Braking a Relentless Killer
The announcement by federal officials last week of the first nationwide decline in AIDS-related deaths marked one of the few stirring moments, and surely the most important one, in the 16-year-old battle against AIDS in this country. Officials also noted that doctors, researchers and clinics in several cities have reported sharp drops in the need for hospitalization and home care.
Experts cited several reasons for the 13% decline in deaths in the first six months of 1996 as compared with the same period in 1995. For instance, more people are taking HIV tests for the AIDS virus. That means earlier detection and prompt treatment well before the infected person’s immune system has been badly damaged. Improved drug regimens are also staving off illnesses such as pneumocystis pneumonia.
Reports submitted at an AIDS conference in January cited combination drug therapy with protease inhibitors as the key factor. As the name suggests, these drugs inhibit HIV’s ability to spread through the body. The improvements are also attributable to the Clinton administration’s generous funding of direct AIDS research, and a federal assistance program that helps pay for expensive drugs.
But it’s important to note here that the battle against AIDS is still far from over. For example, the CDC study shows that the rates of declines in deaths differed dramatically across regional lines and ethnic groups. While AIDS deaths declined by 13% nationally, for instance, the drop was far sharper in the West (16%) than in the South (8%). Moreover, the drop was greater among whites (21%), than among blacks (2%) or Latinos (10%).
AIDS activists say that a principal reason for these striking disparities is that not all Americans are sharing equally in the bounty of recent medical breakthroughs.
The inequalities are likely to mushroom in the near future. Congress is now debating legislation that would give states more flexibility to distribute Medicaid dollars as they wish. More than 53% of AIDS patients depend dearly on those dollars, according to a recent survey by the Kaiser Foundation.
Since Congress passed the Ryan White Care Act in 1990, states receive federal funding to help provide basic care to HIV-positive patients. But since there are no national care standards for AIDS, the budget-strapped states are under no legal mandate to offer patients even the essential “drug cocktail,” unless the patients fall below the Medicaid poverty level.
Medically, no one knows how long the new drug therapies will remain effective against the resilient virus. Finally, these successes are largely confined to the most developed nations. The rest of the world, particularly Africa and Southeast Asia, still reel in an unchecked epidemic, with different strains of the virus.
That is sobering context in which last week’s encouraging news must be placed. Perhaps a spokesman from Aids Project Los Angeles put it best: it’s not the end of AIDS in this country, but it might represent the end of hopelessness.
