| As Brazil breaks the international patent laws to manufacture and distribute nelfinavir in violation of intellectual property laws, and as the various kleptoctracies of sub-Saharan Africa do much that is similar with various of the nucleoside analogue reverse transcriptase inhibitors (NRTIs), there is a public health risk which can and inevitably will impact upon the treatment of HIV infection in these United States and in the rest of what the "Liberal" idiots call the "developed world."
HIV is a slippery little bastard, subject to resistance mutations in the presence of ARV agents. In most cases (despite noise about "structured treatment interruptions"), the inconsistent use of the available ARV drugs results in suboptimal suppression of viral proliferation *and* the development of such mutations. These mutant viruses can then be passed along to other people (and sexual transmission is more likely with those strains of HIV commonly seen in sub-Saharan Africa), resulting in populations of newly-infected people whose pathogens are *not* treatment-naive and therefore *not* susceptible to the available ARV drugs -- most particularly those NRTIs which the miserable damned fools in the sub-Saharan governments have stolen and are using promiscuously and inappropriately.
The parsimonious employment of ARV "wonder drugs" is not fostered because the pharmaceutical companies are greedy, but because the limited number of such drugs -- which come in only three categories: protease inhibitors (PIs) like nelfinavir, NRTIs, and *non*-nucleoside reverse transcriptase inhibitors (NNRTIs). Once there exist broadly distributed and easily transmissible subspecies of HIV which retain mutations conferring multiple-drug resistance capabilities, these drugs lose most of their therapeutic effectiveness, and the advances we have fought hard to achieve over the course of the past several decades go right up in smoke.
The ARV drugs give us nothing in the way of a real "magic bullet." With their judicious use, we can control but not cure HIV infection, and there are dreadful adverse effects attending their employment. The best strategy for managing AIDS in Africa must employ public health measures which contain the spread of HIV infection, and this requires a level of education and individual self-government which is entirely inconsistent with the continued existence of the aforementioned kleptocracies which serve the polities of Africa in lieu of legitimate governments.
In other words, either the silly bastards abandon the cultural baggage of superstition, unreason, "strong man" thuggery, tribalism, and institutionalized stupidity, AIDS is going to continue sweeping through their populations like a bibilical plague, providing the whole world with a lesson on how irrationality and refusal to use your brain for purposes other than deadening the echoes between your ears *will* get you killed. |
