Disease Control; AIDS Activists Should Learn from SARS
Byline: Robert Goldberg, SPECIAL TO THE WASHINGTON TIMES
A person suspected of having SARS refuses to be tested for the disease and, instead, files a lawsuit claiming that government-mandated screening is a violation of his constitutional right to privacy and the Fourth Amendment's prohibition against unreasonable search and seizures. Then SARS activists afraid of being "treated like lepers" hold up Food and Drug Administration approval of a private home SARS testing kit on the same grounds and because of objections that home tests didn't have face-to-face counseling. They also threaten to seize the patent of any company that develops a SARS drug or vaccine and give it to any generic company to ensure "access." Guess how far SARS would spread in the face of such obstacles?
Now, replace SARS with HIV, and you get an idea of why we may have a chance to control the spread of SARS and HIV will never be contained. Chalk it up to post-September 11 thinking about terrorism, bioweapons and the vulnerability of borders perhaps, but SARS is regarded as a clear public health crisis and nothing else. But our approach to fighting SARS could be the exception, not the rule. This is why the incidence continues to climb here and with greater speed in Africa, and parts of Asia.
SARS and HIV are the same in one respect: You can test positive but not show symptoms. That means the only way to control it is through testing, screening and education. But for years, the AIDS community fought implementation of such simple public health measures or what one epidemiologist in Beijing calls Disease Control 101.
That is because then and now, the HIV crisis is defined as a political and legal battle, a civil rights movement instead of a public health crisis. Twenty years ago, HIV activists had good reason to worry that an effort to contain HIV would also be used to discriminate against gay men. Fortunately, America responded aggressively to outright discrimination by disease.
Yet, the activist community still opposes proactive screening and detection despite the significant benefits early intervention can provide. Though antiretroviral therapy can reduce mother- to- infant transmission of HIV by up to 90 percent, the HIV Law Project and ACLU are still suing to prevent mandatory testing of all women giving birth on privacy grounds.
AIDS groups even opposed widespread private and voluntary testing. For 10 years, many AIDS service groups lobbied the FDA and Congress against the approval of a home HIV test kit. They argued that HIV testing through in-home collection not linked to in-person face-to-face pre- and post- test counseling was ineffective and dangerous. (Many of these same groups would stand to lose federal dollars if the people who came into their clinics for counseling decided to test themselves at home. …