The elephant in the room

Wikipedia: The elephant in the room (also elephant in the living room, elephant in the corner, elephant on the dinner table, etc.) is an English idiom for a question or problem that very obviously stands, but which is ignored for the convenience of one or other party. It derives its symbolic meaning from the fact that an elephant would indeed be conspicuous and remarkable in a small room; thus the idiom also implies a value judgment that the issue should be discussed openly.

In 1988 while visiting Uganda I met a missionary physician from a fundamentalist, I believe, Baptist group. We talked about the emerging AIDS epidemic there. Thousands had already died; village populations were decimated; innumerable orphans were evident. His view, and that of his brethren was that those with AIDS had behaved badly and essentially got what they deserved. The problem would take care of itself with their suffering and deaths. He offered sympathy but was not inclined to intervene medically.

Sadly that was the defining characteristic of the fundamentalist religious community (with some exceptions) during the Reagan era and for many years after—you recall that Reagan couldn’t bring himself to utter the words AIDS during most of his presidency. Clinton as president offered sympathy and concern but little in the way of material aid, though he was hampered by a republican socially conservative congress for much of his administration.

It wasn’t until the new millennium that these fundamentalist groups fully acknowledged the epidemic and decided to offer interventions, this after 20 million deaths and many more new infections. With their “clearance” President Bush in his 2003 State of the Union called for funding of treatment and prevention initiatives. While emotionally calling attention to $300/year medications in his address, his subsequent program has sanctioned use only of FDA approved, read that patented expensive medications. So rather than using $140/year (current pricing of generic HIV triple therapy) we pay several times more for similar drugs offered by the pharmaceutical industry. Adding insult to injury the program’s prevention philosophy is guided by the the religious right, the same people, as noted above, who early on opposed any intervention in the AIDS epidemic.

Meanwhile millions are infected and continue to die. Only 1.3 million are under treatment and unless we get our act together our funding will continue to be ineffective and mostly wasted—consider the impact of tripling those treated for the same money we currently spend!

In the next few weeks the elephant will be evident again as the FDA takes up the new vaccine for papilloma virus—thought to be a cause of cancer of the cervix. It’s being opposed by the social conservatives because it’s felt an effective vaccine will increase promiscuity by removing the risk of cervical cancer.

More on this as the FDA takes this up.


One response to “The elephant in the room

  1. Pingback: » Blog Archive » Church Based Medicine–the stem cell photo op

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