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Citizens Against Government Waste
Since the first federal resources were made available to state and local health agencies for AIDS prevention in 1985, federal funding, which now includes money for research, treatment, and housing, has skyrocketed to $13 billion for fiscal 2003. As a result of the work of highly mobilized lobbying forces, more is spent per patient on AIDS than on any other disease, though it does not even currently rank among the top 15 causes of death in the United States. In one year, 1998, heart disease, the nation's leading cause of death, killed 724,859 Americans only 6.8 percent less than the 774,767 who have contracted AIDS in the last 20 years.2 Of those 774,767 total AIDS cases, 462,766 have died. During that same period, 14 million Americans 30 times more have died of heart disease.
Research expenditures at the National Institutes of Health (NIH) demonstrate the uneven use of federal resources. In 1996, NIH spent an average of $1,160 for every heart disease death, $4,700 for every cancer death, and a whopping $43,000 for every AIDS death.3 Even though they get far less research money, that year heart disease killed 24 times more and cancer killed 17 times more than the number of people who died from AIDS in 1996, when AIDS was still the seventh leading cause of death in the U.S.
In addition to research, the U.S. government spends large amounts on AIDS prevention and social programs. The Centers for Disease Control and Prevention (CDC) spent $795 million on prevention in fiscal 2001. But questions have arisen regarding the misuse of some of that money.
HIV and AIDS prevention and social programs have long been cash cows for politically correct nonprofit firms and government bureaucracies. In their book, Private Choices and Public Health: The AIDS Epidemic in an Economic Perspective, University of Chicago economist Tomas J. Philipson and law professor Richard A. Posner concluded that the AIDS epidemic has been overstated in almost every imaginable way in order to gain more funding. They contended, "pressure from small, but organized, groups [including] male homosexuals, health professionals, government bureaucrats, and moral conservatives has deflected AIDS programs from their efficient path."9
In 1998, heart disease 118,151 people under the age of 65.24 Cancer killed 157,255 people under age 65 that year.25 That is nine times more and 13 times more, respectively, than AIDS, which killed approximately 12,000 people under age 65 in 1998.26 In all age groups, including the under 65 group, the death rates for heart disease and cancer have remained steady while AIDS deaths have been in decline since 1993. Furthermore, a typical AIDS case costs approximately the same amount to treat as a terminal cancer case approximately $40,000 to $50,000 per year.27
In 1998, AIDS ranked 17th in the leading causes of death among Americans, behind, among others, heart disease, cancer, emphysema and asthma, pneumonia and influenza, diabetes, suicide, Alzheimer's disease, homicide, and hypertension.28 Despite this, AIDS receives more funding than any other disease. In 1996, NIH spent 43 times more on AIDS than it did on heart disease and nine times more than it spent on all cancers.29
Some AIDS activists think it could be detrimental that AIDS receives much more money than other diseases. Martin Delaney, founder of the HIV treatment information organization Project Inform says that by giving AIDS so much funding, the federal government makes it "almost an advantage to be HIV-positive."30
After SFDPH worker Seth Watkins admitted in an August 2001 New York Times article that he sometimes went to San Francisco bars and ended up having unprotected sex, Tierney did not reprimand him. Instead Tierney, told The San Francisco Chronicle that his employee's sex life was that employee's business.57 Watkins is not the only AIDS prevention worker under scrutiny for such behavior. In 1999, Luis Diaz, director of the HIV and AIDS program for the Nevada Association of Latin Americans was accused of having unprotected sex with two people without informing them of his AIDS infection.
There are AIDS prevention success stories, but they aren't coming from American "health" organizations like SFDPH. In the 1990s, the prevalence of AIDS in Uganda hung around the 30 percent mark. Today only 6 percent of Ugandans have AIDS. A recent Africa News article says the Ugandan government attributes this drop to programs like the School Health Education Project, which, instead of sex and flirting seminars, include discussion and debate on the reality of living with AIDS. The article says, "More emphasis [is] put on the fact that HIV/AIDS has no cure and that abstinence from sex [is] the best way to avoid the pandemic."59
Upon her retirement as Director of the National Center for HIV, STD, and TB Prevention at CDC, Dr. Helene Gayle said of her progress, "Nearly every adult can tell you what AIDS is and how it is spread." Adult prevention and education programs are wasted in well-educated, urban populations that glamorize the behavior that spreads the disease.
America is at war against AIDS and against terrorism. The waste of federal AIDS dollars does a disservice to taxpayers, and most importantly, to the victims and those at risk of contracting the disease. The nation cannot be expected to win those wars unless it gets serious about eliminating wasteful, fraudulent, and abusive AIDS programs.