European Document/AIDS: A British View

...Of course, homosexuals and intravenous drug users remain most acutely at risk, but in Africa it is already true that half of all AIDS cases are women (compared with under one-tenth in the United States), indicating that heterosexual transmission of the disease is now as significant as homosexual transmission...

...In the United States Dr...

...A single test might, therefore, turn out falsely negative and a carrier might subsequently spread the disease to others without knowing it...

...Although this figure may be explained in part by the frequent re-use of hypodermic needles in African medicine, or by the high prostitution rate in some countries, public health authorities in the developed world would be imprudent if they did not take stringent and immediate precautions against accidental infection of groups not now regarded as being at risk...

...Unless promiscuity between infected and uninfected people drops to nil, the disease will continue to spread at approximately its present rate...

...the bulk of them, at any given time, would not be suffering from any symptoms of the disease...

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...Isolation of this comparatively small number would not be insuperably difficult...

...Regular testing would greatly curtail the damage done by those carriers who remained at large...

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...For there i3 only one way to stop AIDS...

...It would, in any event, be thought invidious and discriminatory to limit the testing only to high-risk groups...

...In five years' time, public perceptions of the danger posed by AIDS will be transformed...

...and carefully supervised visits from uninfected people would be possible...

...predictions of the current death-rate have proved to be underestimated, if anything, and present predictions are that the annual death rate from AIDS in the United States alone will be 54,000 by 1991, and continuing to rise sharply every year thereafter unless a cure is discovered, tested, approved, and made generally available...

...Precisely because AIDS is not normally transmissible except by the direct mingling of a carrier's body fluids with the bloodstream of an uninfected person, isolation would immediately protect the uninfected population to an extent greater than with most other communicable diseases: and, even if uninfectedpeople wished to visit or care for friends or relatives in the infected and accordingly isolated community, they could do so without risk provided that stringent precautions against accident were taken...

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...One of the reasons why universal testing is essential is that it is the only reliable way to detect such accidental infections...

...Every member of the population should be blood-tested every month to detect the presence of antibodies against the disease, and all those found to be infected with the virus, even if only as carriers, should be isolated compulsorily, immediately, and permanently...

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...They are allowing an understandable sensitivity to the rights and feelings of minorities to outweigh their higher duty to protect the lives of all their citizens...

...Unless governments act now, the people will begin to take matters into their own hands: uninfected communities, for instance,• will set up their own testing stations and will try to keep, carriers out of town...

...Universal testing would be anti-discriminatory and, above all, it would save the lives of those who are going to be needlessly killed because governments have not the courage to do now what they are, in the end, going to do anyway...

...Confronting AIDS, for instance, bluntly states: "There is no agent currently available to treat the underlying disease process, no one has been known to recover from AIDS, and those exposed to the virus THE AMERICAN SPECTATOR JANUARY 1987 29 must be presumed to be chronically infectious...

...Mentions of the disease still provoke more jokes and laughter than serious consideration of its ultimate effects on the human population...

...A lot of testing could be done for the same outlay...

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...Already the first tentative steps are being taken in this direction: some countries now deny the right of entry to known carriers of AIDS...

...Public health authorities would, therefore, be highly irresponsible if they based their policies for controlling the AIDS epidemic on the wishful assumption that a cure might shortly be found...

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...Confronting AIDS says: "The Committee believes that a vaccine against HIV infection is not likely to be available for at least five years and probably longer...

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...Lyndon LaRouche's Proposition 64, which advocated widespread screening and isolation of AIDS carriers, was heavily defeated on the California ballot, partly because the proposition was proposed by political extremists with a known propensity to cry wolf and supported by documentation that was unconvincing, poorly argued, and hysterical in tone, 'and partly because the public has not yet realized just how dangerous AIDS really is...

...Fortunately, many different tests are available, so if one test proved positive others could at once be tried...

...Would compulsory testing and enforced isolation work...

...Furthermore, it is obvious that the risk of infection by accident is higher still if the carrier himself does not know that he has the disease...

...To take another example, the anti-viral agent against the Hepatitis B virus took seventeen years to develop, and is still not universally available...

...Herein lies the real dilemma for public health authorities...

...The more widespread the disease, the greater the danger that members of low-risk groups may be accidentally infected by an existing carrier...

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...Carriers need not be isolated from each other...

...But Britain will probably not take any radical action yet...

...On the other, they are over-anxious to avoid offending high-risk groups or arousing unreasonable discrimination against known carriers of the disease...

...Alarmingly, no...

...By now it is clear that the AIDS virus will not go away by itself...

