Acquired Immunodeficiency Syndrome (AIDS)

 

AIDS is the physical condition of malaise leading to death that occurs as a consequence of an attack on a human being's immune system by the human immunodeficiency virus (HIV). Its origin remains obscure, but it seems to have bridged the gap of space and culture from West Africa to the developed states in the late 1970s. One plausible explanation is that it was the result of the transfer to human beings of a retrovirus previously found in monkeys, through the use of hypodermic needles that were employed to inject monkey blood and plasma into human beings as part of a cultural ritual. This theory of origin, if true, places AIDS among those other diseases with a technological component, such as toxic shock syndrome (caused by the superabsorbency of a tampon) and Lyme disease (caused by the changing ecology of suburban growth, reforestation, and the altered demographics of deer populations), the Hanta virus, the zebra mussel contamination in the Great Lakes, and the discovery of radon in homes.

Other infectious diseases have exposed residents of the temperate zones to tropical infections owing to increased travel in both regions, the global sources of the food supply, and the ever-increasing number of human hosts within which viruses may proliferate. Whatever its origin, AIDS has been widely spread among heterosexuals in the developed world by the use of hypodermics, and by sexual practices among both heterosexuals, mainly in underdeveloped states, and homosexuals in all states.

Its disconcerting nature has to do with at least three factors: first, such epidemics were widely believed to have been relegated to the past by modern antibiotics; second, AIDS has been invariably fatal, striking the young and otherwise healthy with a grim inexorability; third, although AIDS has been largely confined to groups that, for differing reasons, can be marginalized from the mainstream culture of the developed states, yet it has the potential to overwhelm the populations of those mainstream cultures. AIDS is now the leading cause of death among Americans under the age of twenty-one.

In 1976, the historian William McNeill, writing about the role of plagues in the past, presciently observed that

it now requires an act of imagination to understand what infectious disease formerly meant to humankind, or even to our grandfathers. Yet as is to be expected when human beings learn new ways of tampering with complex ecological relationships, the control over microparasites that medical research has achieved since the 1880s has also created a number of unexpected byproducts and new crises.39

 

Thus AIDS is probably not the last of such disconcerting diseases. Unexpected outcomes of recombinant DNA activities, toxins developed for the purposes of biological warfare, obscure parasites sprung from their remote geographical niches, or even familiar viruses that have developed strains resistant to modern antibiotics are all candidates for the plagues of the twenty-first century. They pose a unique challenge for the society of market-states, as threatening in its way as the challenge posed to Christian faith by the bubonic plagues of Europe because developments in molecular biology—fueled by abundant investment made possible by the financial liberalizations of the market-state—have given many persons a faith in technology and in its ability to grant something like immortality to human beings.

The society of market-states will have to confront its fundamental ordering principle, the market, at a juncture where the market works poorly, the decision to whom to give life-saving medical care. If each state decides on its own, in the manner of current states, then some persons will be excluded from care because they are not members of the preferred groups of recipients, while others will be excluded for lack of personal or institutional resources. If, on the other hand, some multinational market is set up, then the wealthy from one country will sop up the health resources of others, as in the example of richer persons buying kidneys and other organs from impoverished donors.40

The encouraging fact is that a society of market-states will be better prepared to evaluate, analyze, and treat such diseases because it will most efficiently allocate resources to the task and have a worldwide charter to do so. The mere fact of a state boundary will not stand in the way of ad hoc groups, authorized by the society of such states, who act to protect the world from an apocalyptic pestilence. But this too will test the legitimacy of that system, as it assumes authority—by what right?—that the peoples of the world have not given it by any recognizable plebiscite, or other method approved by the nation-state. Moreover, actions by a society of market-states will inevitably bring the values of the market to bear—espe-cially pricing—on goods (such as life itself) that we have tried to treat as priceless.*