AIDS In The US by Dr. Sanjay Gupta (He addresses impact of AIDS on black Americans & lack of funds)

[KittyWampus]

July 30, 2008
AIDS in the US
Posted: 11:05 AM ET
By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

I have logged hundreds of thousands of miles, looking at the burden of AIDS around the world. I have been with the Partners in Health teams in Rwanda and the Clinton Foundation in Kenya. I have seen the work being done in Haiti, to name a few. Today, I would like to draw some comparison with what is happening right here at home.

Yesterday the Black AIDS Institute reported that if African-Americans with HIV/AIDS were their own country, they would make up more HIV/AIDS cases than seven of the countries currently receiving emergency funding for… AIDS. Think about that. There are almost 600,000 African-Americans living with HIV, and there are still 30,000 newly infected cases every year. As things stand now, AIDS remains the leading cause of death among African-American women between the ages of 25 and 34, and the second-leading cause of death among African-American men between 35 and 44 years of age.

As Jesse Milan, board chair of the institute, said, “When the world wasn’t looking, the AIDS epidemic refused to go away.” AIDS has always been a disparate African-American problem. Even at the beginning of this epidemic in the United States, when there were only a few thousand cases, more than a quarter of them were among African-Americans.

Today, 47% of the HIV cases in the United States are in African Americans, even though African Americans make up only 13% of the population. If you peer deeper into certain cities, you find of all the HIV cases in Washington DC, 80 percent are among African Americans. In Jackson, Mississippi – 84%.

Add to all of this: In New York City, African Americans living with HIV are 2 and half times more likely to die as compared to HIV infected Caucasians. So, African Americans living in the United States are more likely to have HIV and more likely to die from it. Staggering.

And, here is another thing — AIDS rates in this nation’s Latino community are increasing with little notice. Though Hispanics make up about 14 percent of the U.S. population, they represented 22 percent of new HIV and AIDS diagnoses tallied by federal officials in 2006.

No doubt, if you live in a resource rich country like Denmark or the United States, you have a better chance at living a longer life with HIV as compared to many other places around the world. But still, the stats you are reading this morning are worse in some ways than a few of the Sub Saharan countries we typically associate with the worst of the AIDS burden.

So, what to do? I think most would agree that global funding for AIDS needs to be a continued priority. Today the President will authorize 48 billion more dollars toward those efforts. But, how do you think we should better address the AIDS/HIV problems at home?
http://pagingdrgupta.blogs.cnn.com/category/aids/

[Uzybone]

1. Are Americans blacks more important than African blacks?

What exactly is your point?

I like the article. He is right, the AA community needs more AIDS awareness.

[KittyWampus]

3. Huh? My point is Gupta seems aware of public health issues. Both here in the US and globally.

Many DU'ers say he has no background in public health.

[Uzybone]

6. Cool..I agree with you

thanks.

[TechBear_Seattle]

15. I can't speak for "many DUers" but my objections...

Are based on the evidence that he is a corporate shill for Big Pharma and the medical insurance companies, from which I conclude that he will be an advocate for them and not for the people.

The Surgeon General has a role that many people seem to be forgetting: he is the President's contact person and advisor on matters of national health. I do not deny that Gupta is qualified, but I do not think he is a wise choice.

[FrenchieCat]

5. I think for America, African American Citizens should have the hedge in importance

over citizens of other countries......

I would kind of hope. Especially as the community is experiencing the largest growth in AIDS cases of any group here in the US.

[cbayer]

2. I read this as a rather severe critique of the US government's neglect of AIDS funding

for minorities in this country.

:shrug:

[KittyWampus]

4. yes, he compares it to Rwanda and Haiti. He seems to have a realistic grasp of the situation.

[cbayer]

8. I guess I misunderstood your original title as being critical of his position in this

area. Your edit makes it clearer.

:hi:

[yardwork]

10. Ok, he's good on AIDS. It's a start.

Since we're going to have to live with the guy for who knows how many years we may as well start identifying positives and try to forget about the lying and shilling.

Good points identified so far:

1. Attractive and comfortable in front of the camera.
2. Loyal following among television viewers who don't normally pay any attention to politics or health care policy.
3. Aware of the HIV epidemic and the fact that the U.S. has neglected funding and treatment.

[Occam Bandage]

12. What "shilling" are you talking about?

It isn't a crime to own stock in a company, nor to work for a television station that accepts advertising from a company.

[dflprincess]

22. I don't think anyone said it's a crime

but you have to wonder about the ethics of pushing drugs that happen to be manufactured by your sponsor.

Gupta is just another corporate friendly appointment who has been in the pocket of big pharma for quite a while.

http://featuresblogs.chicagotribune.com/features_julies...

Pam Martens wrote in her 2007 piece "CNN's Sanjay Gupta, Laura Bush and the Marketing of Merck's Gardasil" in the political newsletter Counterpunch.

Martens pointed out that Gupta, who promoted the use of Merck's controversial Gardasil vaccine against the HPV virus on air and on his CNN blog, was co-host of a program called AccentHealth, a waiting-room TV network that bills itself as "an integrated health education company" and reaches 132 million viewers. Merck was a financial sponsor.

