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A Response to Global Health Concerns for Jesus-followers

Team Members: Hideyo and Tyler

HIV/AIDS and its Prevalence

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According to a December 2004 joint report from UNAIDS and the World Health Organization (WHO):

• As of the end 2004 there have been 20 million deaths worldwide from HIV/AIDS since 1981.
  
• Currently, 39.4 million people are living with HIV/AIDS in the world.
  
• An estimated 4.9 million new cases emerged in 2004, which translates into more than 6,000 becoming infected with HIV every day. Young people (15-24 years old) make up half of all new HIV infections worldwide.
  
• On the continent of Africa alone, AIDS has left 12 million orphans.
  
• Women account for 47% of all people living with HIV worldwide, and for 57% in sub-Saharan Africa.
  
• There are 6.5 million people in developing nations who need life-saving AIDS drugs, but fewer than 1 million receive them. (Source: AVERT.org)

It does not take much effort to realize that health and the status of healthcare in the world are issues that challenge citizens of all countries. As our world becomes less defined by political borders, how are we going to be able to address these concerns? This page will reflect research on HIV/AIDS, give some arguments, as well as provide resources for churches, communities of Jesus-followers, and individuals seeking to address these crises.

Definitions (Provided by AIDSinfo)

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• AIDS (Acquired Immunodeficiency Syndrome): The most severe manifestation of infection with the Human Immunodeficiency Virus (HIV). In 1993, the Centers for Disease Control (CDC) expanded the criteria for an AIDS diagnosis in adults and adolescents to include CD4+ T cell count at or below 200 cells per microliter in the presence of HIV infection.  (In essence, AIDS is a condition of a weakened immune system. The immune system is the system in the body that fights against disease and foreign agents. Although AIDS kills the immune system it does not directly kill the human body. But by killing the immune system, AIDS causes the body to be more susceptible to contracting other deadly diseases that the body would have otherwise fought off.)
• HIV-1 (Human Immunodeficiency Virus Type 1): The retrovirus isolated and recognized as the etiologic agent of AIDS. HIV inserts its own RNA into the host cell's DNA, preventing the host cell from carrying out its natrual functions and turning it into an HIV factory.
• ART drugs (Antiretroviral Therapy drugs): Substances used to kill or inhibit the multiplication of retroviruses such as HIV.
  

Macro-Level Research

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The following sites offer vast amounts of broad information on the HIV/AIDS epidemic and other global health crises. As a warning, navigating through these sites could be daunting, but they provide so much research to readers that they are an excellent start for those wanting to dive in head-first.

• World Health Organization
• RAND Corporation Health and Healthcare Research Site
• Health Affairs
• NationMaster.com
• EarthTrends
• AIDSinfo
• UNAIDS
• AVERT.org
• The Body
  

AIDS and Its Effects

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The UN Millennium Project has adopted eight Millennium Development Goals (MDGs). All 191 member states have agreed to achieve these goals by the year 2015. The Millennium Project describes the goals as


The eight MGDs are:

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development

The sixth MDG contains two measurable targets (Targets 7 and 8, respective to the MDGs):

Since Target 7 deals with HIV/AIDS, we will give specific attention to it. Its listed indicators are:

 
Aside from the fatality of the disease, HIV/AIDS also has shown to have the effects listed below. We can see from the following list how fighting HIV/AIDS is linked with pursuing the other MDGs.

• HIV/AIDS Increases Poverty:

   

• HIV/AIDS Worsens the Nutritional Status of Children:

• HIV/AIDS Compromises Efforts to Reach Universal Primary Education

• HIV/AIDS Has a Negative Impact on Child Mortality

• HIV/AIDS Undermines Global Efforts to Control Tuberculosis

Structures that Influence

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HIV's Origins (source: Avert.org, The Origin of HIV and the First Cases of AIDS)

HIV likely began as a mutated form of Simian Immunodeficiency Virus (SIV) in Africa. There are several theories of how SIV crossed species and became HIV, but the most common theory is known as the "Hunter Theory." Some postulate that hunters ate infected chimpanzee meat and/or the chimpanzee blood entered open wounds of the hunters.

The three earliest known instances of HIV infection are:

1. A plasma sample taken in 1959 from an adult male living in what is now the Democratic Republic of Congo.
2. HIV found in tissue samples from an American teenager who died in St. Louis in 1969.
3. HIV found in tissue samples from a Norwegian sailor who died around 1976.

