‘Compassion Fatigue’ and AIDS

Our (lonely) Benevolent Seed Overlords ask:

To what extent do you worry about AIDS, either with respect to yourself, your children, or the world at large?

Personally, I don’t worry so much–I came of age when nuclear annihilation was a real possibility. It doesn’t get scarier than that. I think one potential casuality of the AIDS epidemic could be public health in the developing world–or more accurately, the willingness of the developed world to support developing world public health efforts.

In the last decade, there has been a tremendous upsurge of funding to combat infectious disease in the developing world–the Gates Foundation being the most famous example. Make no mistake about it–this is a wonderful thing. But I’m very worried that the founders and supporters of these groups, who themselves often have little knowledge of public health, medicine, or biology, have attempted to go after the ‘high-hanging fruit’ without the experience or infrastructure needed to execute these projects. With AIDS, in the developing world, inventing a cure–or more accurately, a lifetime therapy, is only the first step. The delivery systems need to be developed, healthcare providers (who often are not highly trained medical personnel) need to be trained, and funding for the process needs to be sustainable.
These are very challenging problems, and simply cannot be solved by throwing money at the problem. My concern, and one shared by several people I know who reguarly work in public health in the developing world, is that funders will get frustrated because they will not have found the ‘magic bullet’ that ‘solves’ AIDS. Many private funders are not happy with 10% or 20% reductions; too many of them want the glory of having solved the problem. They will be the temptation to remove vital funding for addressing what are chronic, long-term problem. That’s what I worry about.

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