quarterly message to AHF’s Board of Directors and Senior Management
As AIDS Healthcare Foundation (AHF) proceeds with great purpose from year to year and project to project, it is important on occasion to step back and take a grander look at major trends that are shaping the vision of AHF. AHF as an organization has always had an expansive view of fighting AIDS that was motivated and focused on protecting the public health. Circumstance and the success of the organization allow us to act on that larger scope in very meaningful ways.
If you place HIV/AIDS in its proper context, it is primarily a sexually transmitted infectious disease and a global public health threat. HIV is mostly acquired through the same sex acts as other STDs (sexually transmitted diseases). Classic public health disease control measures that involve prevention, early detection and treatment of diseases apply equally to controlling AIDS at this stage.
Communities and indeed entire nations that have superior public health systems already in place, have generally had lower HIV, STD and other infectious disease problems. Societies that deal honestly and without judgment about sexuality have fewer STDs. The global response to HIV/AIDS overall has been thwarted by bad policies derived from political and religious prejudices taking the place of sound public health practices. Therefore, AHF throughout its history has championed applying these principles consistently to HIV but did not have the power to truly challenge the entire system of public health delivery until now.
Symbolically, several years ago AHF changed the name of its Prevention and Testing Program to the Public Health Division, with the intent on placing HIV in a broader context. As AHF has emerged as the pre-eminent global AIDS organization, this name change has helped to re-shape AHF internally and around the world.
It is my belief that one of AHF’s most profound legacies will be improvements in the public health system across the globe.”
Today, for example, we are fighting to have the treatment of HIV and TB integrated; supporting circumcision; working to establish a separate public health department for the City of Los Angeles; championing condoms in porn; taking over the entire Broward County STD program; and, running ads about “cheating” in Uganda, to name only a few of AHF’s public health initiatives. It is my belief that one of AHF’s most profound legacies will be improvements to the public health system across the globe.
The sexual revolution that swept the developed world as a result of the introduction of the birth control pill in the sixties brought with it a nasty unintended consequence – epidemics of STDs. The liberation of women from unwanted pregnancy de-coupled sex and reproduction. Likewise this cultural revolution gave rise to gay liberation. But, there is important unfinished business.
Sexual Revolution 2.0 is coming. It is sexual health as a birthright. The world can keep sexual diseases to a minimum with a proactive public health approach based on science and by accepting human desires and behavior. But, every revolution needs leadership – that’s where AHF comes in.
We have gone as far as we can go in preventing HIV, at the personal or societal level, without taking on the overall issue of sexual health. Sexually active people have to take personal responsibility for protecting themselves and their partners. Individuals have to go for routine sexual health checkups. Communities have to own the problem of sexual health and make it a priority on their agendas.
Untold suffering and millions of avoidable deaths are taking place because we have prioritized drug company profits above human life.”
Another epic issue that the world must tackle is access to lifesaving medication. Today most people in the world cannot get the most advanced treatments for most diseases. Drugs whose availability we take for granted in wealthy countries are unavailable for most of the citizens of the world. Untold suffering and millions of avoidable deaths are taking place because we have prioritized drug company profits above human life. The obscenity of the CEO of Gilead Sciences, John Martin, earning $95 million, while more than 4,000 people die every day of AIDS is only the most glaring example.
Every thinking person knows that in order to promote innovation intellectual property rights must be protected. The question is: What is the appropriate balance between incentivizing new discoveries vs. access? When millions die from treatable diseases, as they do today, it is obvious that the system is way out of balance. As health advocates, the issue of drug pricing must be at the center of our agenda. As the largest AIDS organization in the world, AHF must lead the way.
Lastly comes the issue of development policy. What is the responsibility of rich countries to help poor nations? First, the planet as a whole cannot survive with the disparities that currently exist. National boundaries do not stop diseases and other social perils. We breathe the same air; we enjoy the same climate; we travel the same oceans. Development policies have been harmful in many ways to poor countries.
Today, we see the collapse of HIV treatment programs in many places as a result of the short-sighted withdrawal of support from PEPFAR and other countries. Commitments that have been made are not being kept. As an organization based in the United States, we have a special responsibility to hold the U.S. accountable. At the same time, bad governance and an inadequate commitment to health in the developing world is a major problem. Because AHF employs and trains local leadership across the globe we can fight for more support from other governments as well.
As the world is currently awash in trillions of dollars of newly printed money, AIDS and global health in general should not be begging for billions.