Distinguished Visiting Practitoner
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Epidemiologist Examines Approaches to AIDS Fight
|Brian Williams of the World Health Organization catalogs the history of infectious diseases during his talk on “Fighting AIDS in Africa: Public Health vs. Human Rights.”|
February 17, 2009
In a keynote address during a residency at Brandeis last week, World Health Organization epidemiologist Brian Williams argued that in the delicate balance between human rights and public health in the battle against AIDS, the pendulum may have swung too far in one direction.
"We've been too concerned about individual human rights,” he said.
The third annual Distinguished Visiting Practitioner of the International Center for Ethics, Justice, and Public Life, Williams has worked in the StopTB Department of the World Health Organization in Geneva for the past five years. His primary interest is in the epidemiology and control of tuberculosis, especially in Africa and in places where there is a high burden of HIV infection. During the week, he spoke to Brandeis’s African Forum about HIV/AIDS, to a Heller School class on global infectious diseases, and visited with students about his career in public health. The Brandeis Chemistry Department, with lead faculty member Irv Epstein, co-hosted the visit, which culminated with the keynote address on February 12 titled “Fighting AIDS in Africa: Public Health vs. Human Rights.”
After cataloging previous pandemics such as the Black Death, smallpox, and measles that killed millions of people, Williams said: “The whole history of our species is actually a history of the struggle against disease. HIV is only the latest.” He cited the “almost unimaginably high rates of infection” of HIV/AIDS in southern Africa and critiqued the government of his native South Africa for its failure to act to stem transmissions (the former president of the country, Thabo Mbeki, even denied that the HIV virus existed, Williams said). But he contended that the rest of the world hasn’t done much better when it comes to defining the disease as a public health emergency.
Arguing that HIV is treated in a different way than other diseases, he quipped: “If someone walked into this meeting with the Ebola virus, you wouldn’t say they had a human right to be here,” he said.
People are committed and money is available to fight AIDS, he said, yet the rate of infection has not decreased after 25 years of the epidemic. He pointed to measures that could greatly reduce the spread of the disease, such as male circumcision. While some object to circumcision on individual rights grounds, the procedure could save millions of lives, according to Williams.
“Everybody is terrified of imposing anything on anybody else,” he said. “We have to balance the human rights issues with the public health issues.”
Williams also argued that testing people once a year in places with high infection rates and then providing free anti-retroviral drugs for life for those who are HIV-positive would cut transmission rates ten-fold and control the spread of the virus. (Click here to read a summary of an article on the subject he recently co-wrote for The Lancet medical journal.)
Yet he also acknowledged that “the arguments are never straightforward or easy” when considering the balance between human rights and public health. Indeed, he highlighted the importance of adhering to human rights standards, citing past medical trials like the Tuskegee syphilis study that left infected African-American men untreated.
“You have to be constantly aware and conscious of rights of individuals when you do these trials,” he said. “You lose sight of the fact that you’re dealing with real people.”
He concluded his talk by showing a short video of some of those real people, miners ands sex workers in South Africa who participated in a project Williams directed to find ways to reduce transmission of HIV. “These are the people you’re dealing with in this work,” he said, “and it’s very easy to forget them.”
Brian Williams speaks with students during his Distinguished Visiting Practitioner residency at Brandeis..