From Free Life, Issue 17, January
ISSN: 0260 5112
The Politics of AIDS
In April 1990 I was appointed the Administrator of a north London charity which was establishing a clinic for the treatment of HIV sufferers. My appointment followed a competitive and equal opportunities vetted selection process, and my salary and the funding for the project was provided by a variety of local and national health bodies as well as by private charities.
Within weeks of taking up my post, I realised that while the standard of patient care was absolutely splendid, this was not the paramount consideration when it came to deciding how to spend money.
For example, the contractors had laid the wrong colour carpet in my office. I was compelled to obtain an estimate for its replacement with the "right" colour. The Directors of the charity paid #750 for this cosmetic adjustment.
At the same time, I was arguing with the local hospital about the provision of blood infusion kits for treating patients at home. These were rationed by our monopoly NHS, and cost I think about #18.50.
Patient care was rationed, but it was nothing that our carpeting and other soft furnishings had already cost #16,500, and were about to cost another #7.50. I do not know if my office has since been recarpeted again.
It happens that male homosexuals are the group most affected in the West by AIDS. The prominence which gay men have achieved thorugh their talents in the media - as editors of newspapers, as directors of opera and ballet companies, as television news journalists, and so forth - ensures that any issue affecting them becomes a public issue. This was especially the case with AIDS. It went to the top of the health agenda. It has frequently been described as the number one health threat to the nation, and sometimes, when people are really grasping for hyperbole, as a threat to the very continuance of Western civilisation.
I order to place things in perspective, we need to recall that by the end of 1991, there had been 5,451 reported cases of AIDS, of which 3,391 had so far proved fatal. This fact is opposed to the 200,000 deaths every year from heart disease. Government spending on AIDS, however, does not reflect the condition's priority as a health problem. It reflects the political clout of the groups involved. AIDS is the perfect illustration of public choice theory in economics. In a democracy, the government will always find it easier to buy off the opposition of highly orgaised and vocal groups than to stand up to their demands for special allocations of public resources.
To see this, compare these levels of public expenditure on health education and research regarding specific conditions:
* In 1989, the Government spent about #50 per person who died of heart disease.
* In the same year, it spent about #290,000 per person who died of AIDS.
Please note tht these calculations do not include costs of treatment. Clearly, sick people must be treated, but the need for so much health education, in particular, is highly questionable. Health education in general is a dubious area of public expenditure. There is no evidence that the vast sums spent to warn young people of the dangers of alcohol, smoking and drug abuse have had any effect at all.
However in the case of AIDS, the monitoring of expenditure has been even more lax then usual in health education, because a lot of money has been wasted on the provision of facilities where one are required, or the provision of facilities that could not by any stretch of the imagination be described as health education.
For example, AIDS is the only medical condition for which every health authority in the country is expected to take on a prevention officer. The idea of employing such a person in, say Devon or Cornwall - where almost no cases have been reported - is manifestly absurd.
Furthermore, it is no secret that a number of the groups receiving funds for what is called health education are in fact using their new status as Government-approved and publicly funded bodies to promote a homosexual political agenda. To look only at the most notorious case, in an expose of the Terence Higgins Trust in August 1990, Oliver Gillie wrote in The Independent of an organisation rent with political discord and pursuing political correctness at the expense of medical accuracy, and sometimes of common sense.
Again, a highly successful appeal set up to benefit Romanian orphans afflicted with AIDS, which had raised #200,000, was closed down by the Trust because it was said to be distracting attention from gay men. Edmund Preston, former Chairman of the Trust's communications group, said:
The Trust is a gay cultural ghetto with a lot of trendy lefties. You aren't accepted unless you wear the right kind of T-shirt.
Again, six members of the Trust's drug education group resigned, led by spokeswoman Radhe Bentley, who said:
I wish the Trust would have the nerve to say "We are an organisation for gay men, everyone else forget it". I found the Trust to be hetero-phobic and woman-phobic.
In spite of all this, and in spite of further problems - in accounting for funds and in holding on senior members of staff - the Terrence Higgins Trust continues to be regarded by the Government as the leading voluntary organisation working in the field of AIDS, and is still regarded as deserving its annual grant from the public purse of nearly #500,000.
I might also mention here the scandal which surrounded the collapse of the AIDS conference "Frontliners", which went bust owing thousands of Pounds, much of it unaccounted for. Enquiries revealed that large sums had been spent on building work for a new headquarters, for which the contract had never been competitively tendered: it had been awarded to a gay building company which subsequently went into liquidation.
