Friday, December 02, 2005

Michael: World AIDS day and right reason

Ambassador Richard Holbrooke of the Global Business Alliance on AIDS called for systematic testing for AIDS (audiostream). He points out reasonably that you cannot fight an epidemic if you don't know who has a disease. The problem is especially severe with AIDS because of its unique epidemiology.

Today 12,000 people in the world will be infected with AIDS. On average, those people will not know that they have been infected until 2013. Eight years from infection to detection means that each of those 12,000 stands a very good chance of infecting many more people. That is why the AIDS epidemic grows and grows, despite our prevention efforts.

But systematic testing for AIDS is not feasible, or even desirable to many, until we are able to ensure confidentiality and prevent stigmatization of those who test positive. Americans' health records are pitifully porous. The way that our laws deal with medical records practically ensures disclosure of AIDS status. That would not be so bad if private insurers weren't the backbone of the American healthcare system. The stigma of AIDS flows at least in part from the vitual exclusion from the world of work and private healthcare benefits that are too often a consequence of diagnosis. No one wants to hire or insure persons with AIDS becuase of the risks and costs involved are too great.

What is the solution? Universal health insurance for every American. If you cannot be excluded from healthcare coverage, and that coverage is independent of employment, the stigma of AIDS becomes much less of an issue, and medical privacy becomes much easier to implement. Want to get AIDS under control in this country? A prerequisite step is routine and systematic testing to prevent accidential transmission during the period between infection and diagnosis, and universal health care facilitates that goal.

Stop AIDS; support universal health care.

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