HIV has spread so quickly due to the relative ease of travel in contemporary societies thanks in large part to jetliners; blood transfusions became more common in medical practice, but there was a period before any consistent screening method for HIV, and the increase of intravenous drug use in the 1970's.

HIV/AIDS in the Early Years

In order to have a thoughful and Christ-like response to HIV/AIDS, Jesus-followers need to understand the origins and history of the disease. For a full treatment of the history of HIV/AIDS, see Avert.org's history page. The following brief history is adapted from those pages. We should pay particular attention to the early years of the disease as well as the reactions to it, which set in patterns of behavior and systems of response. An unknown disease with no cure popping up on the scene out of nowhere is going to naturally cause a lot of fear. The early responses to HIV, both in the West and around the world, were not generally favorable to fighting the disease. We have much to repent for as those responses set us behind several years. But we should not allow that fact to discourage us as there have been several encouraging advancements in recent years.

The earliest cases of AIDS in the US were found in homosexual men, though the disease had not yet been named. The disease was originally called Gay-Related Immune Deficiancy, or GRID. Eventually other cases began emerging in intravenous drug users. In 1982, the name of the disease became AIDS, though the virus causing it still had not been isolated. It was also in this year that similar cases were being recorded in Uganda. In early 1983, reports emerged that heterosexual women with no other risk factors were contracting the disease. The CDC also found evidence that people receiving blood transfusions showed similar symptoms as other AIDS patients, putting hemophiliacs at great risk. Hatian entrants into the US showed AIDS as well, leading some to put them in the same group of susceptible persons as homosexuals, intravenous drug users, and hemophiliacs. Studies in central Africa showed an increase of AIDS among higher-income, urban, promiscuous heterosexuals.

It was in 1983 that the fear of AIDS began to really take hold of the US and around the world. There were stories of landlords evicting tenants with AIDS. Some were still unaware of how the disease was transmitted and were worried that they could bring AIDS home by merely being in the presence of a person with AIDS. By 1985, two independent labs had isolated the virus causing AIDS. This virus was later named HIV. It was also in 1985 that the actor Rock Hudson died, being the first major public figure known with AIDS. US President Ronald Regan mentioned AIDS for the first time on September 17, though by the end of the previous year, "there had been 7,699 AIDS cases and 3,665 AIDS deaths in the USA." The number of US AIDS cases would jump to 15,948 and the WHO knew of 20,303 cases worldwide by December 1985.

Better education began to assuage the public's fear of HIV/AIDS, but misconceptions of the disease and its carriers as well as stigma towards those who contracted the disease was still rampant. Ignorance was and still is a primary structure that influences the spread of the disease as well as hinders the treatment of those infected. In the early to mid-1990's health workers found that young women and girls were quickly becoming an at-risk demographic for contraction in Sub-Saharan Africa. Apparently a misguided belief emerged that having sex with a virgin would cure an HIV carrier. (Many of these  misconceptions continue today. Wikipedia has a helpful page outlining common misconceptions about HIV/AIDS, including misunderstandings concerning its history, contraction, and the state of the fight against AIDS.) A robust discussion about HIV/AIDS was still taboo in the US, since two ways of contracting the disease -- sexual intercourse and intravenous drug use -- were scandalous topics themselves.

This reticence to discuss HIV/AIDS and its prevention was especially true in US churches. Churches were rather slow to respond to the crisis for a number of reasons, but primarily because the means of contracting the disease went against many churches teachings. How were churches to respond to and care for a those who carried a disease contracted through activities that were deemed sinful? Initially some churches viewed AIDS as God's judgment against homosexuals and drug users for their actions. This attitude began to change when more "innocent" people contracted the disease via blood transfusions. Sadly, however, some still view HIV/AIDS as a judgment of God against sinners.

The story of the public perception of AIDS is one of prejudice and education. It seemed that every step in the direction toward greater awareness brought another fear to the surface. As the years passed, important events occurred that helped quell fears and biases against HIV/AIDS sufferers including a visit to an AIDS ward in a UK hospital by Princess Diana in 1987. People across the world saw her on television shaking hands with AIDS patients without wearing gloves, helping show that HIV was not spread through normal human contact. Prejudice still remained, however, as students with HIV were not allowed to attend schools due to fears of parents and officials. Demonstrators outside the White House were removed by police wearing long yellow gloves. It was not until 1988 that the US launched a coordinated HIV/AIDS education campaign. That same year marked the first World AIDS Day, which  has been observed every December 1st since.

Also in 1987, Zambian president Kauanda announced that his son had died of AIDS. He called on the international community to treat AIDS as a worldwide problem. In October of that year, AIDS was the first disease ever discussed on the floor of the UN General Assembly.