Like the Terrence Higgins Trust, Frontliners enjoyed the confidence and massive support from officials at the Department of Health and from local authorities throughout the country.
The architects of the gay bureaucracy, which has profited from the perception of AIDS as a significant public health threat, doubtless congratulate themselves on extracting such gigantic sums of the taxpayers' money from a Government which is consistently depicted in the gay press as bigoted, homophobic and oppressive. But there is a price to be paid for the AIDS lobby's sleight of hand.
The shortage of funds within the NHS is a major public concern. It was, for many who were involved in the late general election campaign, one of the critical issues. Since resources within a public monopoly are finite, the consequences of large awards to one section are that another goes without. We know that in sone areas doctors are faced with very hard choices. If there are more patients suffering from renal failure than there are kidney dialysis machines, it may mean that doctors have to make decisions of life or death in allocating the available resources. The spectacle of vast sums spent on the maintenance of AIDS bureaucrats is guaranteed to infuriate the rest of the population.
So what can be done to bring the response to AIDS back into the realms of common sense? The first thing is to aim the health educations programmes at those who are principally at risk - that is to say at male homosexuals and bisexuals and intravenous drug- users, and at the sexual partners of those within these groups. Money spent in an attempt to democratise AIDS with slogans like "AIDS doesn't discriminate" is money wasted.
The present nature of research funding - not just for AIDS but for all medical conditions - seems actually set up to postpone the day on which a cure is found. Research scientists who are handed what are virtually open-ended contracts, go on year after year, employing more and more people, repeating that the cure is just around the corner, if only more public funds were available. As they would put themselves out of a job by finding the cure, there is no incentive for them to find one.
On the other hand, a large cash prize, representing the equivalent, for example, of whatever the Government expects to spend on AIDS during the next ten years, would stimulte the sort of hard-headed entrepreneurial approach which would give us a cure in the shortest possible time.
In an article published nearly four years ago, David Horrobin outlined how such a scheme might work. He describes how in 1714, responding to petitions from the Royal and merchant navies, Parliament offered a prize of #20,000 - about #1 million in our own money, compared witht he price of gold - to anyone who could find a means of measuring longitude at sea, thus saving many shipwrecks and lives. Parliament decided that no public funds for such research should be provided, and instead laid down specific and easily understood criteria by which it could be decided who had won the prize. It was won by John Harrison, a Yorkshire clockmaker, who made a chronometer so accurate that almost everyone doubted that it could ever be made. In the event, it was made; and Harrison became a wealthy man. At the same time, the Navy and the City quickly saved far more than #20,000.
Dr Horrobin puts forward a method for this approach to be used for AIDS and other research. Payment would be amde only for practical success. The initial investment for research would come not from Government but form private sources; and it would be for the Government to set the tasks for which it ought to be undertaken. Economists would calculate how much the prize should be in relation to the benefits from a successful practical solution - the estimated value, say, of one or two years' savings from the elimination of the problem.
This approach contrasts with the present system, which simply doles out more and more funding year after year without accurate or understandable measurment of the results. Committees of worthy experts have never achieved the breakthrough which is always just around the corner - or perhaps beyond the next increase in the budget for research. A prize of #20,000 million - equivalent to the expenditure on treatment so far by European and North American countries - would be an amazing incentive.
Dr Horrobin also suggests a graded system of assessing success. A cure would be defined as sucessfully treating 90 per cent of AIDS patients by restoring them to full health and removing the virus from blood and other body fluids.
The principle benefit of such an alternative system would be its avoidance of central control and the bringing of diversity and competition to the search for a solution. If it failed, it would cost nothing. If it succeeded, it would save billions of Pounds. The scientific community would become independent of the Government. Many lives would be saved.
It is interesting that I have been ridiculed and attacked for being openly gay and a Conservative Councillor by those self- appointed leaders, who deny that it is possible to be gay and Conservative. It is only if these claims are challenged by gay people themselves that true freedom for all the citizens of this country can come about.
The election of a Conservative Government for a fourth term has exposed as a total fallacy the premise that liberty can be delivered by the left. It is under a free market government following libertarian policies that meaningful gay rights can be achieved.
1. There are many other instances of waste and inefficiency in the AIDS industry. The proceeds of the late Freddie Mercury's hit single Behemian Rhapsody, totalling #1 million, have been donated to the Terence Higgins Trust. Its Chief Executive, Nick Partridge, says that the money will be spent on a new headquarters. Who really benefits from that?
2. Economic Affairs, January 1988.