TCS Daily

A Permanent Deathstyle

By James Pinkerton - December 1, 2005 12:00 AM

Here's the formula for the AIDS epidemic: First, start with a deadly contagious virus. Second, take no serious measures as dangerous behavior patterns multiply. Third, ignore the obvious lessons of epidemiological and medical history -- try demagoguery instead. Fourth, apply copious amounts of sentiment and red-ribbon artistry to the issue, substituting, in effect, sentiment for science. Fifth, stand back and watch tens of millions of people die.

Repeat these five steps for as long as you wish. If you do so, you will find that AIDS is never cured, no matter how many press releases are issued, no matter how much money is spent, no matter how much earnest good will is expended, no matter how much intellectual capital is consumed.

To put it as bluntly as possible, the main reason that AIDS is spreading to its current deadly dimensions around the world is this: We are practicing the social and political equivalent of laissez-faire when dealing with a killer-virus. And while "hands off" is usually the best approach for generating economic growth, if a virus, on the contrary, gets the equivalent of a free hand, it will also flourish -- but that's the kind of explosive growth we don't want.

Two decades ago, American AIDS activists came up with the slogan, "Silence = Death." But the issue, in practice, wasn't talking about AIDS, but rather doing something about AIDS. So the American slogan became, in effect, "Behavior Change = Life." And the biggest single life-saving change, back then, was behavioral restraint. Gay bathhouses were shut down, and millions of Americans, many of them gay, changed their sexual patterns: They got serious about condoms, safe sex, or outright abstinence. Were these changes tough to live by? Sure. But they beat the alternative. Let's face it: Just as quarantining worked in the past -- remember leper colonies? -- so the same basic idea, of separating oneself from the threat, works today.

Currently in the U.S., it is common for gay men -- especially as one moves up the ladder, in terms of education and health-consciousness -- to say things like, "I don't know anybody who has died of AIDS in five or ten, or even fifteen years." That is, in their medically aware circle -- after the initial wave of deaths in the 80s -- people got the message. And of course, thanks to medical breakthroughs, many of those who are HIV positive can carry on functional lives for the long term.

Today in America, a few incredibly unlucky people get AIDS through freak accidents. But the blunt reality is that AIDS mostly afflicts those who can be diagnosed as terminally reckless. An example is junkies using dirty needles -- or any needle at all. How does society realistically save the life of someone who holds his or her own life in such obvious contempt? As with smoking, drinking, over-eating, gun-playing and drag-racing, some behavior choices simply defy life-saving. Or to take another example, it's recognized by now that anal sex without condoms, known as "barebacking," is widely recognized as a death trip, and yet plenty of people still seem to do it, with the full complicity of modern marketing. At some point, confronted by the lethal combination of lust and greed, even the best-intentioned American public-health advocates have to throw up their hands in defeat.

That's the U.S., where at least the problem has been isolated to a few hard-to-reach, albeit seemingly suicidal, sectors. Around the world, the situation is far worse. And so, on World AIDS Day, it's time for some honest talk: AIDS, having already killed 15 million, having infected 40 million more, is spreading -- because too many people, and too many governments, have been unwilling to change their behavior, and their policies.

We might consider, as an ominous indicator, this recent article, entitled, plainly enough, "HIV Is Spreading Via India's Highways." The Associated Press' Margie Mason reports, "Just as in Africa two decades ago, truckers and the sex they buy have helped fuel India's spread of a disease that revolves mainly around sex and injecting drugs." Now let's think about that: 20 years after it became obvious that sex-working (known less politely as prostitution) was a major AIDS vector in Africa and elsewhere, India seems to be doing little to put a stop to those same deadly practices. Oh sure, no doubt any number of Indian government agencies and NGOs are busy "working" on the problem, but with more than five million Indians infected, it's obvious that they are not working effectively.

So what would AIDS effectiveness look like? Most obviously, it would begin with a stern, even fierce, crackdown on the sex and drug trades. Such fierceness explains why Singapore, to name a healthy counter-example, doesn't have this widescale problem.

