PHM-Exch> Dissident thought: 15 years late .

[Claudio Schuftan]

*On the importance of considering independent/alternative/dissident thought
earlier rather than later  *

> * *
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>
> ** **
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> I read the announcement below with despair – over the lost lives and lost
> opportunities over at least a decade. Better late than never perhaps, but
> there are lessons to be learned.
>
> ** **
>
> When triple therapies for AIDS were introduced 10 or more years ago, we
> learned that they reduced viral load to undetectable levels. Those of us who
> cared about AIDS victims dared to propose that *the obvious preventive
> potential of triple therapy should be explored and exploited immediately.*Yes, triple therapy was expensive but if it reduced infectiousness of the
> HIV positive person under treatment, in addition to prolonging his or her
> life, surely there was even greater justification for immediate, widespread
> use.
>
> ** **
>
> WHO and UNAIDS vetoed all such discussion (I worked in AIDS around this
> time for both organizations). We were not to talk about triple therapy in
> terms of prevention. Why not? “Because it would encourage people not to use
> condoms”.   Was there any evidence to justify this paternalistic position? I
> doubt it. ****
>
> ** **
>
> Any thinking and caring person working in AIDS despairs of the
> extraordinary aversion to any alternative thinking,  let alone “so called”
> dissidence in this area. ****
>
> ** **
>
> *Censorship, pensée unique in our international establishments:*
>
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> **·         **In relation to *human rights,* I was instructed by the most
> senior human rights focal point in WHO at the time *not to mention social
> and economic rights* in relation to a WHO paper that was to be prepared on
> AIDS and human rights. I was to write only about civil, political and
> cultural rights only.  As my director said when we left the meeting,
> astounded at what we had heard,  “No wonder nothing is ever achieved in
> controlling HIV/AIDS.”****
>
> ** **
>
> **·         **In relation to the role of *weakened and/or disturbed immune
> systems, due to malnutrition/undernutrition and to co-infection* with the
> many other diseases of poverty, no discussion was allowed despite mountains
> of evidence on the ways in which these factors increase transmission.****
>
> ** **
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> **·         **Discussion of the role of *unsterilized equipment in health
> care settings*  is practically taboo!****
>
> ** **
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> Back to prevention and ARVs.  Did we really have to wait for results of
> trials to prove that ARVs might contribute to prevention? Could those trials
> have been conducted earlier? There was, in any case, a moral imperative to
> provide effective treatment, and if as a by-product, (some/many?) new HIV
> infections could have been prevented, surely this strategy should have been
> implemented ?****
>
> ** **
>
> Wherever you look, whether it is climate change, the crisis of water
> shortage, nuclear catastrophes, avoidable disease and death, you will find
> that alternative/dissident activists and thinkers have been sounding the
> alarm and urging the solution for 10, 15, 20 years. ****
>
> ** **
>
> Can we really afford these time lags? Must we wait 10, 15, 20, 25 years for
> people’s interests to finally prevail over the private interests which today
> largely determine the strategies and policies of our international
> institutions?  ****
>
> ** **
>
> In solidarity, ****
>
> Alison Katz****
>
> IndependentWHO/PHM/Centre Europe Tiers Monde, Geneva
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