In 1989, clinical trials for the anti-retroviral drug azidothymidine (AZT) ended. The results were promising as tests showed that AZT could slow the progression of HIV into AIDS for those with the disease who showed no symptoms. The difficulty, however, was that the drug was extremely expensive -- a year's supply costed approximately $7,000. The cost was cut by 20% in October 1989. By 1993, there were reports of people becoming resistent to AZT and other drugs. A call for more research and newer medications emerged.

Why Jesus-followers Should Be Involved

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A Biblical Example

As Jesus-followers we look primarily to Jesus, His actions, and His teachings to guide both our actions and our words.  For the global health crisis of HIV/AIDS, we suggest looking to one of Jesus' more well known teachings: The Parable of the Good Samaritan found in Luke 10:25-37.

Much can be written about the concept of community and the inclusivity of our present culture in contrast to this Jesus teaching.  For the sake of brevity and clarity. however, we would like to focus on the "Good Samaritan's" deeds.  In the last verse, Jesus exhorts the lawyer to "Go and do likewise" setting the Samaritan's behavior as the standard for being a true Jesus-follower.

1) Verse 33: The Samaritan saw him.
We must see those who are suffering.  How can we do anything if we do not see the suffering at all?  We must move out of the comforts of our "world" and see what exactly is going on.  For those who live far far away from the world of suffering, information is readily accessible through the internet.  Travel is far easier and less expensive that it has been in previous years.

2) Verse 33: The Samaritan took pity on him.
Our hearts must be moved by what we see.  But rather than will ourselves to care, we must begin from our knees.  We must ask the Holy Spirit to change and soften our hearts so that we might see the afflicted through Jesus' eyes.

3) Verse 34: The Samaritan went to him.
We must go the afflicted.  Nothing is a substitute for putting a face to the HIV/AIDS epidemic.  We need not go overseas to hear their stories.  HIV/AIDS knows no boundaries.

4) Verse 34: The Samaritan bandaged his wounds.
We must extend our hands to help.  The needs are many.  The resources are out there.  We need only know where to look to help.  We hope that our wiki is helpful in connecting you to some of the ways you can be involved in bandaging the wounds that HIV/AIDS inflicts.

5) Verse 34: The Samaritan put the man on his own donkey.
Our help may come at the expense of our own comfort.  This is the reality of a Jesus-following love for a neighbor hit hard by the epidemic.

6) Verse 34: The Samaritan took him to an inn.
The relief we provide cannot merely be short-term.  Longer term solutions are needed as well.  We hope that our wiki provides a few of these things for the long-haul.

7) Verse 34: The Samaritan took care of him.
As the overall exhortation, we are to care those suffering from HIV/AIDS.  This is not something that we may do as a hobby but a mandate for all Jesus-followers.  For the sake of our discipleship we cannot be like the priest or the Levite in the parable; we cannot merely pass on by while millions die and still more are orphaned or struck by poverty.

Theological Discussion

A cursory reading of the Christian Scriptures shows an emphasis on radical hospitality. Hospitality in the ancient world held a far deeper meaning than our understanding of the term today. In the US, hospitality is likely understood as a synonym of entertainment. That is, having people over for dinner or a party. In the ancient world where Christianity had its roots, however, hospitality was a radical caring for others, often seeking to meet their physical and emotional needs. Hospitable acts included meals, lodging for travellers, and economic and physical assistance. In both Pagan and Jewish hospitality, there was a general expectation of reciprocity in one's hospitable practices. Jesus' ethic of hospitality returned his audiences to Hebrew texts and called for a more radical hospitality: one in which reciprocity could not, or would not be shared. (See: Matthew 5:43-48; Luke 14:1-23) In Isaiah 25:6-8, God is shown to be a generous host of a banquet for all nations. Perhaps Jesus' greatest admonition for radical hospitality comes in Matthew 25:31-46. Here the practices of a Jesus-follower are made explicit: Jesus-followers feed the hungry, welcome the stranger, visit the imprisoned, and care for the sick. (For further study on hospitality in the Early Church, see:S. C. Barton, “Hospitality,” Dictionary of the Later New Testament and Its Developments, ed. Ralph P. Martin and Peter H. Davids, Downers Grove, IL: InterVarsity Press, 1997.)