Which do we prefer? India or Singapore? The AIDS Establishment has made its choice apparent to all: It puts freedom, most obviously sexual freedom, ahead of strict public health measures. That is, the preservation of the Sexual Revolution matters more than people's lives. That disturbing reality came clear to me last summer at the World AIDS Summit in Bangkok, in which brazen sexual braggadocio overwhelmed modesty, let alone safety. And yes, it does seem that AIDS activists are better at announcing holidays and staging summits than stymieing the disease; if media-savvy showmanship were the same as public-health stewardship, the world would be well. But instead, the Band Plays On, at the modern equivalent of a Masque of the Red Death.

The AIDS Establishment argues that it's simply not reasonable to demand that Africans and Indians, or anyone else, for that matter, change their behavior patterns. If people wish voluntarily to change their behavior, that's OK, but never, ever, should serious suasion or sanction be applied -- no matter how many lives might be saved. And so it is that the dubious values of the American Civil Liberties Union are being applied to the whole world.

The AIDS Establishment's preferred solution is much different: It can be described as a combination of extreme libertarianism, plus extreme opportunism, all wrapped into extreme cynicism.

The libertarianism, as noted, is the idea that nobody should be prevented from doing anything -- AIDS is important, but personal and sexual freedom is more important.

The opportunism is found in the alliance between the AIDS Establishment and various generic pharmaceutical manufacturers -- most of them, interestingly enough, in India -- who would like to hijack the patents that are applied to the relatively small number of AIDS medicines. These generic manufacturers are renowned for their indifference to quality, just as the NGO distributors are renowned for their indifference to actual cures. Instead, the main goal seems to be simply to crank out medicines, ignoring the hard-learned reality that poor treatment for an infectious disease is often worse than no treatment, because the pathogen is allowed to mutate into an even more virulent strain. Such accelerated evolution, of course, could yet turn the AIDS virus into much more of a killer than it already is.

And extreme cynicism, of course, is the obvious result of, first, "do your own deadly thing," and, second, "let others make a good living off of your dying." After a quarter century, many in the AIDS Establishment must know that they are facilitating the disease, not eradicating it. But they have carved out a good living for themselves, financially, as well as a high status for themselves, morally.

This arrangement is working, on its own cynical terms, and working well. It's working so well, in fact, that top figures from around the world are visibly prostrating themselves before the putative pieties of the AIDS Establishment. Earlier this week Jim-yong Kim, director of the HIV Department at the World Health Organization, actually apologized for his failure to implement WHO's "3 by 5" program. As with so many other AIDS-related efforts, "3 by 5" had a catchy title, but never the prospect for success. And since the WHO-crats should know that by now, their apology, absent profound changes in their methods, should not be accepted. Although, of course, failure, now and forever, won't stop the WHO from receiving more funding, for as far into the future as the eye can see.

Just today, the President of the United States, George W. Bush, offered his own proskinesis before the AIDS altar, promising more funding, more compassion, more everything -- everything except a hardnosed strategy for AIDS eradication. Bush, of course, has his hands full with Iraq; he doesn't need any more enemies on the left, especially on the world stage.

Still, the President's failure to confront the grim reality of AIDS is all the more lamentable, because in the past, he has been willing to take on, at least rhetorically, "the soft bigotry of low expectations" -- that is, the idea that multicultural ideology should excuse certain people from owning up to basic standards.

Such soft bigotry is bad enough when it's applied to, say, education. It's a shame, after all, to see children of different colors not living up to their intellectual potential. But when essential standards are abandoned in the realm of public health, well, that's the scenario for millions, and maybe hundreds of millions, not to be living at all.

At the rate we are going, the 18th Annual AIDS Day will not be the end of anything, not even the end of a beginning. Instead, the world is incorporating AIDS activism -- flamboyant in its paradigmatic failure -- into a permanent lifestyle.

Or deathstyle.


TCS Daily Archives