Good God, Lousy World, and Me by Holly Burkhalter

Author:Holly Burkhalter [Burkhalter, Holly]
Language: eng
Format: epub
ISBN: 978-1-60142-509-6
Publisher: The Crown Publishing Group
Published: 2013-10-15T00:00:00+00:00

The randomness of who gets to live and who has to die is so painful that mostly I’d prefer not to think about it at all. But I was confronted by the issue very directly when I did some policy work on global HIV/AIDS in the early 2000s, before I had come to believe in a good God.

The HIV/AIDS pandemic was enough to knock anybody off their spiritual pins. The simple fact of the matter was that by 1997, if you had AIDS and lived in the United States or Europe, you could most likely obtain treatment that prolonged quality and years of life. But if you were a poor African with AIDS, you would certainly die. Scientists had cracked the code on life-prolonging antiretroviral drugs, but they were almost entirely unavailable in the developing world. When I became engaged in the campaign to provide access to treatment to Africa, six million people were HIV positive and in immediate need of treatment they didn’t have. Hundreds of thousands of those infected every year were newborn babies of HIV-positive mothers.

In a scientific breakthrough, researchers discovered they could disrupt the transmission of HIV from mother to child by administering a course of antiretroviral drugs to a pregnant woman just before the delivery and to the infant for a period of time after the birth.

A nongovernmental organization called the Elizabeth Glaser Pediatric AIDS Foundation put the science to work, initiating testing of pregnant women and treatment before birth for HIV-positive mothers and their babies thereafter. They called it PMTCT—prevention of mother-to-child transmission. Approximately two-thirds of the infants receiving the therapy seroconverted, that is, they became HIV negative.

The Glaser Foundation lobbied Congress for funding to scale up PMTCT programs in countries with HIV prevalence. In March 2002, North Carolina Senator Jesse Helms, the Senate’s most famous conservative, announced that he would secure five hundred million dollars for PMTCT initiatives in Africa.

But there was something desperately wrong with the Helms approach. The drugs offered in PMTCT programs saved babies but not their mothers. To keep an HIV-positive mother alive required a lifetime of expensive antiretroviral medication, not just a few days’ supply.

I had a chance to talk to a Glaser staff member about using mothers’ bodies for drug transmission to their infants but denying the women the same medication that would keep them alive to raise their children. No doubt, five hundred million dollars to prevent transmission of HIV to thousands of babies was a good thing; surely it was better that an infant should live than die. But saving a child so she could watch her mother die within a few years was unbearable. Babies who lose their mothers experience a world of grief, and then they usually die themselves. Is that what we were funding?

A friend from the Glaser Foundation said, “Of course it is a moral contradiction to save babies while their mothers die. Everyone will recognize that it is unconscionable to create tens of thousands of orphans. A program of treatment for mothers will have to be funded.

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