...Confrorrting AIDS puts the cost of treating an AIDS victim at $50,000 to $150,000 from diagnosis to death...

...T n Britain, my own country, only 1 30,000 carriers are known...

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...By the time the catastrophic consequences of the epidemic have become evident to all, and the will to eradicate the disease has grown strong enough to permit action, much of the fatal damage has been done and the numbers of carriers to be isolated will be very high...

...T he truth, though the public health authorities are not quite admitting it yet, is that everybody, without exception, is potentially in danger of infection by the AIDS virus...

...In many homosexual communities, the rate of promiscuity has dropped considerably in response to growing public awareness of the danger of contracting AIDS...

...Although the idea of universal testing and isolation now sounds extravagant and preposterous, it will eventually happen...

...In any given population, the measured incidences of infection, of disease, and of death double approximately every ten months...

...Everett Koop, the Surgeon-General, has recently issued a 36-page report advocating the stepping-up of public education on the dangers of transmitting AIDS through promiscuity (heterosexual as well as homosexual) and through the re-use by intravenous drug addicts of possibly infected hypodermic needles...

...Accordingly, everyone whoshowed positive on any monthly test should have the right to undergo immediate further tests to establish whether the initial reading was wrong...

...Yet there are occasions when it is imperative to think the unthinkable and then to do the undoable...

...The high risk arises both because homosexuals are, on average, extremely promiscuous and because the forms of sexual activity in which they indulge are particularly favorable to the physical contact between infected body-fluid and an uninfected bloodstream by which the disease is typically transmitted...

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...The problem with the AIDS virus is that, like the influenza virus, it changes its form so fast that the body's immune system cannot keep up...

...During the few hours necessary for awaiting the results of the further tests, the testee would need to be isolated both from the infected and from the uninfected populations...

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...If the vast majority of the population came to accept the need for it and were willing to cooperate, yes...

...come trend among official announcements about AIDS away from earlier misplaced and complacent attempts at reassurance and towards a more honest exposition of the full facts...

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...While the disease is in the early stages of its penetration into the population, when stopping it would be easiest, few will appreciate its dangers and the public will to take drastic measures will be absent...

...It may well be that many people not in the high-risk groups have already become infected without knowing it...

...Many blood-tests for AIDS are nowknown, including enzyme-linked immuno-sorbent assays, immunofluorescent assays, and Western blot analysis...

...The homosexual community, for instance, is the group with the highest risk of contracting AIDS...

...However, it is unlikely that a society which has been habituated to freedom since its foundation would yet be willing to accept the alternative to widespread death which isolation would offer...

...New AIDS cases arising from heterosexual contact will have risen fivefold from their present levels and pediatric cases tenfold...

...the other is to isolate it...

...All responsible medical authorities are agreed that the likelihood of early discovery of a cure is remote...

...W mild isolation be effective...

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...32 THE AMERICAN SPECTATOR JANUARY 1987...

...On the one hand, they want to prevent the disease from becoming one of the biggest killers man has known...

...These irresponsible attempts at concealment will obviously make the Christopher Monckton, a former special adviser to Margaret Thatcher, is assistant editor of the British national daily newspaper Today...

...That is to screen the entire population regularly and to quarantine all carriers of the disease for life to halt the transmission of the diseaseto those who are uninfected...

...Universal testing, then, provided that it were regular, would successfully identify all—or nearly all—carriers...

...Though the disease has been known only since 1981, and the virus itself was isolated as recently as 1983, early W ill the public health authorities' current response—a program of public education about the dangers of spreading the virus through homosexual or heterosexual promiscuity or re-use of infected needles—be enough to achieve a de facto isolation of carriers, and hence a decline in the rate at which the disease spreads, without the need for enforcement measures...

...task of worldwide eradication of the virus even harder than it already is...

...Already, AIDS carriers in schools and workplaces have begun to face discrimination...

...In the United States, between 1.5 and 3 million people are already carriers of AIDS...

...Though the cost of universal testing would be great, the health-care cost of allowing the infection to spread unchecked would be many times greater...

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...Isolation of so large a number of people would be an enormous and daunting task, though not altogether impossible...

...Yet the report concedes that there is little chance of finding a cure in the short term...

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...Yet both reports fail to draw the unwelcome but undeniable conclusion from the disquieting evidence which they present...

...By then, on the official figures, the cumulative total of AIDS cases will have risen to 270,000, of whom 179,000 will have died...

...Strict controls would be needed at all borders...

...The AIDS epidemic is one such occasion...

