Ignorance Isn’t Always Bliss, but Knowledge is Always Power

        

HIV/AIDS is an equal opportunity ailment. It crosses every boundary imaginable to afflict adversity on thousands upon thousands of people from all walks of life while continuing to confound doctors and researchers from around the globe. It is the mystery in medicine, like the one of the HIV/AIDS epidemic, that initially drew me to pursue a career in medicine. As a doctor, I hope to be able to develop the skills necessary to help others lead healthy lives and also to confront the medical maladies that cause so many to suffer.

I seek knowledge so that I will have the power to alleviate the pain of others to the greatest extent possible. My patients will come to me seeking knowledge about their health and how it can be improved. (I guess we’ll see how successful I am at actually convincing people to trust me with their health.)

From Unity Dow and Max Essex’s Saturday is for Funerals, it is clear that knowledge was key in giving the people of Botswana the tools to fight the AIDS epidemic there. Although the incidence and prevalence rates remain high, Botswana is one of the only nations providing anti-retroviral (ARV) medication to all citizens. Such a system ensures that those who are sick will get treatment. Although in certain cases treatment is complicated due to drug resistance, in general the ARV cocktail widely used in Botswana, called HAART is highly effective in prolonging the lives of patients with HIV, and a similar cocktail is also highly effective in combating the transmission of HIV from mother to infant.

The government program of providing ARV medications is accompanied by intensive education and counseling services, so that patients do not only get a second shot at life with an improved bill of health, but they can also understand what having HIV entails and what they must do to protect others from transmission. When just south of Botswana, in South Africa, many leaders, including President Mbeki, many denialists are spreading fallacies about how HIV does not exist and was made up in the West, it is especially remarkable that the government has responded in such a decisive and unified way. South Africa continues to have one of the highest HIV rates in the world, with low quality of treatment. Ignorance and bliss, diametrically opposed.

            This book is an eye-opening account of how Botswana went from a nation where in one year, Unity’s mother attended at least one funeral every week, in which AIDS was often hidden as the cause of the deceased’s death due to stigma, to a land where the epidemic is now spoken of much more openly and where friends and coworkers band together and convince each other to get tested and get treatment.

The bottom line: knowledge about the diesease will help everyone—not just those who are HIV-positive or have a loved one who is. Effective treatment, counseling, and education about prevention is vital to the economy. Instead of losing many of its young adults to HIV/AIDS, Botswana is able to keep those individuals in the workforce longer, reduce the number of orphans (who are unfortunately more fiscally demanding since their parents generally don’t leave much behind to help care for them), and reduce overall costs of healthcare and childcare, by providing ARV drugs. This also ends up creating a more egalitarian societyl.

In 2006, Michael Ganz, an Assistant Professor at the Harvard School of Public Health, released a study that showed society pays $3.2 million to care for an autistic person over his or her life, citing that this was partly due to the loss of productivity created by autistic people who are unable to hold jobs. The point of his study was that early intervention therapies for autism, which are proven to help autistic individuals function at higher cognitive levels as adults, should be instituted and covered by health insurance, which they are currently not. By doing so, Ganz’s work implies that the initial expenses of these therapies will be cost-effective because it will end up being an investment that pays off, allowing society to reap the benefits.

Obviously, autism and AIDS are two vastly different beasts. But, both are lifelong, and until a cure is available, they never go away. Succumbing to them, hurts everyone in the long run. But, knowledge about how to take early action to keep these conditions under control, and taking smart, well-planned action based on that knowledge helps everyone in the long run.

Many other nations struggling with the AIDS epidemic and with other such medical mysteries should perhaps study Botswana’s model. After all, it is following one of the most basic tenets of medicine, straight from the Hippocratic Oath: “First, do no harm.”