Guest editorial – Bill Frist, M.D.

Fighting viral infections: A scientific challenge and humanitarian imperative

Editor’s Note:  Former Senate majority leader Bill Frist, M.D., is a heart-lung transplant surgeon who established the Vanderbilt Transplant Center. He believes global health can be an effective “currency for peace.”

Bill Frist, M.D.
Published: April, 2004

The AIDS epidemic is the world’s most urgent public health need. It is also the greatest humanitarian and moral crisis we confront. More than 40 million people are infected with the human immunodeficiency virus (HIV), which causes AIDS, a disease that kills more than 8,000 people every day according to the World Health Organization.

HIV/AIDS has devastated economies, slashed in half the life expectancy in countries such as Botswana, and left millions of children orphaned, destitute and vulnerable to exploitation. The African continent alone is losing an entire generation as 40 million children will be orphaned by AIDS in the next decade a number equivalent to all American children living east of the Mississippi. By 2010, more will have died of AIDS than all those who perished in World War II, both civilian and military. And 90 percent of those infected do not know they have it.

Through a combination of government and private resources, the United States and other industrialized nations are rising to meet these challenges by aiding educational and public health efforts to prevent the spread of infection and funding to provide anti-retroviral drugs, which can extend life and preserve health in infected individuals.

Until science produces a vaccine, prevention through behavioral change is the key. Even in HIV-ravaged Africa, most of those tested for the virus will test negative. Thus, prevention presents a real opportunity to save countless lives. Access to inexpensive and rapid HIV testing can help reinforce prevention messages and guide treatment options. In Africa, I have personally witnessed how testing centers become centers of hope for the community, a place where those struggling with HIV/AIDS can learn important coping strategies, receive nutritional and medical treatment, and support others with the disease.

Furthermore, we need to continue to develop ways to encourage people to get tested. In every nation of the world, stigma—the fear of discrimination—prevents many people from getting tested. Over the long term, we need to find ways to reduce stigma. For example, we must work towards developing guidelines for medical personnel to make HIV testing a more routine part of medical care.

Testing leads to treatment. And preventing new infections and saving lives through treatment are our two most important objectives. When people with AIDS receive nutritional and medical assistance, they live longer, healthier lives. They are more likely to avoid opportunistic complications such as pneumonia, tuberculosis and certain cancers.