disease

IMMANUEL KANT has been on my mind as I’ve followed the national response to recent measles outbreaks. Kant, a German philosopher, emphasized the danger of a temptation we are all vulnerable to—the temptation to make special exceptions for ourselves. The person who acts against principles that she thinks others ought to follow becomes a kind of moral “free-rider,” attempting to benefit from public moral order without contributing to it.

The spread of disease among the intentionally unvaccinated highlights the free-rider problem faced by parents who seek exemption from vaccination.

Some people believe that leaving their children unvaccinated (or under-vaccinated) minimizes their children’s health risks. If everyone around them has been vaccinated, their risk of infection is indeed low. But when too many people decide to forego vaccination, “herd immunity” is lost and disease outbreaks occur.

“Administration officials have repeatedly assured Americans that they were prepared for Ebola. Less than two weeks ago here at the White House, they insisted they knew how to stop this virus in its tracks. But so far, the virus appears to be outrunning the government. “

So began Scott Horsley’s report from the White House, one of three separate stories NPR’s news showAll Things Considered devoted to Ebola on Wednesday, October 16. According to yet another report, a recent Harvard School of Public Health survey finds that 40 percent of Americans feel “at risk” of contracting the disease.

We have Ebola on the brain.

Several of my friends expressed alarm when the first Ebola patient flew to the United States for treatment. Now we find that not one but two Dallas nurses have contracted Ebola, likely because their hospital did not adopt proper Ebola protocols. Americans know that their medical system is far better equipped to prevent an Ebola outbreak than are those in West Africa. We know our system is better prepared to offer effective treatment. But the appearance of multiple cases, one involving a nurse who took a commercial flight while possibly contagious, has people concerned. When a key public health expert says, “It’s a learning process, and . . . our confidence in the hospitals was ill-founded,” the rest of us might get a little nervous.

I WAS PRESENT when my uncle died. I didn’t plan to be, but once I understood his end was near it felt right. I had been the flower girl at my aunt and uncle’s wedding, the ritualized beginning of their life together, so witnessing this milestone event of my uncle’s death seemed appropriate. And I wanted to support my aunt, I told myself.

My aunt is my father’s youngest sister. They are the last living siblings from nine brothers and sisters; both their parents are also long gone. My aunt wears this fact like a veil. Sometimes it’s barely noticeable; sometimes it’s the only thing she sees. While my parents’ divorce had kept me apart from my aunt for much of my life, it seemed important, the fury of those old family dramas now covered with dust, to offer my aunt support in her husband’s last days, hours, then moments. She was hardly alone. My aunt has three grown daughters, and my uncle comes from a huge family, most of whom were packed into the hospital room where he died at 2:20 p.m. on Sept. 22, 2013.

My aunt told me she was happy to have me, a representative from her side of her family, present. So I was there. For her, I said.

But to tell the truth, I was there to learn. I have plenty of information about the beginning of life. People in my generation received hours of tutoring, lecturing, indoctrinating, and warning about puberty, childbirth, birth control, and “safe sex.” Although we were actually not given much information about sexuality—I had to learn that on my own. But I knew even less about death.

Our health care system is not arbitrary. It does not operate by a set of principles that are beyond comprehension. We govern it. We participate in its capitalistic maneuvering and its political favoring. My family has health insurance in part because we have been given advantages due to racial identity, family networking, and being part of the 1 percent. All of these things have worked specifically in my favor to save the life of my dear mother. None of this is fair. 

When I praise God for my mother’s enduring health, it is impossible not to think of how many others have indirectly contributed to this success. And to wonder if we have also indirectly contributed to their failures.

Usually when I hear people talk about finding the good in the midst of a difficult situation, my cynical radar goes up. I picture the scene in Monty Python’s Life of Brian where Brian and the two thieves are being crucified while whistling and singing “Always look on the bright side of life.”

Yeah, right.

I reminds me a girl named Cathy that I knew in high school who already lived on her own before she had even graduated. At school she was the perpetual ray of sunshine, always offering warm smiles and hugs, but hardly concealing a deeper undercurrent of sadness that you could nearly taste.

But once in a while, we have an opportunity to catch a glimpse of grace in the middle of the worst humanity has to offer. And it’s in those moments that I tend to recognize God in our midst.

The news is hopeful. We have seen both progress and proof:

• New data shows that an HIV-positive person on treatment is 96 percent less likely to pass HIV on to others.
• It only costs, on average, $335 for AIDS treatment through PEPFAR (down nearly 70 percent since 2004!).
• 22 countries in sub-Saharan Africa have reduced new HIV infections by 25 percent.
• Clinical trials show that voluntary male circumcision reduces the risk of new HIV infection in men by roughly 60 percent.

Yesterday was truly a momentous occasion. Looking at all the progress we have made, especially in the last 10 years, it is a moment for us to not only celebrate, but in the words of President Jakaya Kikwete of Tanzania, “recommit ourselves,” to end the fight against AIDS totally.

By 2015, we could have an AIDS free generation.

AIDS was first identified nearly 30 years ago and has claimed countless lives. Currently, 1,000 babies around the globe are born with the virus each day. During much of the past few decades it’s been hard to see much hope when it comes to turning the tide against this disease.

But, thanks to smart public health decisions, public investment in strategies that work, and innovative implementation by NGO’s, we can now begin to envision a day when this mountain will be moved. During FY 2011 PEPFAR, (The President’s Emergency Plan for AIDs Relief) supported the prevention of 200,000 children contracting HIV/AIDS from their mother.

With continued investment we are just a few years away from preventing nearly ALL children from being born with the virus.