Addressing Future Epidemics: Historical Human Rights Lessons from the AIDS Pandemic

Main Article Content

Ambar Mehta
Thomas C. Quinn

Abstract

Introduction: The Ebola epidemic in West Africa sparked many ethical and polarizing public health questions on how to adequately control transmission of the virus. These deliberations had and will continue to influence patients, healthcare workers, public perceptions of disease, and governmental responses. Such extensive and potential ramifications warranted an analysis of prior epidemics to sufficiently inform policy makers and prepare them and other authorities for future epidemics. We analyzed how the general public, medical institutions, federal government, and patients themselves responded during the early stages of the AIDS pandemic in two different countries and cultures, the United States and India.


Discussion: Our analysis identified four key findings pertaining to the human rights of patients and healthcare workers and to the crucial roles of the government and medical community. The first demands that authoritative officials acknowledge the presence of high-risk behaviors and properly educate the public without stigmatizing groups of individuals. For this task, the medical community and federal government must form and display to the public a respectful and collaborative partnership towards battling the epidemic. These two synergistic endeavors will then allow appropriate officials to implement effective, yet civil, interventions for limiting transmission. Finally, the same officials must ensure that their interventions maintain the human rights of high-risk populations and of healthcare workers.


Conclusions: Applying these findings to future epidemics of infectious diseases can aid policy makers in navigating complicated ethical and public health questions, and help prevent them from repeating past mistakes in handling epidemics.

Downloads

Download data is not yet available.

Article Details

Section
Articles

References

Hodge JG. Global and Domestic Legal Preparedness and Response: 2014 Ebola Outbreak. Disaster Medicine and Public Health Preparedness. 2015;9.

Roberts D. US imposes Ebola travel restrictions on passengers from west Africa [Internet]. The Gaurdian; 2014 Oct 21. Available from: http://www.theguardian.com/us-news/2014/oct/21/us-limited-ebola-travel-restrictions-west-africa

Gonsalves G, Staley P. Panic, paranoia, and public health—the AIDS epidemic’s lessons for Ebola. N Engl J Med. 2014 Dec 18;371(25):2348-9. PubMed PMID: 25372947. doi: 10.1056/NEJMp1413425

Heitz D. How Ebola Is (and Is Not) Like HIV/AIDS [Internet]. Healthline News; 2014 Oct 14. Available from: http://www.healthline.com/health-news/how-ebola-is-and-is-not-like-aids-101414

Servick K, Cohen J. How does Ebola spread? Hard facts from key studies. Science Insider; 2014 Oct 23. Available from: http://www.sciencemag.org/news/2014/10/how-does-ebola-spread-hard-facts-key-studies

Petrow S. Why ‘Fearbola’ reminds me of the early AIDS panic. The Washington Post [Internet]. 2014 Oct 15. Available from: https://www.washingtonpost.com/national/health-science/ebola-a-growing-epidemic-of-fear-eerily-like-the-early-years-of-the-age-of-aids/2014/10/15/5781f1fe-5479-11e4-809b-8cc0a295c773_story.html

Centers for Disease Control. Pneumocystis pneumonia—Los Angeles. MMWR Morb Mortal Wkly Rep. 1981 Jun 5;30(21):250-2. PubMed PMID: 6265753.

Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, Ballard H, William DC, Laubenstein LJ. Kaposi’s sarcoma in homosexual men—a report of eight cases. Lancet. 1981 Sep 19;2(8247):598-600. PubMed PMID: 6116083.

Herek GM, Glunt EK. An epidemic of stigma. Public reactions to AIDS. Am Psychol. 1988 Nov;43(11):886-91. PubMed PMID: 3063145.

Altman LK. New Homosexual Disorder Worries Health Officials. New York Times [Internet]. 1982 May 11. Available from: http://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html?pagewanted=all

Centers for Disease Control and Prevention. Prevention of acquired immune deficiency syndrome (AIDS): report of inter-agency recommendations. MMWR Morb Mortal Wkly Rep. 1983;32(8):101-3.

Evatt BL. The tragic history of AIDS in the hemophilia population, 1982-1984. J Thromb Haemost. 2006 Nov;4(11):2295-301. PubMed PMID: 16972935. doi: 10.1111/j.1538-7836.2006.02213.x

Mason PJ, Olson RA, Parish KL. AIDS, hemophilia, and prevention efforts within a comprehensive care program. Am Psychol. 1988 Nov;43(11):971-6. PubMed PMID: 3063150.

Dunlap MC. AIDS and discrimination in the United States: reflections on the nature of prejudice in a virus. Villanova Law Rev. 1989 Sep;34(5):909-32. PubMed PMID: 11651165.

Services USDoHaH. Who Was Ryan White? [cited 2015 20 December]. Available from: http://hab.hrsa.gov/abouthab/ryanwhite.html

Price V, Hsu ML. Public opinion about AIDS policies. The role of misinformation and attitudes toward homosexuals. Public Opin Q. 1992 Spring;56(1):29-52. PubMed PMID: 10118053.

Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991-1999. Am J Public Health. 2002 Mar;92(3):371-7. PubMed PMID: 11867313. PubMed Central PMCID: 1447082.

