Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
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Wall Street Journal Blog - August 7, 2008
Posted by Marilyn Chase
Some health and development specialists are arguing over the attention paid to the disease. AIDS, some say, is exaggerated as a threat, AIDS gets too much money, and AIDS is destroying health systems.
Many people agree that basic health-care systems need strengthening around the world. Gonsalves (pictured) is one of them.
But he argued that a retreat from the roaring pandemic affecting 33 million is not the way to go. Good health systems need to simultaneously attack specific disease threats and provide a breadth of basic health services. Taking resources from the AIDS epidemic, he said, would be an exercise in "doing less for less .... provid(ing) a few basic interventions because doing more will create unsustainable entitlements for the poor."
Gonsalves labels this thinking " Malthusianism for the masses, while (proponents) have access to the highest level of care for themselves and their families."
Maybe the best answer boils down to good management. Well-managed AIDS programs seek to build up systems by training workers, building clinics and labs. Sometimes they shine a light on health gaps ù as did the African Comprehensive HIV/AIDS Partnerships in Botswana, the free AIDS drug program by Merck and the Gates Foundation that languished unused until needed clinic infrastructure was created.
Gonsalves, who dropped out of college in the '80s to fight AIDS as a key member of ACT UP, Gay Men's Health Crisis and Treatment Action Group, is winding up a tour of duty working on treatment access in Capetown, South Africa.
This fall, he told the Health Blog, he plans to work on his own back-to-basics program, by entering Yale to finish a bachelor's degree deferred by his epidemic work two decades ago. His major: History of Science.
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