As Christians, we celebrate the fact that Jesus broke the societal rules regarding who was acceptable and who was not. Jesus ate meals with and touched those who were considered "unclean" or "sinners," such as tax-collectors, prostitutes, and people who contracted leoprosy. Jesus did not reject these people because of their actions or out of fear that he too may contract whatever they had. Rather, Jesus offered a real prophetic message to all around them. To those who were outsiders, he preached a message of love and inclusion. To those who excluded others, he preached a message of peace and embrace (For more on exclusion and embrace, see Miroslav Volf, Exclusion and Embrace: A Theological Exploration of Identity, Otherness, and Reconciliation, Nashville: Abingdon Press, 1996). To all, excluded and powerful, Jesus preached a message of repentance. Those who were "sinners" were not excluded from Jesus' table, but his encounters with them led many to change their lifestyles. They had to repent of their sinful lives. Tax-collectors stopped extorting money. Prostitutes no longer sold their bodies to others.

Our churches have much to repent for. Too often we have been voices of exclusion rather than embrace. It is true that many who have contracted HIV/AIDS have done so through means that are sinful. This activity does not, however, separate them from God's magnificent love. We so desparately want to protect the holiness of our communities, and rightly so. Jesus reminds us that true holiness is seen in love, sacrifice for others, and care for those who are consistently on the margins of society and our communities.

In his ministry, Jesus completely redefined the notions of family in his society. No longer was the family about blood relations, but about receiving and entering the kingdom of God and participating in that new reality. (See: Matthew 12:46-50)  "AIDS Pandemic in Africa is Destroying Family Structures," December 6, 2005 article from AFP, reports on a meeting of international health experts in the Nigerian capital Abuja. The meetings claimed:

"The family has been made fragile in Africa because of poverty and because of AIDS," Rima Salah, deputy executive director of the UN children's agency UNICEF, told reporters....

In poor families where the two parents had difficulty in making ends meet, the death of even one parent from AIDS places an intolerable economic strain on the household.

If both parents die, the children are left to fend for themselves and take charge of younger brothers and sisters.

Girls with little education who find themselves catapulted into the role of head of household may have no option other than turning to prostitution to support their brothers and sisters, putting themselves at risk of being infected if they are not already.

UNICEF

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The Church, as the family of God is to be a family for all of those throughout the world without families. It is our privilege and responsibility to care for others in deep need. In the Hebrew Scriptures, or the Old Testament, there is a consistent call for the people of God to take care of orphans (children either with no living parents or the children of single mothers), widows, and strangers as if they were a part of the Hebrews' own families.

Perhaps the greatest call toward solidartity and service for those with HIV/AIDS is the cross. God's love for us is most greatly displayed in that radical sacrifice when Emmanuel (God is with us) died a vicious death for those who killed him. God's love for humanity was embodied. It was costly. It was no love that merely wished well-being on those who suffered. Rather it was a love that required Jesus to give of himself. Jesus Christ knows what it is like to suffer for he experienced that suffering himself. It is the suffering Jesus who can relate to the victims of HIV/AIDS. The Church, as the Body of Christ must embody this suffering as well. We must be willing to give of ourselves in order to minister with and to minister to those dying of HIV/AIDS. It will be costly. We will have to examine our sinful practices and repent of them. Our pride will take a hit. We will have to sacrifice time, energy, and funds. (The sacrifice of funds will be especially true of those churches that find themselves blessed with monetary wealth, that is, Western churches.)

See also: A Christian Response to AIDS

Ways for Jesus-followers to Be Involved

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We suggest that churches choose to partner with the nations of the world and different organizations by seeking to implement the MDGs. Deciding to work towards these laudable, but difficult goals can seem daunting, and thus we encourage that churches choose to adopt one MDG. Since the scope of this wiki focuses on HIV/AIDS, we will offer resources that churches and Jesus-followers can use to pursue the sixth MDG: Combat HIV/AIDS, malaria, and other diseases. The need for action and support is dire since according to a World Bank report, many countries are "falling behind in the race to improve health and reduce deaths by 2015."

• Prayer

• Bible Study

• From the pulpit

• Action

Examples of Jesus-Followers Being Involved

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Raising Awareness (Seeing)

• Pacto de Esperanza, an HIV/AIDS awareness campaign targeting Hispanic churches in the US.
• African American church leaders gathering together to discuss a collective strategy against the spread of HIV/AIDS.
• Ecumenical HIV/AIDS Initiative in Africa (EHAIA)
• From "Living With AIDS: For one group of HIV-positive South Africans, potent drugs and changing attitudes offer new hope," in the September 2005 edition of National Geographic.

