Keep the promise to fight AIDS and poverty in FY 2007

I've just sent a letter to President Bush asking him to keep the promises he made last year - will you join me? Go to http://www.one.org to send an email to the President.

Thank you,

Take action now at

http://www.one.org/one/campaign.jsp?campaign_KEY=1278

I received this from a friend, and did it myself. I figured I'd post it here for everyone to check it out.

[Meenah]

Thanks!!!!
Luanne

[Rapunzel]

Why AIDS? Cancer kills FAR more people than any other maladay - far more. AND, unlike HIV/AIDS, you can't actually 100% prevent your possibility of ever getting a cancer. I read a study that I'll have to find again showing AIDS getting a disproportionately larger amount of funding than cancer byfar (as in a larger amount of $ per # of people affected was given to HIV as opposed to cancer research). 1% of the Federal budget would be best spent on cancer research.

And, poverty isn't something the government can "fix".

Gee ... I didn't think this would have to be a debate.

I thought we could all agree that AIDS was something that needs research funding (not saying other things don't). And, honestly if it isn't something that you agree with, then there's no need to "sign" the petition.

I guess we need an admin to move it then.

[SueC]

Why must this be in the debate forum? I don't see how funding for AIDS is debatable. Have you ever seen a kid die of AIDS Rapunzel? I have, I've had two relatives die of it--it isn't pretty. Maybe there are other causes out there deemed more worthwhile by others, but I assure this one is a good one, too.

[PrincessFiona]

I'll play.....I don't think we should be cutting HIV/AIDS research funding, but we may want to reconsider where some of the research dollars are going. Here is an interesting article though from 1999:

Aids Funding and Health Statistics
July 01 1999
Stats staff

Should we pay any price to stop the AIDS epidemic? The temptation is to say "yes." But what if the price includes less help for victims of other diseases? Though AIDS is an undeniable tragedy, medical science is always confronted with trade-offs when allocating finite research dollars. Before we know what share of funding should go to AIDS, two key questions must be answered - where does AIDS stand in comparison to other tragic diseases, and what is the true state of the epidemic today?

Though AIDS has been devastating, the actual "disease burden" of the condition, measured in the number affected and life-years lost, is lower than many other diseases. A new study in the New England Journal of Medicine (June 17, 1999) shows that AIDS ranks below a host of other conditions such as diabetes, stroke, and asthma in disease burden. On a number of measures, AIDS ranked between 15th and 20th out of 29 conditions examined.

There is, however, a dramatic exception to the rankings: AIDS is far and away the largest recipient of National Institutes of Health (NIH) funding. In fact, AIDS receives nearly 30 percent ($1.4 billion) of all NIH funding, almost four times the amount allocated to the next largest recipient, breast cancer research ($381 million).

Diseases such as epilepsy, asthma and prostate cancer receive less than 2 percent of funding apiece, even though they afflict vastly more people. For instance, while 1.3 million suffer from AIDS in 1999, asthma afflicts nearly 16 million. This disparity in funding raises questions not only of fairness but also of sound public policy. Is this the best way to spend medical research dollars?

The media role in the public awareness of AIDS has been a factor. News of the AIDS crisis consistently emphasized rapidly encroaching danger, often in the face of potentially good news. Even as the epidemic began to abate, the American public rarely got this news, no matter what course the actual numbers took. Though reporters appropriately focused on the alarming numbers of HIV infections during the early stages of the epidemic, as the numbers began to decline news stories did not sufficiently track this development.

Instead, media reports now focused on other issues, such as how AIDS was "moving up" as a leading cause of death. For instance, England's highly-regarded Independent (May 23, 1999) reported, "AIDS became the world's deadliest infectious disease over the past year, displacing tuberculosis."

In this instance, journalists had ample help conveying the alarming news. The authoritative journal Science (May 14, 1999) proclaimed, "AIDS is now the fourth leading cause of death in the world ... according to figures released this week by the World Health Organization (WHO). The disease has moved up several notches from last year's ranking as the seventh leading killer worldwide ... AIDS cases have been skyrocketing."

