The HIV infection is like a stealth bomber that moves at supersonic speed, with major direct and collateral effects. There are two important direct effects of the infection: The infective status which is infinite, and, the deteriorating health status during the AIDS stages of the disease. Once an individual becomes HIV positive, that person is theoretically, and for all practical purposes, capable of transmitting the infection to another individual. At least 90% of all infected individuals citywide are unaware of their high risk status because of their robust physical appearance. These individuals may continue to propagate the disease, unwittingly. Thus, it is not surprising that in many parts of Detroit, robust or healthy looking individuals are not seen as at risk of transmitting the virus. The second direct damage is the deteriorating health status that invariably incapacitates the individual during the AIDS phase of the disease, with multiple opportunistic infections. This is the stage that many relatives begin a whispering campaign on the cause of the individuals illness.
The collateral effect of HIV/AIDS is as devastating as the direct effects. I will summarize the collateral effects as follows:
1) Poverty is the second cousin of HIV infection. Poor neighborhoods or communities in Detroit are more likely to have high rates of infection, and less likely to have the resources to combat the disease. Once HIV/AIDS establishes a foothold in a poor setting, that community is on a slow but progressive economic, social, and cultural decline;
2) Sex is a taboo subject in Detroit, and the predominant heterosexual transmission of HIV in Detroit makes it a difficult subject matter.
3) HIV/AIDS is closely related to sexually transmitted diseases and Tuberculosis.
4) HIV/AIDS has devastating effect on the life expectancy of any city. Many people in Detroit will lose at least twenty or more years of life expectancy in the next decade because of AIDS.
5) HIV/AIDS destroys the economic engine room of Detroit such as teachers, professors, doctors, nurses, engineers, lawyers, community leaders, and so on. The children of these bread winners are likely to drop out of school, with the older children assuming increasing parental roles for their younger siblings;
6) HIV/AIDS may lead to the long run political instability of Detroit. To behave as if the HIV/AIDS problem does not exist or to waste time in puerile ideological or moral debates, could lead to catastrophic results. What's worse is that we still have churches in our community that will not discuss the pandemic from their pulpits.
7) A new generation of Detroiters will grow up in this century believing that no matter what they do, they may never live to adulthood because of rampaging effects of the virus. The rate of infection among Detroit youth is the highest in the nation.
The danger of the HIV/AIDS epidemic is real in Detroit. Present and future generations of Detroiters are at grave risk of a multifaceted menace. As elites jostle over semantics, many Detroiters become infected or die of the disease. It is important to understand the concern of the HIV/AIDS patients with the rhetoric of experts. The time is now ripe for a comprehensive approach to HIV/AIDS prevention strategy in Detroit.
The HIV/AIDS strategy in Detroit should be predicated on four fundamental principles:
1) The need for the urban community to mobilize resources to provide life saving treatment to the 25 million Africans living with the HIV virus. There is no justification for denying thousands of Detroiters, access to life saving drugs. These drugs have made it possible for HIV positive individuals in other communities to go back to work, assist their families and contribute to the betterment of their society. Until the powers that be resolves the issue of providing the same treatment opportunities to all HIV/AIDS patients, the rhetoric of HIV/AIDS will remain hollow.
2) The need for Detroit leaders to develop and implement a credible HIV prevention program that recognizes the following facts: There is no known cure for HIV/AIDS; The best safe sex message is abstinence or monogamous relationship after relevant tests and knowledge of HIV status, and; The urgent need to lift the conspiracy of silence about sexual matters in Detroit.
3). The critical importance of improving the health care system in Detroit and Michigan. As of today, the current health system in Detroit cannot manage the complex logistics of providing cheap or free drugs to HIV/AIDS individuals if they are made available. Many people in Detroit neglect their health systems and do not provide incentives for their health workers. The strategy of multi-sectoral sectoral approach to health matters is not firmly rooted in Detroit.
4) The ultimate responsibility for managing and eventually conquering the HIV/AIDS menace lie with Detroiters, in the continent and the diaspora. As shown by the debacle of aid and debt relief, no amount of state or national assistance will change the HIV/AIDS situation in Detroit unless sustained progress is achieved in the following areas of governance (a) Adequate political representation where various shades of opinion are represented at the highest decision-making apparatus of government (b) Transparent macroeconomic policies that promote private enterprise, ensure the implementation of unambiguous rules and regulation, and, assure the protection of the weak and the infirm in the society, and, (c) Engage community-based entities and non governmental organizations in the design and provision of grassroots health programs.
Local urban governments must develop a mechanism for engaging their professionals in the diaspora in the design, implementation, monitoring and evaluation of HIV/AIDS programs. This approach should be multi-sectoral with sustained interactions with experts in clinical care, public health, pharmacy, economics, agriculture, business, manufacturing, engineering, political science, anthropology, sociology and other professionals that can help design proactive health and non health programs that will address the direct and collateral effects of HIV/AIDS.
HIV/AIDS is real in Detroit. No matter the origin of the HIV virus or the so-called disagreement about the pathogenesis of the disease, hundreds of Detroiters have died of this horrible disease, and thousands of individuals are living under a certain death sentence. The time to act is now to save lives and create a better future for Detroit. The much vaunted Detroit renaissance will become a pipedream if Detroit intellectuals and leaders waste time chasing shadows while the proverbial Rome burns. The die is cast.