  Siyaphila La ("we are living here," a joint project of the Nelson Mandela Foundation, Médecins Sans Frontières (Doctors Without Borders) South Africa, and the local health department) is proving wrong the widely held idea that the three-pill drug therapy used by millions of Westerners but only 11 percent of Africans with AIDS is too expensive and too complicated to administer in poor African communities. The project relies on nurses in clinics rather than on doctors in hospitals, on inexpensive generic ARV drugs, and on the commitment of patients and families to the daily treatment regimen. Siyaphila La is also challenging the social stigma associated with HIV/AIDS by changing perceptions. Instead of dreading the disease as a killer—something to be denied rather than faced—the people of Lusikisiki now see it as a manageable chronic illness. Patients, as well as their families, medical staff, and others in the community, wear T-shirts with an HIV-positive logo.

Extending the Hand (Bandaging the Wounds)

• The United Methodist Church's HIV/AIDS camp

Supportive Help (Our donkey)

• CORE Initiative, a group that supports faith-based groups fighting against HIV/AIDS primarily by awarding grants.

Direct Action (Caring)

• AIDS Care Network, a Christian community in Grand Rapids supporting those already living with HIV/AIDS by meeting transportation needs, social/friendship needs, and doing food delivery among other things.

Microfinance (A Way for Longer Term Help)

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Because of the promise of microfinance in assisting communities in developing nations, the UN has named 2005 the International Year of Microcredit. Microfinance, or microcredit is defined as,

Microfinance has shown to help fight the AIDS crisis, though its effects are seen mostly prior to the introduction of HIV into the family system. The UNAIDS 2000 background paper, "The Role of Microfinance in the Fight Against HIV/AIDS" (PDF) outlines some ways that microfinance can help fight the disease. By assisting families to save money so that if the disease does come, microfinance can allow those families to have capital in order to help take care of themselves if and when someone is infected. Perhaps more important in terms of justice, microfinance has been directed mostly at women, who are at a disadvantage in terms of social standing in various parts of the world.   If women can establish sustainable work for themselves and their faimlies via microfinance, they may not have to resort to high-risk behaviors such as prostitution for economic necessity. Thus microfinance can also have a prophylactic effect. (1-2) The paper also describes a case study of FINCA/Uganda's project in microcredit. Under this program, the FINCA/Uganda was able to provide for its clients health insurance, savings plans, life insurance, as well as AIDS education seminars. (4)

FINCA International, a microfinance organization makes it clear that they offer loans, not grants to communities. The goal is to develop sustainability in the poorest regions of the world, not dependence upon richer nations or organizations. FINCA calls their work "villiage banking" and describe the advantage of loans:


The Calvert Foundation has the following to say about microenterprise development :


One should be aware, however, that microfinance is not the savior for the AIDS crisis, but only a tool in the fight. In "Microfinance -- Not a Goldmine, but Saving Livlihoods," allAfrica.com reports that an October 28, 2005 press release from the International Labour Organization found that,

To become involved with microfinance is to move beyond a system of giving money that can lean toward paternalism and an unhealthy dependancy of developing nations on richer countries, or on international and national banks. Microfinance is a creative means of generating sustainable wealth within a smaller region. By giving to microfinace organizations, we are inputing capital into systems so that they can become more self-sustainable. It is not about charity, but about partnering alongside new entrepreneuers.

 For more information on microfinance and for ways to get involved, we recommend these resources:

• Microfinance Gateway is a "comprehensive source of information for and about the microfinance industry. It includes research and publications, discussion groups, specialized resource centers, organization and consultant profiles, and the latest news, events, and job opportunities in microfinance."
• The Calvert Foundation has on its site a list of reputable microfinance funds. The page offers research into each organization so the churches, small groups, and indiviuals can best choose in which fund to invest.
• Ecumenical Church Loan Fund
• Oikocredit
  

Exhortation

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Jesus told His followers that whatever they do to the least of these, they do to Him.  Considering not only the global impact of HIV/AIDS but also the effect it has on the individual physically, socially, and economically, those living with HIV/AIDS can easily be considered as the "least of these". 

The very least we can do as Jesus-followers is lift our eyes and see them for who they are, people made in the image of the God we worship.  We must do away with judgement and include them in our worship and our prayers.  If you find this action still lacking, we highly suggest looking at the World Vision web page for ways to be a neighbor and bandage the wounds, take them on your donkey, take them in, and care for them.

God bless you on your journey and may you be found to be called a good and faithful servant.

Other Links of Interest

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• Wikipedia's HIV page
• The ONE Campaign
• Debt Trade AIDS Africa (DATA)