Brandt AM. AIDS in historical perspective: four lessons from the history of sexually transmitted diseases. Am J Public Health. 1988 Apr;78(4):367-71. PubMed PMID: 3279834. PubMed Central PMCID: 1349361.

Hansen H, Groce NE. From quarantine to condoms: shifting policies and problems of HIV control in Cuba. Med Anthropol. 2001;19(3):259-92. PubMed PMID: 11341180. doi: 10.1080/01459740.2001.9966178

Perez-Stable EJ. Cuba’s response to the HIV epidemic. Am J Public Health. 1991 May;81(5):563-7. PubMed PMID: 2014854. PubMed Central PMCID: 1405068.

The President’s News Conference—September 17, 1985. 1985. Transcript available from: https://reaganlibrary.archives.gov/archives/speeches/1985/91785c.htm

Barker G. Frontline: The Age of AIDS [motion picture]. WGBH-TV. Boston (MA): Frontline: 2006, 240 min. Available from: http://www.pbs.org/wgbh/pages/frontline/aids/view/

Petro A. Koop’s Crusade: The surgeon general made public health a divine commandment. Slate; 2013 Feb 27. Available from: http://www.slate.com/articles/health_and_science/medical_examiner/2013/02/c_everett_koop_and_aids_he_defied_and_collaborated_with_the_religious_right.html

Koop CE. Surgeon General’s report on acquired immune deficiency syndrome. JAMA. 1986 Nov 28;256(20):2783-9. PubMed PMID: 3773188.

Piot P, Quinn TC, Taelman H, Feinsod FM, Minlangu KB, Wobin O, Mbendi N, Mazebo P, Ndangi K, Stevens W, et al. Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet. 1984 Jul 14;2(8394):65-9. PubMed PMID: 6146009.

Gould RE. Reassessing news about AIDS: A doctor tells you why you may not be at risk. Cosmopolitan. 1988 January 1;(204):146-147.

Brandt AM. How AIDS invented global health. N Engl J Med. 2013 Jun 6;368(23):2149-52. PubMed PMID: 23738542. doi: 10.1056/NEJMp1305297

Centers for Disease Control. First 100,000 cases of acquired immunodeficiency syndrome—United States. MMWR Morb Mortal Wkly Rep. 1989 Aug 18;38(32):561-3. PubMed PMID: 2503696.

Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S. Ebola 2014—new challenges, new global response and responsibility. N Engl J Med. 2014 Sep 25;371(13):1177-80. PubMed PMID: 25140858. doi: 10.1056/NEJMp1409903

National HIV/AIDS Strategy. Office of National AIDS Policy. 2010. Available from: https://www.whitehouse.gov/administration/eop/onap/nhas

Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2012. HIV Surveillance Supplemental Report 2014;19(No. 3). Available from: http://www.cdc.gov/hiv/pdf/surveillance_report_vol_19_no_3.pdf

Solomon S. Interview by: Mehta A, editor. 2014 Sep 8.

Rewari BB, The Association of Physicians of India. Medicine Update 2013. Chapter 14: HIV/AIDS in India: Journey So Far and the Road Ahead. 2013. Available from: http://www.apiindia.org/medicine_update_2013/chap14.pdf

Bharat S, Aggleton P, Tyrer P. India: HIV and AIDS-related Discrimination, Stigmatization and Denial. 2001. Available from: http://data.unaids.org/publications/irc-pub02/jc587-india_en.pdf

Mawar N, Saha S, Pandit A, Mahajan U. The third phase of HIV pandemic: social consequences of HIV/AIDS stigma & discrimination & future needs. Indian J Med Res. 2005 Dec;122(6):471-84. PubMed PMID: 16517997.

Quinn TC. Interview by: Victoria Harden DS, Caroline Hannaway, editor. National Library of Medicine. 1996 Dec 5.

Ramanathan G. Stamp out AIDS? Forget it, stamp the victims instead! The Sunday Observer, pg 3. Mumbai, India. 1998 Feb 17.

Public Health Aspects of HIV/AIDS in Low and Middle Income Countries—Epidemiology, Prevention and Care. David D. Celentano CB, editor. New York, NY: Springer New York; 2009.

Harris G. India’s Supreme Court Restores an 1861 Law Banning Gay Sex. The New York Times. 2013 Dec 11. Available from: http://www.nytimes.com/2013/12/12/world/asia/court-restores-indias-ban-on-gay-sex.html

Bhowmick N. Homosexuality is Criminal Again as India’s Top Court Reinstates Ban [Internet]. TIME–India. 2013 Dec 11. Available from: http://world.time.com/2013/12/11/homosexuality-is-criminal-again-as-indias-top-court-reinstates-ban/

Ministry of Health and Family Welfare GoI. NACO Annual Report 2013-14.

UNAIDS. HIV and AIDS estimates. 2012. Available from: http://www.unaids.org/sites/default/files/media_asset/20121120_UNAIDS_Global_Report_2012_with_annexes_en_1.pdf

Luckerson V. Fear, Misinformation, and Social Media Complicate Ebola Fight. TIME. 2014 Oct 4. Available from: http://time.com/3479254/ebola-social-media/

Prevention CfDCa. 2014 Ebola Outbreak in West Africa. 2015. Available from: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/