US Presidential candidate Mike Huckabee is refusing to suck back comments made in 1992 about isolating people with HIV, according to an AP report reprinted in the IHT.
Web sites are buzzing with outrage: Huckabee wants to quarantine people with HIV. Shame! Despite his own, rather incompetent efforts to defend himself from that assertion on Larry King (videolink from JoeMyGod), that is not, in fact, what he said in his 1992 interview with AP. What he said was that AIDS was being treated differently from any other infectious disease in history. Which was, and continues to be true. What he said was that AIDS was being treated as a human rights issue instead of a health crisis. Which was, and continues to be true. He also pointed out that federal funding for AIDS research was disproportionate compared with other diseases on a per-case basis. That was true in the US at the time, and though I don’t know the comparable figures right now, I can say with confidence that spending on HIV by international donors and international organisations is in most continents disproportionate compared with other things that wreck health and happiness.
But why is HIV being treated as a human rights issue (in a way that SARS, avian flu and other infectious diseases are not)? In large part because of people like Huckabee. AIDS first came to the world’s attention among gay men in the United States. That would be the men that Huckabee said led an “aberrant, unnatural and sinful lifestyle”. His tub-thumping set the tone for the likes of Jesse Helms (who said HIV was spread by the “deliberate, disgusting, revolting conduct” of gay men). It was this sort of prejudice that forced gay communities into a corner, that forced them to organise HIV prevention programmes because the government wasn’t doing it, that forced them to lobby loudly, passionately and ultimately successfully for investment and protection of basic rights to employment, insurance and treatment for people infected with HIV. In other words, it was people like Huckabee who created the “AIDS exceptionalism” that Huckabee complains of.
That exceptionalism was exported to other continents as they faced (or more frequently failed to face) the HIV epidemic. In many parts of the world, and especially in sub-Saharan Africa where HIV is most deeply entrenched, it has become an obstacle to a sensible response. That’s in part because we continue to see a “Human Rights” approach and a “Public Health” approach as somehow inimicable — the furore over Huckabee’s dredged-up comments is a very good illustration of the polarity. But it is a false dichotomy. Staying alive is surely the most basic human right. If “classic” infectious disease control measures such as case finding, treatement, active provision of prevention services and partner notification help people to stay alive, if those measures help people to avoid contracting and passing on a fatal disease, then surely they promote the rights of the communities most threatened by fatal infectious diseases such as HIV.