I've been thinking a lot about the Argentine policy that provides free testing for HIV/AIDS, as well as free medication to anyone with the disease. Specifically, I've been wondering if this is an efficient way to use limited national resources for the betterment of society. Also, should or could this policy be implemented in the US? I don't have a firm answer to these questions, but based on my own limited experiences (and refraining from weighty health statistics), I'd like to share my thoughts.
Free testing for HIV/AIDS is a no-brainer to me. Someone who thinks they may have HIV should have any and all obstacles removed from getting tested so they are fully informed of the risk they pose to others. But I now have a new reason to support free testing. The majority of people who have come into the clinic for an HIV test have been young women of reproductive age. The sad truth is many of these young women were victims of sexual assault and rape. Abortion is not legal in Argentina (a topic I'm not going to touch.) All of this is important because, with proper treatment, a baby born from an HIV positive mother will not get HIV. Women in this situation should be encouraged to get tested as early as possible so that HIV does not pass to the next generation. That's where free testing come in. I believe anyone would agree this is cost-effective way to prevent a deadly disease from taking an innocent life (no matter how you define innocent).
The policy of providing free treatment causes me more internal debate. Argentina is not a fully developed country. While it has tremendous natural resources, decades of political instability have led to higher inflation, lower unemployment, and more poverty than the US and Western European nations. Can it really afford to be giving away expensive anti-retrovirals to HIV patients? More important to me (and to the potential convertibility of this system to the US), does treating the HIV patient really fight the source of the problem or does it merely extend the life of those in poverty. I was leaning towards the latter, until I went to a community prevention meeting last week and realized the logic of Argentina's system.
In Argentina they start off with the realization that the people infected with HIV and AIDS tend to be the poorest citizens. Then they take the moral stance that these people deserve treatment they otherwise cannot afford, so the state offers it for free. By using tax money to pay for AIDS treatment, it means everyone has a stake in the disease. It gives an incentive for all people in a community, both the rich and poor, to work towards prevention. I believe it takes a community effort to fight this disease because only the community has access to many of the root causes: violence at home, teenage drug abuse, dangerous teenage sexual habits, etc.
In the US, people need insurance to afford retrovirals. But the majority of HIV/AIDS patients are poor and the majority of the poor do not have insurance. As Paul Farmer wrote, "[HIV] has spread along the path of least resistance, rapidly becoming a disorder disproportionately striking the poor and vulnerable." I believe when a community fails to invest in treating uninsured HIV victims, there is less incentive for the community to prevent them from passing on the virus. You can think of the US as a big community, or if that's impossible (understandably so), think of the community of New York City. There's certainly no shortage of millionaires in NYC, but there are also over 78,000 people KNOWN to be living with HIV or AIDS in 2008. If citizens had to directly pay to keep these people alive with antiretrovirals, maybe they would care more. Maybe people would use their business contacts to disseminate more AIDS information or pressure schools to provide more rigorous sexual education or even set up free condom vending machines. Who knows? The point is people would do something if they had a stake in the disease.
Am I becoming a socialist now that South America has a hold on me? I doubt it. I just think AIDS is something that concerns us all. And maybe we need stronger action for people to realize this fact.
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2 comments:
I love that you analyze the community side of the "socialist" or social welfare system in Argentina. I actually completely agree with you, but I think that one thing that Argentina lacks is that the rest of the community is aware that is a community problem and that they have to work together to fix it. I think that many of the people who pay these taxes and pay for these peoples treatment, would do well in understanding that their taxes are going towards something they can assist in preventing.
I don't know if that knowledge is wide spread...a little community education wouldn't hurt.
That's an excellent point, Jen. Community education is essential. Members of the community need to be aware of the costs as well as what they can do to prevent the disease. If not, a feeling of complacency could set in. But I feel like this can be accomplished with some effort and political will (admittedly both can be lacking here).
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