A friend of ours was telling Ingrid about this new woman she's been dating. Things were going along swimmingly... until it turned out that the new inamorata, a youngish thing in her early thirties, was an AIDS denialist. She was swallowing all that bullshit about how HIV doesn't really cause AIDS, AIDS drugs are what causes AIDS, and the whole thing is a vast conspiracy by the drug companies to get rich selling people drugs they don't need and that just make them sick.
This was absolutely the wrong thing to say to our friend, who had been an AIDS activist since the early days of the epidemic, had nursed several beloved friends through the illness, had seen way too many of those friends die... and had seen others come back from the brink of death when the protease inhibitors and combination therapies finally came out.
So Ingrid and I were talking, not only about how ignorant AIDS denialism is and what a perfect example of the Galileo Fallacy it's proving to be... but also about how profoundly insensitive and clueless it was for this woman to talk this way to someone who'd been through the worst days of the epidemic. Doesn't she remember? we said. Doesn't she know what AIDS was like before the drug cocktails came along?
And it occurred to both of us:
No. She doesn't remember.
And that's the problem.
There are some AIDS denialists who were around in the '80s. But an awful lot of them don't remember. They weren't around during the early days of the epidemic, when there was absolutely no treatment and your life expectancy when you got diagnosed was a few months, a year or two if you were lucky. They don't remember the days when a diagnosis was pretty much a death sentence -- a sentence to a slow, painful death. (Some people with AIDS lived through those days to tell the tale, but not many.) They don't remember having half their gay male friends get sick and die. They don't remember people lying in the streets screaming for the medical establishment to fucking pay attention and work on a treatment, some treatment, any treatment at all.
And they don't remember what it was like when the cocktail came along, and suddenly people started getting better and living longer. They don't remember the wonderful (although not entirely trivial) "problem" of people with AIDS who had quit their jobs and run up huge credit card debts, and now actually expected to live for a while. They don't remember what it was like when AIDS turned, almost overnight, from a deadly illness to a chronic but often survivable one.
To them, AIDS has always been what it is now. They look at HIV and AIDS, and they see a bad disease, one that still kills a lot of people and makes a lot of people pretty damn sick, but also one that people have a decent chance of surviving for a good long time. They see the cocktail making some people feel crappy. And they see the cocktail being really expensive, and making drug companies very rich indeed.
What's more, they have little or no awareness of what AIDS is still like in Africa, and other places where prevention and treatment still range from lousy to non-existent... and where the pandemic is as bad or worse as it ever was in its early days in the U.S.
So it's much easier for them to ignore or dismiss the effectiveness of the cocktail, and to treat it as a drug-company conspiracy. It's easier for them to see themselves as brave Galileos for resisting the "lie" of HIV drugs... because they have no memory of the harsh, horrible truth of HIV before the drugs came along.
And I think the same thing is happening with the vaccine resisters: the people who insist that vaccines -- measles, mumps, rubella, polio, tetanus, what have you -- are useless poison, foisted on an unsuspecting public by a Big Pharma cabal of cackling men in expensive suits.
The problem, again, is that they don't remember.
They don't remember what the world was like before the vaccines. They don't remember the polio epidemic that killed thousands of children and disabled tens of thousands -- in 1952 alone. They don't remember the rubella pandemic of the 1960s, when tens of thousands of babies were born dead or with birth defects because their mothers were infected. (FYI, I could easily have been one of those babies -- my mother got rubella shortly after I was born, and it could easily have been just a little earlier when she was pregnant with me.) They don't remember the time when people routinely died of lockjaw... and they don't live in non-industrial parts of the world where people still do.
All they see is a world in which polio, rubella, tetanus, etc. almost never appear... and people are immunized against them for no apparent reason.
See, this is the problem with public health efforts that work. When they work, they quickly become invisible. It's very hard to see prevention working: when it works, you don't see it. So it's easy for people to see things like immunization as pointless. They do happen for no apparent reason... "apparent" being the operative word. The reason is very good indeed, the reason is unassailably excellent -- but unless you've lived in a world without immunization, the reason isn't very apparent at all.
(Interestingly, the conspiracy theorists linking vaccination with, for instance, autism don't seem very interested in the actual, documented, verified conspiracy in which the researcher who originally published the now-discredited "vaccines cause autism" study was paid hundreds of thousands of pounds by trial lawyers trying to prove that vaccines were harmful. Links here and here, via Wikipedia.)
Look. I'm no great friend of the drug companies. I get that the way health care is handled in this country is -- how shall I put this? -- evil. Its purpose is largely to make insurance and drug companies rich, not to help healthy people stay healthy or sick people get better. Ingrid works in health care in this country, and she could tell you stories that would curl your hair. See "Sicko" if you don't believe me.
But that doesn't mean that AIDS drugs don't work. And it doesn't mean that vaccines don't work. The evidence is overwhelming that they do.
Yes, our country's health care system sucks. But our educational system sucks as well. And one of the ways it sucks the most is in its failure to teach reasoning, cause-and-effect... and history. The history of AIDS drugs, and the history of vaccines, are a history of the prevention of pointless suffering and death -- millions of times over.
P.S. I will warn you right now: I am not going to get into debates with AIDS denialists or vaccine resisters in this blog. I don't have the patience, and other people make these arguments better than I can. AIDS denialists or vaccine resisters are hereby directed to Denialism and to Skeptico. My apologies in advance to the keepers of those blogs. I'm putting you both on my blogroll to make up for it.