Aids and Capitalist Medicine

By Hunt, Charles W. | Monthly Review, January 1988 | Go to article overview

Aids and Capitalist Medicine

Hunt, Charles W., Monthly Review


AIDS Epidemic History

In the spring of 1981, the Center for Disease Control (CDC) in Atlanta, Georgia, began to see an unusual pattern of illnesses. These illnesses were not usually seen in healthy adults but were generally found in individuals who were either very young or very old and who had compromised immune systems. Such diseases as Kaposi's sarcoma (a type of skin cancer), toxoplasmosis (a usually harmless parasitic disease often spread by cats and chickens), thrush and herpes began to appear in patients along with severe weight loss and fevers of unknown origin. Those who had these "opportunistic" infections were unable to shake them and died as a result. The patients in these cases were all healthy and 20 to 40 years old, supposedly the time of greatest health and vigor. As the spring turned to summer and the cool days of fall approached the CDC began to see more and more of these cases concentrated in Los Angeles, New York, and San Francisco. Since all the early victims were homosexuals, this cluster began to be referred to as "Gayrelated immune deficiency" (GRID) by many although this was never the official name used at the CDC.1

Early theories tried to determine whether the life styles of the victims had caused the immune compromise. This was made less likely in mid-1982 when it was discovered that the syndrome was not confined to the gay community. Intravenous drug users in the same cities began to evidence the symptoms. The syndrome began to appear among Haitians and among some females. Hemophiliacs were next. In September of 1982 the term "Acquired Immune Deficiency Syndrome" (AIDS) was adopted by the CDC. By December of 1982 the first cases of AIDS linked to blood transfusions occurred as well as the first appearance of AIDS in female sexual partners of those in high risk groups. In 1984 the communicable retrovirus which caused AIDS was discovered and identified, thereby finally eliminating explanations for the disease which relied exclusively on life style.2 However, by this time an epidemic was on the rampage in the U.S. The number of cases was doubling every six months. In 1983 reports from Africa and Europe had confirmed an epidemic of worldwide proportions.

Today, in its sixth year, AIDS is epidemic in the United States; in fact, the costs of AIDS are truly staggering. A study of the economic impact of AIDS found that the first 10,000 cases required 1.6 million days in the hospital and resulted in an estimated 1.4 billion in expenditures.3 In 1987 public spending on AIDS will exceed $1 billion. The price in suffering and pain, misery and loss is, of course impossible to put into dollar terms.

By mid-May 1987, 35,518 cases of AIDS had been reported in the U.S. with 20,557 deaths. There are predictions that in 1991, 324,000 cases will have been reported with 215,000 deaths. This could involve a projected medical cost of $8.5 billion, lost wages as high as $55.6 billion, and research, education, and blood-screening costs of $2.3 billion!4 These cost estimates may turn out to be too low since they do not include costs for AIDS-Related Complex (ARC), a disease that is not AIDS but is caused by the same virus, present in considerable numbers, and could, many experts think, progress into AIDS.

Historical Specificity--The Threefold Crisis in U.S. Medicine

Like any other event in history, disease and epidemics are historically specific; that is, they have characteristics of the time period in which they occur and undergo a complex dialectical interaction with that period, both being affected by and affecting the human history of which they are a part. AIDS has been perceived in North America as a disease primarily striking gays and drug addicts. This has profoundly affected the response to the epidemic, both from the health establishment and from organizations for gay rights. Further, AIDS occurs in an historical context of North American responses to sexually transmitted disease, for as Allan M. …

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