The greatest known plague in human history was the Black Death. A
colossal outbreak began in Constantinople in 1334, and it spread rapidly
throughout Europe (returning Crusaders were a factor). In as little as 20
years the Black Death is estimated to have killed — a prodigious thought —
as much as three quarters of the population of both Europe and Asia. This is
the sort of thing we have to look forward to.

The latest global survey of our current epidemic, published last week by
the United Nations Agency dealing with AIDS, estimated that one third or
more of all the 15-year olds in the worst affected countries are destined to
die even if infection rates miraculously drop. And this — a distinction
from the past — applies now to girls as well as boys, particularly in
sub-Saharan Africa.

It must be kept in mind that AIDS can’t be dealt with in Zimbabwe (or
Haiti) as it is dealt with in New York or San Francisco. Free distribution
of condoms and free needles will not do the trick, nor will either lectures
in schools or alarming articles in the press. Much of the Third World, which
is at risk, simply cannot read. Furthermore most of the Third World doesn’t
even know it has the disease because it has never been tested. Nor will it
be tested because it cannot afford the drugs required.

Therefore, as can be seen, AIDS is the medical enigma of the age.
Meaningless figures have been hurled about. $2 billion a year for
sub-Saharan Africa has been mentioned, of which only the smallest fraction
of the money has been committed. But that seems like a bad joke in view of
the scope of this disease — particularly considering the fact that $2
billion is only for prevention. When we try to calculate the cost of
medical care, we are in deep trouble. As for an “AIDS cocktail” of
anti-retroviral drugs it is almost useless because these therapies must be
closely supervised.

And now for price. In addition to care, the cocktail will cost $1,400 per
year for each illiterate African peasant. (It would come to almost 10 times
this figure for an American peasant.) To reach this bargain basement price
drug companies would have to either cut their prices by 90 percent or import
drugs from Brazil, India, or other countries that consider patents so much
tissue paper.

If all this could be contrived by 2005 the cost could be worked down to a
mere $1.7 billion a year: For which we would get the cheapest care for the
dying, 40 percent of expenses for all those infected, and AIDS cocktails for
10 percent of those exposed. If the drugs become more expensive, or the
coverage rate is increasd, costs will increase proportionately.

No one even dares calculate what it would cost to give Africans and
Asians the kind of health care that Americans receive. It would run into the
hundreds of billions.

To sum up: The world is inhabited at present by 34 million people with
HIV infections. A minimum of at least 30 million of these people are poor.
And I mean really poor — living on less than two dollars a day.

The world’s health specialists rarely, if ever speak of this, but a
knowledgeable expert recently said that the world is at present carrying an
overload of 30 million people, an overload which somehow or other must be
“written off.”

Writing off is a term from accounting. How do you “write off” 30 million
people? Millions were written off during the Middle Ages, by flood, famine,
the Crusades, religious war, imperial wars and, in modern times, by
political purges. But we are more civilized and humane now. Aren’t we? Or
aren’t we? Keep your head down. Grim times might be coming.

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