Merson evaluates global responses to HIV/AIDS

Forty million people live with AIDS today. Fourteen-thousand new HIV infections are reported daily. AIDS is undoubtedly among the most pressing health issues the world faces today, yet some believe global response has been inadequate and sporadic.

“Our response has been delayed, inappropriate and grossly inefficient,” Michael Merson, Dean and Anna M.R. Lauder Professor of Public Health, said

This was the unambiguous note upon which Merson began his lecture entitled “The HIV/AIDS Pandemic: A Failed Global Response,” yesterday afternoon to a crowd of approximately 80 students and faculty assembled in the McDougal Center in the Hall of Graduate Studies. The lecture discussed both the technical and political aspects of the disease, including the history of the pandemic and the bureaucratic obstacles encountered in its recognition.

Merson began by documenting the horrifying statistics behind the AIDS pandemic, which is now in its 23rd year. As of December 2003, 31 million people had died of AIDS, and another 40 million were living with HIV or AIDS. A recent study by the National Intelligence Council entitled “The Next Wave of HIV/AIDS” predicts that several countries, most notably India and China, will see HIV/AIDS cases skyrocket over the next 20 years.

However, Merson’s larger point was not the tragedy of the disease itself, but the tragedy of the world’s non-response. In 1994, the World Health Organization Special Program on AIDS — which Merson directed from 1990 to 1995 — held a summit in Paris. Leaders from around the world were invited, yet representatives from only 21 countries attended. Merson’s chief rationale for this phenomenon is the stigmatization by society; people find it hard to deal with a disease associated with such social taboos as homosexuality, illicit drug use and death.

“We need to face up to the severity of the epidemic and the great public health crisis that it is,” Merson said. “We must destigmatize and not be judgmental about the disease and those affected.”

Improvements have been made in recognizing and fighting the AIDS pandemic. Drug prices have decreased significantly in countries where people need them the most, and when an AIDS summit similar to the one organized in 1994 was held in 2001, every invited country attended. However, Merson’s ultimate point was that to efficiently combat world AIDS, organizations must cooperate. Over the past two years, three separate initiatives have been created to fight AIDS. These organizations are all attempting to provide aid to countries in need, but they overlap in several areas, decreasing the efficiency of each.

“While more [resources] are needed, there’s a greater need for coordination,” Merson said. “You have the U.S. government, the Global Fund and the WHO’s Three by Five Plan; we need to bring them all together if we’re going to make the best use of our resources.”

Merson held directorial positions within the World Health Organization for 17 years, before becoming the chairman and first dean of epidemiology and public health at Yale in 1995. Merson is also the director of the Center for Interdisciplinary Research on AIDS (CIRA), founded in 1997.

The talk was part of the Dean’s Lecture Series, “In the Company of Scholars.” The lectures are held by the Graduate School once a month and allow some of the University’s most prominent scholars to discuss their fields on a level that all members of the Yale community can appreciate.

“We try to get scholars from all around Yale to talk about their work to a general audience,” Graduate School Dean Peter Salovey said. “The goal is to break down barriers of specialization. Yale is a rich institute of phenomenally good speakers who don’t usually get to talk to general, intelligent audiences.”

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