HIV, Diarrhea, and Trauma in Poor Countries

A group in Eugene recently celebrated another AIDS awareness day, I don't recall for what reason, which included someone singing "Imagine a world without AIDS." Well, I can't, frankly. We have made it possible for HIV carriers to live long lives, during all of which they will be HIV positive and hence disease vectors. Unless we convinced tens of millions of people to have only safe sex and/or only safe intravenous drug use, we will always have new cases.

Meanwhile, I don't recall the last diarrhea awareness day. Roughly two million children under six die from diarrhea annually, which is also roughly the mortality from AIDS across all age groups. Another enormous source of mortality in developing countries is bone breakage, which takes place with disturbing frequency due to increasing auto traffic, bad roads, and inexperienced drivers.

I don't know exactly what the per capita cost of providing clean drinking water would be, but that's a readily available solution to most of the diarrhea epidemic. Kiwanis in the Pacific Northwest supports a program through which severe injuries can be repaired with a steel rod and surgery at a total cost of $100 per patient. These people go on to live productive lives without further cost.

HIV/AIDS is a diagnosis which leads either to death or a lifetime of drug treatment. Expensive drugs, even with subsidies, and the survivor remains a vector. The obvious choice would be to provide palliative care, let them die, and focus on the low-cost and effective use of money for the greatest benefit.

But that would be rational and there's nothing rational about our methods of doing good.