But this is misleading. AIDS had "moved up several notches" in the ranking not because AIDS deaths were increasing but because other leading causes of death, in particular tuberculosis, had fallen. TB plummeted from fourth to eighth overall. In actual fact, the number of AIDS cases was unchanged from the previous year. (On the positive side, both The Washington Post and the Atlanta Journal reported the situation accurately).

Current news accounts also focus on specific sub-groups of infected patients, not all of which are declining at the same rate. For instance, The Washington Post (May 17, 1999) recently turned to a group not often considered at risk for sexually transmitted diseases -- older people. A front page story warned,

"An increasing number of older men and women are contracting the virus through unprotected sex, according to an analysis by the Centers for Disease Control and Prevention."

Courtney Williams, community planner for the D.C. Office of Aging, was quoted as saying, "you have a lot of people in their forties and fifties going back into the dating scene."

Is there really an emerging problem of HIV infection among those older than 50? The article points out that 6,962 new AIDS cases were reported among people older than 50 in 1997. But not until the fourteenth paragraph are we told that since 1993 the number of new cases among people older than 50 "has declined 31 percent."

The apparent rise of cases in older people follows from the fact that many of them were infected with HIV earlier in life and are only now moving to the second stage of the disease. As the Post acknowledges, "Because the virus can remain dormant in the body for many years, they probably were infected at a much younger age."

More commonly, the characterization of AIDS as a "woman's issue" has kept the crisis reportage bubbling. As AIDS infections continue to decline more rapidly among men than among women, news can convey alarm year after year by ignoring the absolute number of cases and instead focusing on the relative proportions. For instance, a recent Washington Post front page story (June 22, 1999) declares, "In just over a decade, the number of women with AIDS has increased dramatically - from 7 percent of the total number of AIDS cases in 1985 to 22 percent in 1997, according to the Centers for Disease Control and Prevention (CDC)."

Those numbers appear truly alarming - but in actuality, the Post reporter has mis-stated them by using the phrase "number of women with AIDS," rather than the more accurate, "relative proportion of all AIDS cases that are women." Since the overall number of cases has gone from about 60,000 in 1997 to about 48,000 in 1998 (a 20 percent drop), women's cases now represent a slightly larger slice of a substantially smaller pie. By definition, the total of all AIDS cases had to equal 100 percent.

Since the number of infections among men declined, the percentage of females among those infected rose. Because cases among males fell more sharply than they did among women, the decrease in actual numbers of new female cases was reported as an increase in the percentage of all cases. The raw data show that the actual number of women's cases has continued to fall, from nearly 14,000 in 1995 to less than 11,000 in 1998. You would think this is good news.

Instead, we see the "woman's issue" approach now being applied to the international stage. As the Toronto Sun headlined , "HIV Infection Climbing Among Women Worldwide" (June 23, 1990). A report from the Joint United Nations Program on HIV/AIDS declared, "As the AIDS epidemic has evolved, the burden of the disease is shifting from men to women....Women account for 43 percent of the HIV-positive cases worldwide, compared to about 25 percent in 1992." Once again, we are presented with relative proportions instead of the actual number of cases.

It would be unfair to single out reporters alone for this misleading emphasis, since they get lots of encouragement from AIDS researchers. It was Science magazine that neglected to tell the full story of AIDS as a leading cause of death, the CDC has stressed the woman's angle in presenting their data, and UNAIDS executive director Peter Piot who stressed both the "AIDS is moving up" line as well as the international "burden shifting to women" account. Little has changed since then, as illustrated in a June 4, 1999 editorial in Science ("AIDS in the United States"). Authors Neal Nathanson and Judith Aurbach of the Office of AIDS Research, National Institutes of Health write, "HIV infection rates continue to climb in a number of population groups, such as women and racial and ethnic minorities."

As the data show, however, the rates for women in the United States are not climbing. And the disproportionate funding for AIDS in the NIH budget is not slowing. Regardless of good intentions, the media have ill-served this public health debate.

AND, unlike HIV/AIDS, you can't actually 100% prevent your possibility of ever getting a cancer.

Actually, you cannot 100% prevent the possibility of contracting AIDS, either.

