreading; yet they don't have the wherewithal to mobilize substantial changes in behavior. And while no white person dare suggest pandemic-blocking actions, such as abstinence and quarantines, Third World countries are unwilling or unable to do so as well. With the exception of Uganda, few afflicted countries seem interested in trying. These countries will accept money and of course condoms, but the number of sex acts always seems to exceed the number of sheaths.

Since millions of lives are at stake, we might as well be as honest as we can: in the great Darwinian social test, some countries are passing, and some are flunking. As human beings, it is our obligation to help all in need, but in a world of finite resources, we also need to be realistic about what's possible, and where.

Today is World AIDS Day, and that's nice. But it really should be World Darwin Day, which doesn't seem so nice. But human survival is nicest of all, and the folks who brought us WAD aren't so helpful on that score. Because, as Mother Nature reminds us, whether we admit it or not, whether we like it or not, every day is World Darwin Day.


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