Monday, February 25, 2013


Big Pharma has little to do with producing an AIDS-free generation.  Big Pharma can only produce meds and market them -- maybe pull together a bit of research.  That’s not what keeps people from getting what they need to be cured of AIDS any more than it truly has eliminated smallpox (because the mega-countries have hidden some of it to use for weapons) and can’t seem to produce an STD-free generation of any kind from chlamidia to gonorrhea.  Focusing on a PILL to cure diseases that are epidemic- pandemic-syndemic lets everyone off the hook so we can all blame some mysterious white-coated figures far away, as though seen in buildings lit in the night, moving to and fro behind the glass.  Big Pharma likes that image.  If they seem mysterious and privileged, it helps keep the prices up.

Identified and devastating diseases -- polio, plague, Lyme disease, malaria -- are ecologically based.  At origin, HIV is NOT a gay disease -- not even a human disease -- not even a primate disease.  It appears that the first of its kind evolved as a lentivirus, a subcategory of retrovirus, (which are only genetic machinery codes) in simians (monkeys), possibly 12 million years ago.   “In hopes of getting a more accurate estimate of how long primates and lentiviruses may have coexisted, Michael Emerman, Ph.D., a virologist at Fred Hutchinson Cancer Research Center, and Alex Compton, a graduate student in the Emerman Lab, examined the interaction between host and virus on a molecular level and traced back the dynamics of this relationship. They found that APOBEC3G, an immunity factor in the hosts, has evolved alongside Vif (viral infectivity factor), the viral protein that targets APOBEC3G. . . The researchers determined that this co-evolution dates back at least five to six million years -- and possibly even 12 million years.

“The oldest known primate is the Late Paleocene Plesiapius circa 55–58 million years ago.  Molecular Clock studies suggest the primate branch may be even older, originating in the mid-Cretaceous period around 85 mya.”  
It wasn’t the genes that suddenly changed, kicking off a wave of deaths, so much as it was the memes, which changed the ecology, both in the human body and in the environment of that body.  The SIV version of HIV was fiddling along in the bodies of monkeys and then chimps until hungry hunters after bush meat got deeply enough into the jungle to catch it and transmit it to other humans who carried it out to the “civilized” world.  That is, HIV like venereal diseases is dependent upon human vectors. (HIV is NOT essentially venereal -- it is a BLOOD disease which is sometimes transmitted at the same time as STD’s.)  That means avoiding contaminated blood, semen, etc., not just avoiding sex.  It’s the BLOOD, not the sex.
Since it was human memes (travel, adventure sex, habitat destruction, hunger, etc.) that got us into this mess, then that probably is the way to get out.  What memes do we need?  What cultural arrangements?

1.  The meme of families needs ecological support so that it doesn’t eject members, forcing them to do survival sexwork, or doesn’t leave them so dissatisfied that they spread their viruses around while searching for relationship.  Backup alternatives should be provided for genetically-based families that don’t work.

2.  The stigma memes have got to go.  They feed into an ecology that rewards vectors for viral contact by monetizing contagious behavior.  Stigma is a way of making something hard to access and therefore attractive and expensive.  It also justifies violence, suppression, secrecy and bullying.

3.  Some stigma markers make people attractive targets, mark them as vulnerable, set the law against them, and convince the stigmatized people themselves that they are weak and unworthy.  Other reverse-stigma markers (let’s call them authority markers) label “virtuous” religious people as universally judgmental, helpless, callous, and without resources.  These are effective in preventing people from expecting or asking for understanding or help.

4.  Persons need memes that teach them how to ask for help, where to go, how to figure out whom to trust.  We need “reach out” memes both as helpers as helpees.

5.  Social memes need to provide ways to network, join in solidarity, spread information, tolerate risk, and take action.  These were everywhere in the Sixties and Seventies and still remain in the culture, mostly latent but now waking.  However, the Status Quo people, who know that war gives them the upper hand, are fighting back -- so far with considerable effectiveness.   Until this last election. 

Genes are spread by contact.  Memes are spread in stories.  Effective stories, as powerful as “Black Beauty” or “Uncle Tom’s Cabin” -- books that changed the nation -- have been shut down by demand for proof, details, certifiable facts -- even when the stories themselves are told through publishers pursuing profit who know that sensational exaggeration will make sales go up and therefore strong-arm authors to push up the heat -- but dodge out afterwards.  Or when the demand is made to break the secrecy that made telling the story possible.  Shift the focus off the story onto the life of the author and stigmatize that person.  This is not different from focusing on Big Pharma and pills to solve a disease that thrives on poverty, ignorance, poor health, lack of housing, broken families, and in general a society that values only getting and spending -- the commodification of everything, including misery.

There have been some stellar and moving AIDS stories, both in books and on the stage or in movies.  Some of them are traveling via word-of-mouth, some of them are in our own families, and finally some of them show up in the newspaper.  We still haven’t broken the idea that HIV is only relevant to the people who catch it or that if the stats are good where you live, then the problem is solved.  

A distinguished elderly big city psychiatrist who was visiting last summer, a woman who devotes herself to helping disadvantaged women, told me that the HIV-AIDS was solved.  The meds existed, were subsidized, and amounted to a cure.  Of all people, she ought to have known better.  She seemed unaware of the many forces that keep people from maintaining pill regimes -- I can hardly remember to take my two daily blood pressure and diabetes pills, but people with HIV-AIDS take as many as twenty pills a day, spaced out at specific times.  They need to be stored and constantly available, often taken with food.  Many of them, like chemotherapy, induce nausea and fog.  

Recently pill shortages have been showing up in as many as a hundred different meds, not just HIV meds.  Unregulated companies are not working.  The pills aren’t being produced in timely quantities.  Some are not properly formulated.  There is no international access.  Prices are incredibly high and though there are supposed to be subsidies, those are also not sufficient.  The money just doesn’t arrive or -- here comes sequester -- is gone.   Dealing with needy people makes the dispensers surly -- so if you’re already confused and discouraged, you go to the clinic and the person at the desk bites your head off, and you say “forget it.”  If you blow up, you’re thrown out.  These are not magical molecular concoctions -- these are social memes.  

Not that I want to let Big Pharma off the hook.  They are outrageously gaming the system.  They say there are already “printers” that can fabricate medicines as easily as printing a paper copy or burning a DVD. They ought to be at every county health office.   Demanding action is not a gene, not even a regulation, but a crucial social reform meme and it ought not to be stigmatized.  To achieve an HIV-AIDS free generation, we’ve got to change people themselves and the way they treat each other.  Without ways to get access to meds, to have food and shelter and enough order to follow regimes, the most super pill in the world would not end HIV-AIDS.  Why wait for a pill when there’s so much to do now?

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