World AIDS Day passed yesterday, and for the first time since the epidemic struck there is a glimmer of hope. With the success of a new class of drugs approved quickly by the Food and Drug Administration, the possibility has arisen that AIDS could become a manageable disease. The medication works by inhibiting the ability of the HIV virus to reproduce and has managed to prolong the lives of certain AIDS patients. The drugs have been touted as the possible end of the epidemic.
But despite advances, it is clear that the crisis is not over, and hailing protease inhibitors as a miracle drug is irresponsible. Infection rates are rapidly increasing for women and minorities in the United States. Asia and Africa continue to suffer as the virus spreads virtually unchecked. Limited knowledge about the new drugs’ effectiveness, the high cost of treatment and the changing demographics of those infected raise even more questions. Although the protease inhibitors are welcome hope, too much optimism makes it easy to breathe a collective sigh of relief and write off the controversial, complicated AIDS crisis.
Although the new drugs have managed to extend some lives, their true effectiveness remains undetermined. There has been no long-term testing, so it is unclear how long inhibitors work. And in some AIDS patients, the drugs cause side effects worse than the symptoms of the disease. Also, testing has been almost exclusively limited to white men. African-Americans have an infection rate five times higher than whites, and women of every age group are increasingly at risk, but it is impossible to accurately judge the drugs’ power for these groups. Currently, 20 percent of Americans with AIDS are resistant to AZT because they were infected by someone taking the drug. It’s entirely possible that new, even more stubborn strains of the disease could develop.
Furthermore, the inhibitors are complicated medicine, requiring up to 40 pills a day in various combinations that require careful control of diet and activity. The treatment carries an average cost of $25,000 annually, making the less effective AZT seem a bargain at a measly $10,000 a year. The high cost makes protease inhibitors virtually inaccessible except to those with wealth or extraordinary insurance plans. The growing rate of infection among the poor in America, not to mention the Third World, means the costly drugs may provide hope for a few, but not the majority.
That AIDS is a manageable disease for anyone is truly an inspiring advance. But any declaration of victory at this point is premature and could have dire consequences. For most people in the world, AIDS is still a death sentence. Over-hyping new treatments may only exacerbate the problem by easing public concern. It could drain already limited public funding from research and work against education efforts that have successfully encouraged safer sex practices. If anything, these breakthroughs should only strengthen efforts to find a permanent cure for the disease. Preventive education and continued research, not high-priced medicine, is a far more realistic way to deal with the spread of HIV.