The ability to manage HIV with antiretroviral treatment, and turn it into (something like) a chronic disease, obviously constitutes important medical and public health progress. Before that, the only alternative was wasting and death. But it is normal that humans adapt to progress, and look for something better. After all, on closer inspection, HIV treatment may not be all it is cracked up to be, particularly as it plays out in low-resource countries. There may not be opportunities to receive the diagnostics that are needed inform optimum treatment. You may be switched from one treatment regime to another without any real medical justification. Patients may have some serious side-effects with certain medications, which may not be the drugs of choice in the better-off countries. And all too often, the supply of antiretroviral drugs may just plain run out. In the greater scheme of things, this fragile dependence on HIV drugs in order to survive can also be culturally and politically distasteful. The pills are little chunks of Western technology and culture, symbolizing an objectifying biomedical approach to human health and disease, and the pills are produced by multinational corporations in affluent Northern countries, some of them ex-colonizers. All in all, it can be a bit much to swallow.
In Tanzania this week, a news report states
that quite a number of HIV-positive patients are going off their treatment and embracing traditional therapies. Some are dying in the process. Perhaps the time is ripe for the next phase: not HIV treatment, but HIV cure. No more pills, no more CD4 counts, no more going to the hospital and being ill-treated by staff. But who can say whether the cure would come without its own medical, cultural and political complications and dependencies.
Labels: anti-retrovirals, bioethics, HIV, Tanzania