The Myth of “Too Much Spending on AIDS”
A popular notion in the media is that too much is spent on AIDS research, to the detriment of people suffering from other life-threatening illnesses. Proponents argue that more is going to AIDS than to cancer and heart disease, despite the apparent fact that greater numbers of people die from these diseases. A related claim is often made which argues that AIDS, unlike cancer and heart disease, is a behavioral problem which could be solved by behavior change, without massive research expenditures.
These arguments have always played well among those who have sought to blame people with AIDS for their illness, but they have recently made inroads among people who are otherwise sympathetic to the problem of AIDS. The debate pits people with AIDS against those suffering from other life-threatening illnesses.
This “divide and conquer” strategy helps no one except those who wish to preserve the federal government’s pitifully low level of spending for the health of the American people in general—which is the real problem. But most importantly, a careful examination reveals that these arguments are based on false and misleading information. Unfortunately, too few people have adequate access to the real facts, which are presented here:
1. It is not true that more is spent on AIDS than cancer. Federal spending on cancer well exceeds that spent on AIDS—by several hundred million dollars, according to Bush Administration budget figures for 1992 and 1993. There is no honest debate on this point, only misinformation.
2. The amount spent testing treatments for AIDS is shockingly small. Although the Administration has frequently claimed that $4 billion is spent annually on AIDS research, this figure is false. It includes all federal dollars spent in any way remotely related to AIDS, of which only a fraction are actual research dollars. Congress believes it is spending just under $1 billion annually on AIDS research, but this figure is also misleading as it includes many expenditures that play little or no role in the search for a cure.
For patients, perhaps the most meaningful definition of AIDS research is the amount spent testing treatments in people. In 1991, this figure amounted to approximately $150 million dollars, and the figure for 1992 is little different. This includes funding for the AIDS Clinical Trials Group (ACTG), the NIH’s own clinical studies, the Community Trials Program, and special funds earmarked for Pediatric AIDS. Some aspects of this funding, such as that for the ACTG, have actually diminished for 1992, resulting in the closing of several important research centers. Important therapeutic options go untested year after year because of inadequate funding.
3. Unlike cancer and heart disease, AIDS is an infectious disease requiring special costly expenditures. AIDS research requires funding large, nationwide “population studies” which track the history and spread of the infectious disease throughout the country. These are among the most expensive kinds of studies. The need for similar studies in cancer and heart disease is greatly diminished because they are not infectious. Thus, comparisons of funding between AIDS and the other health problems is unfairly biased.
4. AIDS has not “plateaued” as critics charged. The first 100,000 cases of AIDS accumulated over the first 10 years of the epidemic . The total reached 200,000 less than 2 years later. This hardly sounds like a disease which has plateaued. The most conservative estimates show an annual growth rate of nearly 40%, with triple digit growth in some subpopulations. Almost all sources believe that these figures underestimate the real rate, especially among the poor, women, and minorities due to poor reporting and continued discrimination. The growth is slowing only among gay men—a tribute to the success of their efforts and years of education programs. Worse yet, these figures only count the most serious stage of the disease (AIDS), while ignoring the millions who are HIV-infected. Yet we know that the disease is routinely progressive. The majority of those infected will develop AiDS within 12 years and most scientists believe all will eventually do so. In contrast, the rate of heart disease is shrinking, not growing, as are some forms of cancer. While some forms of cancer are on the rise, this is most likely the result of better testing and reporting programs.
5. AIDS is a new and rapidly spreading disease, while deaths from cancer and heart disease are stable or declining. We are burdened today with funding the necessary basic research of a new disease. These early research costs for cancer and heart disease were borne generations ago. Federal dollars have been spent on cancer and heart disease for decades, when nothing was spent on AIDS, but critics of AIDS funding count only the current expenditures for these other illnesses.
6. AIDS is primarily a disease of the young, striking young men and women in their prime, as weil as their children. The majority of deaths from heart disease occur in the elderly, as do most deaths from cancer. Although these illnesses also strike younger people, they do so at a far lower rate. When death rates are compared in specific age groups, the picture changes dramatically, with AIDS often being the larger killer of young men and women in the big cities. Crude comparisons which lump all cancer and heart disease patients in a single group without regard for age make no distinction between the inevitable effects of aging and the onset of disease in otherwise healthy individuals with long life lifespans ahead of them.
7. Although they remain serious problems, major progress has already been made against heart disease and cancer. Some cancers are routinely cured with early intervention, and treatment provides extended life in many others. Similarly, there are useful treatments for most forms of heart disease which permit many of those afflicted to live long and useful lives. Even heart transplant patients, for example, have a greater average life expectancy than the typical AIDS patient.
8. AIDS is no more a “behavioral disease” than many forms or cancer and heart disease. Few would seriously dispute the links between smoking and lung disease, dietary habits and some forms of heart disease, exposure and skin cancers, etc. As a society, we must resist as inhumane and immoral any effort to blame the victims of any disease for their illness. We must renew efforts to educate people about the behavioral links to many illnesses, but most importantly, we must treat all who are ill with compassion and kindness. This message is common to virtually all major religions and philosophies.
No, the problem is not that too much money is being spent on AIDS. On the contrary, there is still far too little being spent on AIDS research. The problem is that the government spends far too little on health research overall, including AIDS, heart disease, and cancer. The American people must resist the divisive effort to pit one disease group against another. But we must always resist the temptation to compare one disease against the other, simply because such comparisons are so often dealing with “apples and oranges“. Instead, people fighting for all those afflicted with life-threatening illnesses must band together and seek a larger pie for all and resist the pressure to fight each other over the meager scraps falling from the Federal table.
Plus see this thread about what's going on RIGHT NOW:
http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=104&topic_id=1748773
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