Prof Bartholomew warns: AIDS could decimate large portion of mankind

UNITED States basketball superstar Earvin “Magic” Johnson is scheduled to visit Trinidad and Tobago in May next year. This was revealed by Prof Courtenay Bartholomew yesterday in an address at UWI marking World Aids Day. The occasion was the Gala Enterprises Presentation of “AIDS 03 Stigma and Discrimination.”

In his candid address on the AIDS pandemic, Prof Bartholomew strongly condemned the promiscuity and degeneration in moral standards which is responsible for the world wide spread of the disease. In his conclusion he announced the coming visit of Johnson who is HIV positive and “a great crusader for lifestyle change.” “He has become a popular evangelist in this respect, and what it may take the National AIDS Programme and the Medical Research Foundation years to achieve, he might be able to do in one visit,” Prof Bartholomew said.

The following is the full text of  Prof Bartholomew’s speech.

Sexually-transmitted diseases have been with us since time immemorial. In the 15th century, for example, syphilis was rampant in many parts of the world. It is recorded that in London’s St Bartholomew’s Hospital (and I am not choosing that particular hospital to advertise myself) seldom was there less than 15 out of every 20 admissions for syphilis. A third of the citizens of Paris were also said to have been affected with syphilis in the 15th and 16th centuries and, on the other side of the world, in the America of 1914, it was estimated that over half the male population had gonorrhea at one time or the other.

There is also nothing new about the present-day superstition in some parts of Africa because there was also a time in the 1800s when there was a growing demand for virgin prostitutes because there was a myth that intercourse with a virgin would affect a cure for venereal diseases. And so, there is nothing new under the sun nor between the bed sheets. The AIDS virus has passaged over time from chimpanzees to man and has flourished because there was a suitable and ideal culture medium for its growth. But whereas syphilis, for example, was spread from continent to continent via sailing vessels and “slow boats to China” and elsewhere, the AIDS virus quickly spread from country to country and continent to continent via the airline industry, sometimes even by Concorde!

Now, when AIDS was first reported in 1981, it was thought to be a homosexual scourge. We now know that the AIDS pandemic is not because of homosexuality. Neither is it because of heterosexual intercourse. It is a result of promiscuous sexual behaviour, be it homosexual or heterosexual. Today’s sexual revolution can probably be said to have started in the ‘60s with the advent of the contraceptive pill. Condoms, of course, had an earlier history. It was the 16th century great Italian anatomist Fallopius, who described the anatomy of the fallopian tube, who invented the condom as a protection against syphilis, not conception. It was only in the 18th century that it began to be used as a contraceptive. At that time condoms were usually made from sheep gut, sometimes from fish skin, (and stocked and sold in brothels as well as by a few wholesalers.)

The poet Decimus Junius Juvenalis better known as “Juvenal” (c 50 to 130 AD) wrote that chastity was a virtue that had scarcely been seen in Rome at that time. However, we are witnessing in today’s world a level and scale of promiscuity and sexual deviation as perhaps never before recorded in human history. Sub-Saharan Africa has the largest number of AIDS cases in the world, affecting mainly the poor, and in some cities civil servants are allowed to attend no more than two funerals a week and the coffin-making industry is big business. However, as a country, India has the highest number of HIV/AIDS cases, guesstimated to be about ten million. It is said that in Bombay (Mumbai) alone, there are almost one million prostitutes.

But you may well ask what is the link between poverty and AIDS? Excuse me if I repeatedly quote the ancient bards, but I do so if only to show that today’s philosophers are no wiser than the sages of old, if not much less so, and that nothing is really new. So said, as far back as the fifth century AD, the poet Juventus had said: “It is not easy for men to rise whose qualities are thwarted by poverty.” Indeed, the malady which brings the greatest distress to mankind is the plague of poverty. Aristophanes a Greek philosopher around 380 BC, also said at that time: “Poverty is the sister of beggary.” In short, poverty makes one a victim of so many ills, exploitations and deprivations, one of which is also a good education. But there are other “P” factors besides poverty and promiscuity which fuel today’s AIDS pandemic. There are the permissive societies which condone the distribution and sale of pornography. There are the sexually inappropriate columns in the press, especially unsuitable for the eyes of children, eg that of “Dr Ruth” and some other young local precocious columnists. There is the television, particularly cable television, and now also the Internet. In fact, it is estimated that there are over one million porn sites and chat rooms on the Internet, which children find easy to access under their parents’ unwatchful eyes. And so, there is yet another P factor which stands for so many parents who no longer parent, nor are they concerned or curious about the whereabouts of their children, who leave home around midnight “to party.”