"Given the incestuous nature of 'integration,' should Dr. Sanjay Gupta have revealed to his CNN viewers during his extolling of the virtues of Gardasil that its manufacturer, Merck, was a financial sponsor of this integrated marketing scheme he co-hosts at AccentHealth?" she asked. "Inquiring minds not yet 'integrated' want to know."

[Occam Bandage]

25. In this case, I think it's perfectly ethical.

Gupta's awareness-raising of Gardasil undoubtedly saved lives. Gardasil is the only effective vaccine (and it is 99.1-100% effective) against the world's fifth-leading cause of cancer deaths in women. Are you seriously suggesting that a doctor should not talk about a safe, effective drug if he also appears on a television show that has that drug's manufacturer as a sponsor? Or that he should quit his healthcare show if a healthcare company thinks that the people in a hospital might be a good target for advertising? That seems entirely unreasonable to me.

There's no conflict of interest if he sticks to the evidence base. He does.

[dflprincess]

27. As with any drug, there are also risks associated with Gardasil

which he did not go into.

And he didn't stick to the facts when he tried to attack Michael Moore and "Sicko".

[Occam Bandage]

30. Gardasil has less than half the incidence of complications of the average vaccine.

It is extraordinarily safe. He is not bound to go into the one-in-two-thousand risk of brief and non-threatening flu-like symptoms when he's posting on a blog or a 60-second segment on a TV show. The "as with any drug" you mention covers that.

[ProSense]

7. Sanjay Gupta for Surgeon General - worse then I thought

Sanjay Gupta for Surgeon General - worse then I thought :

There are some real problems with the possible selection of Dr. Sanjay Gupta as Obama's nominee for Surgeon General. And it goes way beyond his being factually wrong in his dust-up with Michael Moore.

Let me start by saying that he is a qualified neurosurgeon and obviously has media skill and connections beyond those of the typical nominee.

However, he has no professional background or training in public health, preventive medicine, and has shown de facto disdain for the basic precepts of evidence based medicine, all of which would be the underlying scientific basis of a Surgeon General.

And he has huge conflicts of interest as a bought-and-paid-for shill for Pharma, that should actually be disqualifying as a so-called journalist, to say nothing of being "Americas Family Physician" or the leader of the Public Health Service.

Wow, what was Obama thinking? Did he even weigh Gupta vs. Moore in considering Gupta?

[KittyWampus]

9. I'd say Gupta has more understanding of public health than many give him credit for

as evidenced by this article and his actual resume.

[Occam Bandage]

11. So as a response to a post demonstrating a good depth of understanding of a public health issue,

you copy-paste someone claiming without justification that Gupta does not have a good depth of understanding (before heading off into the ill-defined and clichéd wilderness of "he's a shill"). Perhaps a better response would be some evidence that Gupta does not understand public health issues.

Say, a batch of quotes of him demonstrating a shallow understanding of public-health issues.

[ProSense]

13. Why not?

"claiming without justification that Gupta does not have a good depth of understanding "

There is a lot of that going around. This is the perfect place for such a post.

I'm still wondering if Obama weighed Gupta vs. Moore? Even if he did, I doubt it weighed heavily in his decision.

[Uzybone]

14. Probably not

and I don't think even Michael Moore would want a television dustup (yes Sanjay was totally wrong) be the pivotal issue on a government appointment. Moore is a smarter man than that.

[Occam Bandage]

16. It doesn't come off as convincing in the face of the OP's demonstration

that Gupta has, at least on one issue, given public health a great deal of thought, done thorough research, and come from a perspective of solid understanding. I think that's far more important than him not following up on a transcription error or misidentifying a guest in his bickering with Moore.

[Barack_America]

17. This is quoting statistics researched and published by someone else...

I would hardly consider it a "good depth of understanding".

I do give him marks, however, for seeming to care about the issue. But caring and expertise are very different things.

[Occam Bandage]

19. I hardly expect him to commission his own studies. He isn't a university.

I agree he has more to prove than a public health professor somewhere would have, but I don't fault him for finding data and presenting it in a way that the average American can understand. That is, after all, his future job as surgeon general.

[Barack_America]

23. Not true. He is an Assistant Professor of Neurosurgery at Emory University.

http://neurosurgery.emory.edu/FacultyGupta.htm

His stated clincal interests are:

* complicated spine surgery
* spine trauma
* 3-D image guided operation

Not exactly public health areas. I'm trying to compile a list of his publications (hard as there are many S Gupta's). But his wikipedia entry lists his publications to include:'

"He has recently had articles published in the Journal of Neurosurgery and Neurosurgical Focus on percutaneous pedicle screw placement. He has also published on brain tumors and spinal cord abnormalities."

Also not exactly public health related.

[Occam Bandage]

26. I did not say "he does not work for a university."

I said, "he is not a university." As such, I do not expect him to commission studies. Are you seriously attacking him for going to the evidence base before writing an article, instead of deciding to spend a year and hundreds of thousands of dollars doing his own research? That's terribly inefficient.