...A palliative drug, azidothymidine (AZT), appears promising as a way of deferring the death of AIDS victims by slowing the progress of the disease in the body, but its side-effects have not yet been fully investigated and it will not, in any event, prevent the spread of the disease...

...The reason is that, because AIDS is transmitted by contamination of the victim's bloodstream through direct contact with body fluids from a carrier, infection can occur in many innocent and accidental ways: for instance, through even a very small cut in the skin, or (in one case on record in Germany) by an infected boy_biting his previously uninfected twin brother...

...About two-thirds of all AIDS cases in the United States are among homosexuals...

...Visitors would be required to take blood-tests at the port of entry and would be quarantined in the immigration building until the tests had proved negative...

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...EUROPEAN DOCUMENT AIDS: A BRITISH VIEW by Christopher Monckton T he responses of governments and public agencies to the threat to mankind from the rapid spread of AIDS and its related diseases have been dangerously and perhaps fatally inadequate...

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...Isolation of AIDS carriers need not, therefore, be as terrible in practice as it sounds in theory, and it need not be as rigorous as the isolation which was once necessary for more readily communicable diseases such as smallpox or typhoid...

...The authorities in some countries in Africa (where the very high infection rate leads many to believe the disease may have originated) are now refusing to report AIDS cases to the World Health Organization, which now has a small, under-funded but growing program to combat the disease internationally...

...At the end of October a committee of the National Academy of Sciences produced a 390-page report entitled Confronting AIDS,' describing federal anti AIDS funding as woefully inadequate and calling for a $2 billion annual program of public education and research on the disease in the hope of finding a vaccine against it...

...Hence, even where sexual behavior becomes less promiscuous, the advance of the disease appears inexorable...

...Any program of action as radical, as costly, as universal, and as undeniablycontrary to individual liberties as this appears to be unthinkable, which is why too few of the people who ought to have thought about it have done more than to dismiss it as impossible, unethical, unfair, discriminatory, or undemocratic...

...Some actual or potential carriers, particularly among the high-risk groups, might be THE AMERICAN SPECTATOR JANUARY 1987 31 driven "underground" by fear of being identified and isolated: but the risk to the population from these few would be considerably smaller than the present risk from those who are spreading the disease because they are not known to be carriers...

...Privately he admits that, if his, campaigns against smoking, drink, and drugs have made little impact, a campaign to change people's sexual behavior will have still less chance of success...

...but, more to the point, it would also be a failure...

...As the incidence of AIDS increases, the likelihood of accidental infection of 30 THE AMERICAN SPECTATOR JANUARY 1987 theoretically low-risk members of the population also increases...

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...It will probably be harder to find a cure for AIDS than for the influenza virus, for which—despite decades of research—no satisfactory or general cure has been found...

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...In these respects, AIDS is more threatening than any plague which has previously afflicted mankind...

...But unfortunately the disease is not confined solely to these high-risk groups...

...By 1991, the annual cost of caring for sufferers from the disease has been put at a conservative $16 billion...

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...The great plagues of history were eventually extinguished partly because the victims were killed so quickly that the diseases could not transmit themselves to new hosts, and partly because immunities to them began to arise...

...The testing would have to be monthly because after the moment of infection there is a "window of apparent safety," varying in length from two weeks to three months, during which the victim shows no antibodies...

...haVerhills 131 Townsend Street, San Francisco, CA 94107 1-1 o justify a program of universal blood-testing and enforced isolation, it is first necessary to establish that there is no alternative...

...There are only two ways of eradicating a disease like AIDS...

...And, though the vast majority of cases will still be coming from the high-risk groups, cases arising in low-risk groups from accidental infection will begin to become significant...

...What, then, is the prospect of a cure...

...Equally, a test might show falsely positive...

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...Yes, and here is the one ray of light in an otherwise gloomy tale...

...AIDS, however, lingers as a carrier for years before killing its victims, allowing plenty of time for onward transmission, and it assails the very immune system (specifically the T-lymphocyte white cells) that might otherwise develop the power to destroy it...

...Most of these techniques are quick, painless, and inexpensive and all are accurate to a respectably high degree...

...One is to cure it...

...Some slowing of this rate of increase can be hoped for once the disease has reached saturation among the high-risk groups (homosexuals, intravenous drug addicts re-using infected needles, prostitutes and their clients, other heterosexually promiscuous people, hemophiliacs using infected clotting agents, transfusees receiving blood from infected donors, spouses of carriers and children of infected mothers...

...Yet the rate of infection has not dropped, because increasing numbers of homosexuals are already infected and the higher percentage of existing infection tends to cancel out what would otherwise be the beneficial effects of the decline in promiscuity...