Indeed, we have a cultural preoccupation, almost obsessive, with partying and Carnival in this country, the latter being the high point of the year for some. In fact, it can truly be said today that the Carnival really starts on Ash Wednesday, is officially launched at the sacrilegious pyjama parties on Christmas night, which are patronised by hundreds of so-called Christians and pseudo-Christians (am I now in for a law suit?). It all then comes to a climax on Carnival Monday and Tuesday with, unlike the days of yore when we were fully-clad, a progressive vulgarity and the monotonous and un-innovatory bra and panty designs, the latter fast approaching the thickness of dental floss — all to satisfy the vanity of today’s women. And then there is the loud and frenzied wine and jam music with its sometimes crude and pelvic-oriented lyrics, only outmatched in boorish inanity by many witless chutney verses. Moreover, there is no longer any Lenten restraint. It is now a whole-year preoccupation and preparation, which then starts all over again from the following Ash Wednesday. Strangely, very strangely, many of us apparently do no seem to realise, or shall we say, admit that all this is seriously shaping human sexual behaviour in this island, including a disrespect of and lust for women and the resultant rape epidemic, only a tip of which is reported in the press. We at the Medical Research Centre see them almost daily. And yet, some surprisingly are still wondering why there is such a high prevalence of HIV/AIDS in Trinidad and Tobago! But, there are probably more people who are HIV positive and do not know it than are those who are reported to be HIV positive.

Medically speaking, we are what we eat. We are also what we see, hear and read, and so, if the media of whatever type, print or electronic, are creating us into what we are today, who then bears the greater blame and sin, those who control the media or their readers? Unfortunately, no amount of anti-sex campaigns could match the financial investment and extent of the promotion of worldwide pornography and licentious advertisements. But back to Africa. Have you also noticed, those of you who are cricket fans, the scarcity of crowds who watch the series in Zimbabwe? Zimbabwe has the second highest prevalence rate of HIV/AIDS in sub-Saharan Africa. The HIV prevalence among their pregnant women is 40 percent and 50 percent of all patients in Zimbabwe’s hospital wards are infected with HIV. While there are 250,000 AIDS orphans in the Caribbean, there are close to one million in Zimbabwe. And so, the concrete stands are fairly empty for the cricket. It is partly due to poverty and AIDS. One would expect that under the circumstances, including its unsavoury politics, it should be quite a demoralised society and yet Zimbabwe has still been able to defeat Brian Lara’s team. Nuff said!

Meanwhile in Trinidad and Tobago, it is reported that there are over 4,000 cases of AIDS in these islands and I can assure you that this is a gross underestimation of the guesstimate. We do know, however, that many more females are infected than males, and so, theoretically and paradoxically, the rapists stand a fair chance of being infected by the women they rape! Do you also believe that the indiscipline in many or our schools, the extraordinarily high failure rate in English and Mathematics and the violence in our society, which has now extended into the schools, are totally disconnected with our HIV/AIDS epidemic? They are all part of the progressive degeneration of our values. Now, in the early days of the AIDS pandemic, people were so scared that many curbed their promiscuous lifestyles. However, after a few years and particularly with the advent of antiretroviral drugs, it is business as usual. Because of pressure, mainly from South Africa, it is now “patients before patents” and not “patents before patients” as it was before, and cheaper drugs are now available to the developing world.