[Barack_America]

29. No, just saying that the quoting of published facts does not make one an expert.

However, his affiliation with a university does give him the ability to research issues in public health (perhaps issues pertaining to neurosurgery). And I do not see that he has done that. His interests seem to be in perfecting surgical techniques rather than addressing public health concerns.

[Occam Bandage]

31. And I don't think anyone is saying that this article absolutely makes him an expert,

but rather that it demonstrates to some extent that he does have both an interest and an understanding of public health. His academic interests certainly do trend towards the technical, but I don't think anyone is using his academic career as a primary reason to select him. Rather, it seems to be his work (mostly on television) explaining public health issues for the general public. Obama's concept of a surgeon general seems to be more an informer and less a policy creator than yours.

[xchrom]

18. there are a lot of average DUERS who have this depth of understanding.

my objection is that through his hysterical attacks on moore he reinforced americans superstitious suspicions about 'socialized' health care.

he lied -- big time -- to accomplish this.

[Occam Bandage]

20. I don't think failing to identify a guest's think-tank association is "lying big-time,"

nor do I think failing to follow up on a transcription error making $251 read as $25 is "lying big-time." Both are sloppy research, and both are cause for concern, but neither are "lying big time."

[phleshdef]

21. Some people around here wouldn't care if someone like Howard Dean had made even bigger mistakes...

Its selective criticism at its finest around here.

[xchrom]

24. he was caught lying and had to apologise for his 'mistakes'.

nobody who has had to undergo the kind of rigorous training that a neuro-surgeon does or report on an issuse i.e. medicine -- makes 'mistakes' like that.

[Occam Bandage]

28. So you find it utterly impossible to believe

that Sanjay Gupta might have just taken a research list handed to him by his research team at face value. You instead think that he decided to lie about what Moore said about Cuba's health-care system, despite the fact that such a lie would be instantly verifiable by anyone with a computer, or indeed anyone who had seen Sicko. Somehow "he got lazy and trusted his research assistants" seems more reasonable to me than "he decided deliberately to lie about something absolutely idiotic, easily fact-checkable, and which in fact does not even counter any points Moore made."

[xchrom]

33. funny how his 'laziness' and and 'innocent misstatements' about cuba, france and

other facts put out by moore plays right into americans hysterical misgivings about 'socialized' medicine.

[Occam Bandage]

34. There are only two things Gupta said that were factually incorrect.

The first is that Moore said that Cuba pays only $25 per person per year in health care costs, when in fact it pays $250. Moore actually did said Cuba pays $250. How does that "play into Americans' hysterical misgivings about socialized medicine?" Gupta didn't say Cubans paid more then they actually do; he said that Moore got that figure wrong when he didn't.

The second is that he claimed his guest on that episode was not a member of a Republican think-tank, when in fact he was. This is misleading and smacks of either bias or extraordinary laziness, but has absolutely nothing to do with France, Cuba, or Moore's facts.

[xchrom]

41. and the thrust of his critiques were to further the

mytho of mistrust that americans have for 'socialized medicine'.

that was the atmosphere surrounding his critisism of moore and why moore spanked him so hard.

[yardwork]

36. Uh, yeah. I do find that impossible to believe. Actually.

[Runcible Spoon]

39. ok so he's either lazy/stupid or was complicit...either way he sucks

I might actually forgive him for being too lazy or stupid to look over some research done by his proxies on this issue. I won't forgive him for being a shill for big pharma/insurance industries. In either case, Obama chose a shiny media whore instead of someone who could actually make some informed policy observations.

[yardwork]

37. I've discovered that there are a lot of DUers who don't have a clue about health policy.

The level of understanding revealed by the reactions to this nominee indicate that many DUers have the same grasp of health care policy as that of my cat.

[genna]

32. 600,000 and 47%...just staggering

If they see some potential in Gupta, I say let the man have a crack at it. He has 2 children and one on the way. He will take an extraordinary pay cut and step away from private practice.

I'd like to hear what Obama and he have discussed in terms of a policy direction for the Surgeon General. My only memory of the Surgeon General is a dust up over masturbation during the Clinton years.

If Obama was talking about change, I liked to see how he is going to take the entire government in this new direction with the team of managers he has assembled.

[KittyWampus]

38. IMO, they discussed need for National AIDS program and outreach to minorities.

[Runcible Spoon]

40. oh right step aside and let him have the position because he has kids

and is taking a pay cut :eyes: What a stupid rationalization that should have ZERO relevancy to him being named SG.

[Bluenorthwest]

35. This is an issue dear to my heart

And while I continue to have major reservations about Gupta for many reasons, I am always happy when anyone draws attention to this ongoing American shame. I award a point to Sanjay. Gupta is correct on all of his numbers, and he is asking a difficult question, about our priorities and our responsibilities. I can promise you, this is no one's favorite subject, and so yeah, point for Gupta.
I would really like to know what steps he thinks should be taken. He did not offer any of his own thinking in the piece as to solutions. That would be of great interest to me. But even this piece gives me some common ground with him.