[PrincessFiona]

We are such a fiesty bunch :>

[SueC]

I'm still confused about why we are turning this into a debate. Everybody cares about different things--often things they are touched by personally. I have had friends go through various types of cancer, lost an aunt to cancer, and lost two cousins to AIDS. And it doesn't matter how they contracted it, but for the record the baby got it through breastmilk. This was in the 80's when nobody knew much about it. Regardless of how the disease started or whether or not it is "preventable", it is insensitive to use the means of contracting a terrible, deadly disease as a reason not to fund research to fight it. You can't tell me that kid didn't deserve for somebody to care enough to find a cure because of a mistake one of his parents made. I don't know the stats on which cause is getting more money. If life was perfectly fair, somebody would rank all the causes in the world by importance (as if you could) then put all the donated money into a pot and divvy it up accordingly. That's not how it works. I'll jump into a debate if somebody wants to put a link to a cause that wants to increase pollution or spread disease (I'm being facetious), but honestly, I would never insinuate to somebody that there cause is less important or worthy than the next guys.

[PrincessFiona]

Sue,

I don't think anyone really was. I honestly think that one of the biggest mistakes that our country just made was cutting research funding dollars to the NIH in general...I'd be willing to personally slap the president :> over how he continues to slash educational/research funding at a time when our country desperately needs to be working on becoming globally competitive.

All grave illnesses are a serious matter and deserve to have research dollars thrown their way. I think there is a disproportionate amount of money currently being spent in areas of medicine that are quite lucrative. There have been many advances made in HIV/Aids treatment...DH often talks about how it really is a 'treatable' disease now....and no longer the death sentence that it was in the 80's. They are missing a vaccine, but they have treatments now that do wonders for people.

I'd certainly rather put more money in HIV research than in fighter planes...

At the end of the day, we should be 'debating' putting more funding in all areas of medicine that are underfunded. Is there a form I can fill out that will just...slap bush...when he opens it?

Let's not debate it...it will just make everyone unhappy.

kris

[Sheherezade]

I think research funding via the NIH has been going down for a long time -- not just under Bush. Am I wrong? I think Clinton gave it a token bump once. Still, funding was pathetic when Clinton was in office as well. I hear that now NIH grants are funding at 7%. When I was working (8 years ago), they were funding at 11%. I'm sure that could be due to the astronomical rise in applications as well as reduction in funding. Still.....it's pretty sad. Only 7% of our ideas are being funded. Obviously, some are bad ideas with bad research plans, but I doubt that 93% are. I worry that so much research now has to be funded/accomplished by going to private industry. There is always an agenda with private industry. I also worry that with funding so low, people tweak their results and slant their research so that money can be obtained. How else can they stay in business? I have seen many, many people leave science because of the funding situation.

I don't know what the solution is.... but I agree that funding to research in general needs to be increased and better managed. AIDS is our nemesis now, but who knows what lurks around the corner? Prion diseases? Bird Flu? Antibiotic-resistant super bacteria? We need to improve our research structure now so we have knowledge to build on when the next "plague" appears.

[SueC]

All right, I guess I went a little overboard. That is a bit of a hot button with me, if you couldn't tell.
My dh and I were just talking yesterday how unfortunate it is that every disease has to have somebody famous suffering from it before it gets any notice. He treats CF patients, and said nobody else cares about it because it doesn't have a name like Michael J. Fox attached to it, as Parkinson's now does. (I don't mean for that to sound spiteful, I like Michael J. Fox and am thrilled that he is calling so much attention to Parkinson's.) There are so many worthy causes out there, from the environment to healthcare to education and I know the govt. can't do it all, but I often do question their priorities with regards to where their funding is going. There is nothing to be debated here, and this thread obviously wasn't headed in the direction that I initially thought.

[spotty_dog]

I think research funding via the NIH has been going down for a long time -- not just under Bush. Am I wrong?

It's certainly taking a nose dive right now. Our researchers who just a few years ago were rolling in hundreds of thousands of dollars of federal monies from NIH and NSF (the guy who studies the proteins in Alzheimers-associated brain plaques, the guy who is synthesizing RNA hybrids that can carry chemotherapeutic drugs to the site where they're needed) are seriously struggling; the number of postdoctoral fellows in the department has fallen by half since I got here (they're usually paid out of new grants). Both basic science and practical, health-oriented science are really hurting.

On the other hand, it might reflect a bias in the scientific world. With the current trend toward nanoscale technologies, the researchers in those areas are still landing hefty sums.