I do, however, wish to give this warning, not only to Trinidad and Tobago but to the world at large. It is that whereas these drugs are prolonging the lives of many, albeit not all, we do not know for how many years one can continue taking them without eventual long term and serious toxic effects. Moreover, it is not commonly known that in the best centres of HIV/AIDS treatment and care in the United States, the stage has now been reached where between 35 and 65 percent of HIV-infected patients have developed resistance to all the antiretroviral drugs available to date! As I have written in the British Medical Journal recently, unless the physical and laboratory infrastructure is in place in the developing world, unless there is a medical expertise and full-time devoted staff to HIV/AIDS and their treatment, and unless patients adhere and religiously comply with their treatment schedule, a drug resistant strain of virus will soon emerge in the Third World which will decimate a large portion of mankind. Let us also hope that that resistant virus will not also be a more virulent one with a shorter incubation period from infection to disease.

Many of us have learnt the lesson of the virus but too many are still literally prepared to die for sex and die they will. Meanwhile, the solution is said to be the condom. But in spite of all this condomania, six million new infections have occurred in 1998 and the same number in 1999, 2000, 2001 and 2002 — six million. The answer to the pandemic is also said to be “safe sex.” However, Archbishop Edward Gilbert once expressed his religiously mature view about “safe sex” when he remarked: “It is not the responsibility of the Church to teach how to sin with a greater degree of safety!” At the Medical Research Foundation the word “stigma” is not part of our lexicon. Ours is a calling to save and prolong the lives of those who are affected with HIV/AIDS and it is our aim to have the best treatment centre in the Caribbean. We have seen 1,300 patients to date. There have been many changes of lifestyle but, unfortunately, there are also many, who in spite of being lucky to be on treatment free of charge through the largesse of the government (including the expensive cost of laboratory investigations and viral load equipment which will soon be purchased by the Ministry of Health), continue their same promiscuous lifestyle. Regrettably, we have also discovered that there are a few people who are infected with HIV, know it and do not inform their sexual partners for various reasons; one is fear, one is due to ignorance, but another is deliberate.

The latter is particularly disturbing and the law will have to do something about the deliberate transmission of HIV to an unsuspecting sexual partner. In this respect the Law Reform Commission, under the chairmanship of Justice G.L. Persaud, has been consulting me re the criminalisation of the intentional exposure of another to infection with HIV. England has just done it for the first time last month. A Kenyan was sent to jail for eight years for infecting his sexual partner without informing her of his known HIV status. She is now on antiretroviral drugs. What then should be the sentence for one whose uninformed sexual partner has actually died? There is also talk about sex education in schools but the question is who will be the sex educators and what will they teach? In other words, who will be the guardians of our children’s sexual education and what are their qualifications, religious backgrounds and beliefs? Once more, as Juventus once said: “Who is to guard the guards themselves?” As far as I am concerned, there is only one thing that needs to be taught to children in schools — chastity, old-fashioned chastity, period. It is as simple, brief and restrictive as that! One thing is certain and it is that religion must be brought back into the schools to counteract the gospel of promiscuity which is being fed to us and to our little children through the media and cyberspace. As the old Negro spiritual said, the country is “standing in the need of prayer.” No amount of quilts, condoms and commemorative stamps on World AIDS Day are going to “stamp” out this pandemic unless we address the root causes — poverty, permissiveness, promiscuity, prostitution, pornography and parental palsy. But the question is how can this be done in so-called democratic societies with a similarly so-called freedom of the press?

Sex was devised by the Creator to create and propagate life. Today it is being used for the propagation of death. Perhaps the Creator will have to intervene as He has sometimes done in the past. On one occasion it took Him 40 days before we had to start all over again. Let’s hope not, but a drug resistant virus might well do the trick. Who knows? In the meantime, we at the Medical Research Centre will be doing our best to delay any drug resistant HIV strain in Trinidad and Tobago while at the same time continuing to try to change the behaviour of our patients. Finally, as a consequence of his past experience, Leon “Magic” Johnson is now a great crusader for lifestyle change. He has become a popular evangelist in this respect, and what it may take the National AIDS Programme and the Medical Research Foundation years to achieve, he might be able to do in one visit. With the assistance of my friend and a great friend of Mr Johnson, Dr Beny J Primm Executive Director of the Addiction Research and Treatment Corporation of Brooklyn, New York, “Magic” is scheduled to visit Trinidad in May next year. With this good news I now end my talk and I thank you for inviting me to speak to you today.